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Living with Autoimmune in Your 40s and 50s

In this article, we continue to examine living with autoimmune disease over time, specifically focusing here on the pre-menopausal/menopausal years, during your 40s and 50s decades of life.  As a reminder, this entry will mainly cover the differences in health and disease that these two decades present for autoimmune disease sufferers.  A more comprehensive look at life with autoimmune disease can be found in the first installment of this series, “Living with Autoimmune in your Teens”.

In terms of managing my autoimmunes during this period (taking into account general health, diet and activity level, kids/no kids, hormones), what can I expect for: a) amount/intensity of symptoms, b) flares, and c) onset of additional autoimmune conditions?

The first thing that bears mentioning is that not all autoimmune diseases are alike in their presentation of symptoms and the timing of the same.  Therefore, for some conditions, this age range may produce more issues than for others, and these issues may very well be affected by a number of factors, including those indicated above.  Having said that, let’s examine some of the questions before us.

In considering the factors listed above, these decades are a major period of flux for symptoms, flares and onset, which will in some ways determine state of health during this time.  For example, while most people will still be in relatively good health, these are the years when health problems may begin to arise, and when diet and activity level may simultaneously become worse.  At the same time, whether having kids will affect disease is a non-issue during this time, and with the exception of specific endocrine disorders, hormone levels should remain relatively stable, until the onset of frank menopause.

Beginning with the last concern and moving backwards, after a brief literature search, it seems that the age of the patient is not much of a factor in terms of onset of additional autoimmune conditions.  This is in contrast to the onset of a primary autoimmune disease, of which many have windows during which times they are more likely to occur, such as autoimmune ovarian failure, which is generally seen in younger women.

The problem arises in that many disease descriptions will state something to the effect of:  “disease x is most commonly diagnosed at these ages, but may develop at any time outside this range.”  However, as mentioned in previous posts, having one autoimmune disease does absolutely predispose one to developing additional autoimmune disorders according to BMJ Journals and UpToDate.

Furthermore, the management of flares within this twenty-year window also differs very little from that of prior decades, in that proper medication prescription and compliance remain the key to successful treatment.  There are some exceptions though, such as when a patient may have liver or kidney disease, where medications may need to be changed or adjusted to account for these conditions.  Likewise, there are sometimes secondary considerations that must be taken into account with autoimmune disease treatment, such as development of osteoporosis during steroid treatment.  Finally, it will come as no surprise that the amount and intensity of symptoms will vary from person to person, and disease to disease.  Some arthritic manifestations of autoimmune diseases may fare worse with increasing age, as expected non-autoimmune disease arthritis pains may compound those from the autoimmune disease itself.  While far from absolute, this is also a time when staying healthy and active can and often does aid in reducing symptomatology, although this obviously varies from patient to patient, and by condition.

How will managing my overall health, the number of children I have, and hormone balance/imbalance affect my symptoms in future decades?

As noted above, the number of children you have will, for 99% of women out there, be of little additional consequence, since the likelihood of becoming pregnant and delivering a baby is quite low at this age.  Thus, the impact of having had children in the past, if it is indeed a factor in your disease, will not change during this time.

Also, most, though not all, autoimmune diseases are discovered and diagnosed during the childbearing years, such that development of completely new diagnoses after this period is less likely.  And again, overall health is a crucial factor in dealing with any state of health or disease, now and in the future.  It’s difficult to predict how much or little this may impact you specifically, since all autoimmune diseases present differently, with various courses.  But it is fairly safe to say that maintaining decent health will always be beneficial in dealing with any disease, whether autoimmune or not.  In fact, a patient’s health upon entering the hospital (for whatever reason) can often determine his or her course while there, in terms of being healthy enough to fight off infections, perform physical therapy, and tolerate certain treatments/procedures.

Lastly, hormone balance is important for many reasons beyond autoimmune conditions, and in these pre-menopausal/menopausal years, such levels may remain steady, or may begin to decrease slowly, en route to menopause.  How these levels affect you will depend on whether your specific condition has been shown to react to certain hormones.  As an example, estrogen seems to play a role in the genesis and impact of certain autoimmune conditions.  Additionally, the age of onset of your disease will sometimes impact prognosis for the future, although as with other autoimmune condition particulars, this varies widely, depending on the condition in question.

Questions for your doctor:

  • What are specific things I need to be concerned about during these two decades?  How can I help you help me in this regard?
  • How can hormone levels impact my specific disease(s), and what can I do, if anything, to control these levels naturally?  Which hormones are most concerning?
  • Do you know of any literature or support groups that cater to someone in this age range?
  • How will the onset of menopause specifically affect my autoimmune conditions?
  • If my symptoms become decidedly worse during this period, are there additional measures or meds that may be utilized, that weren’t an option during childbearing years?

 

About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians.  After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time.  He may be reached at [email protected].

 

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Comments

  1. TY for the useful info! I wouldnt have found this myself!

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