Rheumatoid arthritis (RA) patients who take oral contraceptives may see a reduction in their symptoms.
A new study shows that the pill and other hormonal therapies may help quell the severe pain, swelling, stiffness, and inflammation associated with RA.
It isn’t the first time that birth control, pregnancy, and hormonal ebbs and flows have been debated in relation to RA disease control and management. In fact, these kinds of discussions have been around since the 1970s.
Impact of Oral Contraceptives
The latest study looked at 273 women aged 18 to 60 who had early RA. It studied them over the course of a year to determine if birth control — or the lack thereof — seemed to have any impact on their symptoms.
The majority of those who were taking or who had previously taken oral contraceptives scored better on tests designed to measure RA symptoms and pain.
Those tests included the Rheumatoid Arthritis Impact of Disease Score (RAID), the Rheumatoid Arthritis Disease Activity Index (RADAI), the Profile of Mood and Discomfort (PROFAD), and the Hannover Functional Assessment (FFbH).
However, like many medical studies — especially those pertaining to mysterious and complex illnesses like RA — the results leave room for further interpretation.
Looking at Neural Connections
What’s unique about this new study is that it looks at brain and neural involvement instead of just inflammation rates and other disease markers.
The brain, after all, is where pain receptors are located. The perception of pain can impact how one copes with, manages, or views their disease — and even how they physically feel it on a biological level.
Despite varying levels of acceptance from public and medical professionals, Dr. Rainer H. Straub, one of the study’s authors and a professor at the University Hospital Regensburg in Regensburg, Germany, is adamant that the brain and the way it’s affected by birth control pills holds the answers when it comes to RA treatment.
“The brain is much more plastic than we earlier thought,” Straub said in an email statement to the media.
He explained that neuronal stem cells might play a role.
“We more and more recognize that fatigue and other central nervous system symptoms are mainly dependent on pain,” he said. “Thus, the sensory nervous input to the brain is probably much more important than the cytokine-driven input to the brain.”
He said oral contraceptives could work because they might affect the central nervous system locally.
“From studies in developmental plasticity in utero, one knows that hormones can have a long-term effect on later gender,” Straub said. “It is a kind of long-term programming initiated by epigenetic imprinting. Therapy with hormones over longer time might have a similar epigenetic reprogramming.”
Women More Affected by RA
Nearly 75 percent of RA patients are female, so it’s important to keep in mind the link between hormones like estrogen and diseases such as RA.
According to Arthritis Research UK’s website, “There is a strong link between hormones and arthritis, and that includes both osteoarthritis and rheumatoid arthritis. Women, of course, have such dramatic surges (pregnancy) and ebbs (the menopause) in hormone concentrations and this may explain the common occurrence of arthritis starting after pregnancy and the menopause.”
These hormonal swings may explain why RA is more prevalent in women.
“In fact it is now thought that taking the contraceptive pill may be protective against developing rheumatoid arthritis, although reports are conflicting,” the website states. “The use of oral contraceptives may also reduce the severity of rheumatoid arthritis once it has developed.”
As always, it’s crucial to discuss individual treatment options — especially outside-the-box ones like this — with your doctor, as medications can have contraindications and side effects that may pose more risk than benefit for some patients with RA.