Psoriasis is a chronic condition characterized by areas of dry skin and other skin changes. Certain health conditions or factors such as a menstrual period can trigger it.
Psoriasis affects around 8 million people in the United States, all of whom experience hormonal changes throughout life.
Read on to learn how the menstrual cycle and hormonal fluctuations can affect psoriasis flare-ups.
Hormone levels change greatly throughout the menstrual cycle. During menstruation and right before it, estrogen levels drop significantly. Hormone levels generally increase later in the cycle.
According to available evidence, it is possible that the fluctuation in hormones, and the drop in estrogen in particular, around a period may cause psoriasis symptoms to worsen.
If a person experiences worsening symptoms at any point in their cycle, they should talk with a doctor about ways to manage them.
If psoriasis symptoms flare during or before a period, speak with a doctor. They may recommend additional therapies or medications at these times to help prevent flare-ups.
A person might also consider taking extra steps to avoid psoriasis triggers during or before a period. The American Academy of Dermatology report that some common triggers include:
- cold, dry weather
- hot conditions and sunburn
- alcohol
- tobacco smoke
- certain medications, including some for heart disease and arthritis
- shaving
- injury to the skin
- infections
In addition to taking extra precautions and possibly having additional treatment, a person might consider using hormonal birth control, if a doctor recommends it.
Some hormonal birth control increases the amount of estrogen and progesterone in the body, which may help improve psoriasis symptoms by limiting hormonal fluctuations.
Hormones are molecules that send signals throughout the body. They appear to play a role in psoriasis for many people.
Several studies have explored the effects of hormonal changes on psoriasis symptoms. The link between psoriasis symptoms and fluctuating hormones may be particularly noticeable during:
- Pregnancy: A
2016 review found that the huge increase in hormones during pregnancy can cause psoriasis symptoms to either improve or worsen. - Menopause: The decrease in hormone levels during menopause could cause psoriasis symptoms to flare, according to the same review.
- Perimenopause: A
review from 2015 found that worsening psoriasis symptoms may be associated with changes during perimenopause — the period of time leading up to menopause. - Puberty: In a 2013 review, researchers observed that psoriasis flare-ups often begin or worsen during puberty.
All three reviews found that, in general, a reduction in hormone levels led to flare-ups. Estrogen was the main hormone to play a role.
In another review from 2015, researchers noted that psoriasis often went into remission during pregnancy, but it was not clear whether an increase in estrogen was the cause.
Fully understanding how hormonal changes should influence psoriasis management will require more research.
No studies have directly explored the potential for a relationship between irregular periods and psoriasis. However, increased stress levels can cause both to occur or worsen.
Research suggests that stress can affect the area of the brain that releases the hormones needed to regulate the menstrual cycle. When the level of stress reduces, the cycle should return to normal.
Stress can also affect psoriasis symptoms. The National Psoriasis Foundation explain that stress can cause psoriasis flare-ups. In turn, psoriasis can lead to an increase in stress for some people.
It is a good idea for anyone with psoriasis to practice stress management techniques. Having a strong support network can help.
Psoriasis generally does not affect a person’s birth control options.
A review from 2015 cited findings that psoriasis symptoms could be successfully managed with hormonal contraceptives. However, very little research has looked specifically at the potential for birth control to improve psoriasis symptoms.
Based on the available evidence, it is possible that birth control pills with high levels of estrogen may help reduce psoriasis symptoms, but more research is needed.
In the future, conducting studies using estrogen as the primary treatment may help researchers better understand the relationship between this hormone and psoriasis.
Based on the available evidence, there seems to be a connection between psoriasis symptoms and hormonal fluctuations.
During a monthly menstrual cycle, hormone levels rise and fall, and the decrease in estrogen around the time of a period, in particular, may cause psoriasis symptoms to flare up.
Other life events that involve changes in hormone levels, such as puberty and menopause, can also affect psoriasis symptoms. However, identifying the specific causes and effects will require more research.