It’s been long established that Complex Regional Pain Syndrome (CRPS) is more prevalent in women than in men. In her article, ‘Who is likely to develop CRPS?’, Libby Parfitt says:
“The first correlation I found is that researchers believe CRPS is far more likely to occur in women. My own informal research certainly bore this out, with 97% of my respondents being female. There’s disagreement on how much more likely women are to contract the illness, with the ratio going from as high as 4:1 women to men, to as low as 56% women versus 44% men, depending on the study you read.”
One theory for this imbalance may be the role played by oestrogen in the management of the immune system (see below). Perhaps that may also go some way towards providing a possible explanation for the interplay between CRPS, menstruation and ultimately the menopause.
Women suffering CRPS report that the condition seems to affect menstruation in broadly two ways:
- It changes in the symptoms of menstruation, including changes in the frequency and duration of their periods and a dramatic increase in the intensity of abdominal cramping and pain than before they developed CRPS;
- The CRPS symptoms change noticeably during menstruation. A variety of changes are reported, most commonly a significant increase in the levels of pain in the affected limb or limbs (many report that their pain “goes through the roof”) and the affected limbs becoming freezing cold for the duration of their period.
In addition, some report that the onset of CRPS resulted in the complete cessation of their periods.
As with so many facets of this complex condition, the scientific literature is all but silent on any correlation between CRPS and menstruation. What we do have therefore is almost entirely anecdotal. However, it is thought that oestrogen may be one of the substances in the body that helps to regulate the immune system. This may explain why there is a higher incidence of autoimmune disease (including CRPS) among women than men.
With a significant majority of CRPS sufferers being female, plus weighty anecdotal evidence of its affect on menstruation and, as Libby Parfitt says, “…a slight skewing towards onset around the age of 40 and older…”, would it really be surprising to find that CRPS can affect the perimenopause / menopause?
In seeking an answer to this question, one thing became swiftly clear – and once again perhaps we shouldn’t be surprised – there has been no specific research on the point.
However, casting my net more generally around various online forums, I discovered, again anecdotally, a strong suggestion that CRPS can and does affect the perimenopause / menopause. That said, in considering a link, it is important to bear in mind that there are some symptoms common to both CRPS and the approaching menopause including sweating, sleep disturbance, memory problems and osteoporosis.
My research also led me to speak, in a very unscientific manner, to two of our clients, both in their late 40s, who were going through the perimenopause at the time of their CRPS diagnosis. Interestingly, neither required prompting to volunteer that following the onset of CRPS, both night sweats and hot flushes have been significantly intensified.
One also reported that whilst her periods had become irregular before the onset of CRPS, she has not had a period at all in the two years since its onset (see above).
I did specifically ask them about mood changes. Both said they felt more irritable, but also agreed that was equally likely to be the result of living with the torment of CRPS.
In conclusion, and as with menstruation, I believe that there is a weight of anecdotal evidence that CRPS has at least some effect on the perimenopause / menopause. However, I fully expect that will have to remain no more than strong speculation as there seems little if any prospect of specific research on this subject any time soon.