Living with Psoriasis Throughout Menopause

Plenty of women will tell you their psoriasis got worse during menopause. For one woman, hormone changes in her forties spurred her worst skin problems ever. That’s when she learned the real culprit behind her lifelong skin problems was psoriasis.

Ellen Clements, a 64-year-old insurance broker at Willis Group in Boston, was told throughout her childhood and into adulthood that the scales on her skin were from eczema. When she began experiencing menopause symptoms, her skin condition began to show its true nature: She had psoriasis — a bad case of it.

When she was a child, Clements’ doctors told her parents her flaky skin needed prescription cream meant for treating eczema. During her teen years, when scaly areas appeared in her navel (a common place for psoriasis to occur), her doctor said she had been wearing her jeans too tight.

Her skin problems became much worse when she started experiencing symptoms related to perimenopause, the years leading up to menopause when hormones begin to fluctuate.

Psoriasis and Menopause

Although there’s not a lot of scientific evidence to support the idea that psoriasis and hormones are connected, some research suggests hormone changes during pregnancy and menopause may influence the frequency and severity of psoriasis flares. In particular, lower estrogen levels during menopause may worsen psoriasis for some women.

In one survey of 63 women who had psoriasis, half of the women said their psoriasis worsened around the time they went through menopause. Doctors also have noted that women experience psoriasis flares more often in their sixties.

Clements’ first severe outbreak seemed to coincide with hormone fluctuations related to perimenopause when she was in her forties. She started experiencing night sweats, and the perspiration on her head led to thick scales on her scalp. Dandruff treatment didn’t help, so she saw a dermatologist and was told she had the worst case of scalp psoriasis her doctor had ever seen. About a year later, she was diagnosed with psoriatic arthritis too.

Her second-biggest outbreak came when she was 55 and had a hysterectomy, which put her body into menopause. “All of a sudden I had a full-blown psoriasis outbreak all over my body,” Clements recalled. About 80 percent of her body was covered with thick, bleeding scales. At the same time, she was experiencing work stress — something she has learned is a trigger for her psoriasis.

Her doctor prescribed creams for her psoriasis symptoms. When they didn’t work, the doctor prescribed phototherapy, in which Clements was exposed to ultraviolet B light therapy three times a week for 18 months. It calmed her skin, but, unfortunately, the psoriasis came back immediately after the therapy ended.

That’s when she tried biologic drugs — medications that target specific cells in the immune system. It took five tries to find the correct biologic drug that worked for her, but now her psoriasis symptoms have essentially resolved.

Living With Psoriasis

In addition to taking biologics, Clements has found that making lifestyle changes helps. She knows excess weight is associated with psoriasis, so she makes an effort to eat healthy and exercise.

She also works on her stress levels. She has depression, and seeing a therapist helps her manage stress.

Perhaps the most helpful change in her life has been that she came out of the closet about her psoriasis. As a child, she did her best to hide her skin condition. That, however, didn’t stop other kids from calling her names because of the way her skin looked. Although psoriasis isn’t contagious, she has noticed that people have gotten out of a hot tub after she got in.

When she started working, psoriasis was a major stress factor for her at the office. “I’m in a dark-suit, global broker world with lots of executive meetings,” she explained. Before walking into a conference room, Clements would take off her blazer and shake it out and try to use her hair to hide the flakes on her scalp.

She thought psoriasis was something she had to hide at work, but when she finally told her employer about her disease, her colleagues showed her nothing but support.

Clements became involved with the National Psoriasis Foundation, and her employer gave her a large donation to give to the foundation. Her company also gives her time off to go to Capitol Hill as a patient advocate and donates to the Walk to Cure Psoriasis, which Clements helps organize every year in Boston.

Although Clements’ psoriasis symptoms have been harder to control since menopause, they have forced her to find ways to deal with the disease, which means living with psoriasis has made her a healthier and happier person overall.

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