Can psoriatic arthritis cause a hormone imbalance?

[YourSpleenIsDamp]

Does anyone here know if psoriatic arthritis can cause a hormone imbalance? Or if a hormone imbalance can trigger PsA?

Diagnosed with psoriatic arthritis 12 months ago. Really struggling with pain and fatigue - ankles and feet are the worst, and it's hard to walk. Fatigue is crazy - I just fall asleep for a couple of hours every day around 1pm. Not currently medicated, having failed methotrexate, sulfasalazine and leflunomide; waiting to start biologics in the next month or so. Thought fatigue was because of PsA, but I started HRT three months ago, and recent blood test showed my oestrogen at a level expected post menopause (I'm 45 and still have regular periods), and testosterone at "undetectable" levels!

Now thinking WTF?! Is the fatigue because my hormones are so wonky? Or is the hormone imbalance part of the PsA? Or does it sound like another bastard autoimmune disease? I'll see rheumatology in about three months to review biologics; wondering what I should be asking there? Or would I be better approaching the GP? Feeling a bit confused and worried, not sure what to do next.

I read something about this very recently but I can't remember the details except yes auto immune diseases can be triggered in peri menopause and I think taking body identical progesterone can be helpful.

Fatigue for me is usually due to low oestrogen. You haven't said what dose you are on. After 3 months if your blood levels are very low could it be possible you are not absorbing?

Histamine can also cause fatigue.

Thanks - I should have said, I've been on Evorel 50 patches, but the doctor thought perhaps I'm not absorbing them, so has prescribed oestrogel instead. Two pumps, increasing to three if no improvement after a month.

That's good. If you start to feel better you'll know you weren't absorbing and now you are. What progesterone are you on?

It's important to get oestrogen and progesterone dosage right before starting testosterone. You might not feel you need it anyhow.

I've been on Utrogestan, but found it a bit itchy, so I'm swapping to Cyclogest next cycle. The menopause doc said adding testosterone is an option too, but as you say, best to get oestrogen sorted out first. Damnit - should have come to MN first, I could have saved the consultation cost 🤣 Thanks for responding - it's reassuring knowing that others have had the hormonal exhaustion. I'd been so convinced it was the PsA causing the fatigue that it had never occurred to me that it might be "just" the perimenopause!

Absolutely get on to the testosterone. Until mine went down to zero, I had no idea that we need it as much as we need female hormones. In fact, we have more testosterone than we do female hormones, and not having any leads to
extreme fatigue,
muscle weakness
depression and anxiety
far more likely to get osteoporosis, and more quickly..

a few other things, but these are the outstanding issues for me.

I have a very small drop of gel on my skin every day, and it makes a huge difference. Also taking tibolone (an HMT, rather than HRT) which works beautifully for me.

Doesn’t fix everything, but definitely can start that any time. You know you’re using too much if you start getting a bit furry I started very very small, and gradually increased dose. When I realised I was getting a few hairs on my tummy etc, I just stayed at that point. Just start very very small.