Some people with psoriasis find that certain factors can trigger flares (periods of worsening symptoms). Common psoriasis triggers include stress, skin injuries, some medications, infections, and even the weather. Although some of these triggers can be avoided, others are harder to control.
Hormone levels can sometimes be responsible for flares in psoriasis symptoms. Hormone changes can occur during puberty, pregnancy, and menopause. Some people find that their symptoms improve during these periods, and others experience flares.
“Hormone imbalances cause my psoriasis to flare up,” wrote one MyPsoriasisTeam member. Another said, “My psoriasis cleared up completely during pregnancies but got much worse during menopause. I’m convinced hormones have some effect.”
Estrogen is a female sex hormone that can influence the immune system. Estrogen also has potential skin benefits, such as preventing dry skin and wrinkling.
Estrogen levels vary at different times, including during menstruation, pregnancy, and menopause. Increases and decreases in estrogen levels can lead to improvement or worsening of psoriasis symptoms.
The other main female sex hormone is progesterone. Research shows that changes in progesterone levels do not typically lead to changes in psoriasis symptoms.
The menstrual cycle is regulated by hormones. During the menstrual cycle, estrogen levels rapidly fall in the days leading up to menstruation. Low estrogen levels increase the body’s immune response, which may lead to a psoriasis flare in some people.
Pregnancy causes estrogen levels to surge. Due to high levels of estrogen, psoriasis may improve during pregnancy. In fact, one study found that at 30 weeks of pregnancy, more than half of the study participants noticed an improvement in their psoriasis symptoms. Only about one-quarter felt their symptoms had worsened.
The same study found that after giving birth, about two-thirds of participants reported worsening psoriasis compared to when they were pregnant. This can be attributed to the drop in estrogen levels after giving birth.
Interestingly, these participants showed similar levels of psoriasis symptoms in the first trimester of pregnancy and after giving birth — the percentage of their skin affected by psoriasis was nearly the same in both time periods. This means that the postpartum “flare” they experienced was actually a return to their normal levels of psoriasis.
Menopause is associated with a decline in estrogen levels. Low estrogen levels cause the classic menopausal symptoms of hot flashes, sleep problems, and vaginal dryness.
A drop in estrogen levels during menopause is also thought to cause psoriasis flares. In one study, almost half of menopausal women reported worsening psoriasis, while only 2 percent showed improvement.
Hormonal contraceptives come in many forms, but they all work by influencing hormone levels.
Oral contraceptives (birth control pills) all contain hormones. Some have a combination of estrogen and progestin (a manufactured version of progesterone). Others contain just progestin.
The effects of oral contraceptives on psoriasis are unclear. One study found that taking high-dose estrogen oral contraceptives led to a general improvement of psoriasis. Another study found that oral contraceptives didn’t have any effect on psoriasis. More research is needed to evaluate whether oral contraceptives can affect psoriasis symptoms.
An intrauterine device (IUD) is another form of birth control. An IUD is a small, flexible piece of plastic that’s placed inside the uterus to prevent pregnancy. IUDs are one of the most effective forms of birth control currently available. Once inserted into the uterus, an IUD will last for several years.
The U.S. Food and Drug Administration has approved five brands of IUDs for use in the United States:
Paragard is a copper IUD and does not contain any hormones. Instead, the copper coating repels sperm and prevents pregnancy.
The other four IUD brands contain progestin. Research does not suggest any link between progesterone levels and psoriasis severity. However, no studies have looked at the relationship between psoriasis and hormonal IUDs specifically. It’s difficult to say whether there is a correlation between hormonal IUDs and psoriasis symptoms.
However, some people have noticed worsening psoriasis symptoms after getting a hormonal IUD. So far, there is only evidence based on reports or observations to support this claim. Further research is necessary to connect hormonal IUDs and psoriasis severity.
If you have noticed that you experience psoriasis flare-ups with changing hormones, talk to your dermatologist or other health care provider. They can help evaluate your hormone levels and work with you to manage your psoriasis.
MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. On MyPsoriasisTeam, more than 109,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.
Are you living with psoriasis? Have you noticed that hormone changes affect your psoriasis? Share your experience in the comments below, or start a conversation by posting on your Activities page.