What you can do:

·     Stay active. Weight-bearing exercises, including brisk walking, helps strengthen and build bone.

·     Get plenty of calcium. Milk, yogurt and other dairy products are rich in calcium, which is crucial for strong bones. Non-dairy calcium sources include leafy green vegetables and canned sardines with bones. Also ask your doctor if a calcium supplement is right for you.

·     Get more vitamin D. Your body needs vitamin D to absorb calcium and build healthy bones.  Vitamin D food sources include fatty fish such as salmon, mackerel and tuna, egg yolks, cheese and fortified milk, juice and cereal products. Your body also makes vitamin D when you spend time in the sun. Finally, ask your doctor if a vitamin D supplement is right for you.

4. Your muscles need more attention, too.

Age, menopause, and rheumatoid arthritis, especially active rheumatoid arthritis, are associated with decreased muscle mass and worsening of muscle tone, explains Dr. Matteson. “Joint pain can be aggravated by poor muscle tone because of the loss of joint stability, he adds.

What you can do:

·     Get regular exercise. Exercise keeps your muscles strong and helps control weight. That’s important, since one pound of excess weight puts another four pounds of pressure on the joints.

·     Keep control of your RA. “While it is not possible to turn back the clock on aging and its effects, good control of rheumatoid arthritis is associated with better joint and overall function and decreased joint pain,” says Dr. Matteson.

5. Your sex life may need some adjustment.

Menopause-related hormone changes cause vaginal dryness, which can make sex uncomfortable or even painful for some women. Swollen, stiff or painful joints from RA might it even more challenging.   

Medications used to treat RA and comorbid conditions, such as depression, can also zap your sex drive or make it difficult to achieve orgasm.

What you can do:

There are ways to maintain a satisfying sex life. Some suggestions:

·     Use a water-based lubricant like Replens or Liquid Silk to ease vaginal dryness.

·     Ask your doctor about low-dose vaginal estrogen therapy. Prescription vaginal tablets, creams or rings can help relieve dryness and discomfort. Only a little bit of estrogen is absorbed into the bloodstream.

·     Use a pillow to cushion aching joints during sex.  Some online retailers sell special pillows that may create more comfortable sexual positions.

·     Ask your doctor if your medications could affect your libido or cause dryness.

·     Talk to your partner about your concerns. Sometimes a slower approach to intercourse may be helpful.

6. Sleep woes become more common.

Hot flashes, night sweats and insomnia related to menopause can make it tough to get a good night sleep. And too little sleep can exacerbate the pain and fatigue of RA. “Many women in menopause…don’t sleep as well or soundly, so menopause can add to the fatigue already associated with RA,” says Bykerk.

What you can do:

Good control of RA-related inflammation is always important and can help you beat fatigue. “Control of inflammation often improves energy,” says Bykerk.

And, try these tips to help improve your sleep hygiene: 

·     Do not eat a heavy meal before bed.

·     Do not drink caffeinated beverages or alcohol before bed.

·     Do not watch TV in the bedroom.

·     Keep your bedroom comfortably cool, quiet and dark.