Estrogens and arthritis.

Sex hormones seem to play an important role as modulators and perpetuators of rheumatic disorders with autoimmune involvement, such as rheumatoid arthritis or systemic lupus erythematosus. Estrogens are implicated in the immune response as enhancers of the humoral immunity. Sex hormones can exert local actions (paracrine) in the tissues in which they are formed; an accelerated peripheral metabolic conversion of upstream androgen precursors to estrogens has been well-assessed. Local effects of sex hormones in autoimmune rheumatic diseases seem to consist mainly of the modulation of cell proliferation and cytokine production. All of these data further suggest caution in exogenous estrogen administration in patients who have autoimmune diseases.