Menopause mimics Sjogren's Syndrome

Don't apologize!!!  This is great information to have and to share with others.

So what are the treatments for SS? 

Jancie -- mainstay supportive "treatments" for Sjogren's address the "sicca" (dryness) symptoms:

• eyedrops/artificial tears, like Restasis
• saliva stimulants, like Salagen or Exovac (or things like lozenges, gum, lemon drops, Biotene mouthwash)
• vaginal lubricants
• saline nasal spray

For joint pains, Plaquenil (hydroxychloroquine) is the first-line drug.  If more serious flares occur, then maybe immune suppression with corticosteroids (prednisone), or azathiaprine (Imuran), or cyclophosphamide (Cytoxan) -- these are usually limited-term treatments.

About the ANA test (antinuclear antibodies) -- a positive test does NOT mean a person definitely has lupus or Sjogren's.  Five to 10% (some studies say up to 13%) of otherwise healthy people have ANA antibodies.  And -- very rarely (about 2% of people with these conditions) people can have lupus or Sjogren's symptoms that need treatment, but have a negative ANA test.

So, a diagnosis of Sjogren's or lupus is made on the basis of having a certain number of symptoms and/or lab tests (see links):
Sjogren's syndrome diagnostic criteria
Lupus (SLE) diagnostic criteria

[Don't mind me -- can you tell I have worked as a research assistant to rheumatologists for 25 years? ]

Thanks - since I'm having pretty major pain and fatigue symptoms, SE's from the AI's and other treatments, my PCP did all the tests, including teh ANA, to rule out other causes for the issues.  It's great having a doc that thinks of those things!!! 

Just going to point out that there are many medications (even the OTC allergy meds) that give the dry mouth/dry eye symptom, in addition to menopause causing it.

My own hand and foot pain (I call it fibromyalgia now) is still stumping doctors, as I always come back healthy on paper from the diagnostic tests they hane me do.  I have asked every doctor if menopause/low hormones could be at the root of my pain.  About all I get back is a non-comittal, "Well, maybe."

cs34, glad you found an appointment sooner!  (Wonder if it's somebody I know?)  Since you work in midtown, maybe we could meet for lunch sometime! (I work at 2nd Ave and 17th St -- with occasional work trips to First Ave and 34th.)

Plaquenil is not a steroid ("its precise mechanism of action is unknown" -- great, right?).  "Shouldn't be taken during pregnancy unless risks of untreated disease outweigh possible risk to fetus of partial hearing loss" (it's used to treat malaria, and that's usually the case when benefit to mother outweighs possible risk to fetus -- though since this thread is titled "menopause" I guess maybe that's not an issue...).  Should have a baseline eye exam prior to starting plaquenil because it can cause changes to the retina.  Most common side effects are diarrhea/weight LOSS, and possibly nightmares.  Can trigger depression/other mood disorders.  (But I know lots of patients experience it as an "easy" drug.  But maybe an NSAID is what they'll prescribe for your hand pain?)

Anyway -- glad you got an earlier appointment, and hope they can help you with something easy!

cs34,  Oh, I do agree with not just "living with" these plaguing pains and ailments, when you know you should be feeling better.  How can we not help looking for relief when we have symptoms that remind us on a daily basis?

I just did the full battery of blood tests to determine if my symptoms of increased dryness - especially eyes, nose, mouth - are related to any autoimmune disorder including SS. All results were negative. What I learned is that most likely my immune system is reacting to the cancer to produce the whole range of symptoms common to SS and in some ways lupus. And even if tests were positive very few options for standard treatment if a person is on chemo. If I wasn't on chemo the doctor would try out steroids or other treatments to see if my body responded to reduce symptoms. Best guess is that when cancer is gone symptoms would decline. My symptoms increased exponentially when I had the last CT scan even though I was premedicated because of possible allergic reaction when I had scan before treatment started. The 1st time I was pre-medicated with predisone and benedryl only slight increase in symptoms. In addition to dryness I have an all body rash that matches to autoimmune disorder. I was diagnosed with inflammatory breast cancer 18 months ago. After initial treatment of chemo, surgery, radiation, it was metastatic to pelvis and neck bone. 6 months later metastatic to liver. First time to post but thought I'd share my experience in case it is useful. I am coping with extreme dryness by trying out various eye drops, nasal spray, lotion, etc.