I wonder if this play includes a song about the estrogen/autoimmunity connection? Hm. Interesting.
Take some time to read this incredibly interesting but lengthy article, entitled Effects of Menopause on Autoimmune Diseases and authored by Miranda A Farage, Kenneth W Miller, Howard I Maibach. Published in Expert Review of Obstetrics and Gynecology. 2012;7(6):557-571.
It can be read here, on Medscape for Nurses.
The immune system undergoes constant physiological changes over the human lifespan.  The infant has no immunity of its own at birth; immune function develops quickly over the first few years and then builds to a complete maturation by puberty.  In fertile women, immunity fluctuates cyclically in sync with the menstrual cycle; dramatic changes occur during pregnancy as well as the postpartum period.......Articles such as these evoke in me a very mixed response. On one hand, I'm gratified to see how much is already known about autoimmunity and to understand more about our disease process. But on the other? The inevitable conclusion of seemingly all studies and writings on the subject of autoimmune disease -- that more research is needed -- makes me want to just pound my head against the nearest wall:
Estrogen, with receptors in nearly every tissue of the body, is a principal regulator of homeostasis in the female body, with the hormonal tides characteristic of a woman's reproductive years having demonstrable effects on nearly every body system. The sudden and dramatic removal of estrogen from the female body, particularly in the form of estradiol, is a veritable tsunami with significant and largely negative effects on many body tissues, including a loss of skin integrity and tone, poorer muscle tone (affecting heart, vasculature, eye and bladder function; declining brain function; and deterioration in bone strength). Estrogen levels, and particularly the estrogen withdrawal of menopause, undeniably impact autoimmunity in women as well. (Bolding mine. Continue reading here).
The role of menopause, with its attendant depletion of estrogen, in autoimmune disease should be an important part of that research effort, given the drastic dichotomy in incidence of autoimmune disease in women and men and the longer expected female lifespan. A better understanding of the interplay between genetic, hormonal and environmental factors that lead to autoimmunity in menopause is necessary to provide appropriate prevention and/or treatment options for older patients, preserving health into old age and providing an increased quality of life throughout those additional years. (Bolding mine).Yes, I would agree. More research is needed, and desperately.