{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T10:33:17Z","timestamp":1793097197816,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>The objective of this narrative review is to synthesize existing evidence on menstrual\u2010cycle\u2010associated variation in patient\u2010reported outcomes (PROs) in reproductive\u2010aged women with systemic lupus erythematosus (SLE), integrate comparative findings from disease controls and nondisease controls, identify clinical implications, and indicate directions for future studies. A review of the literature was conducted using PubMed, Medline (Clarivate), JISC Library Hub, PsychINFO, and Web of Science. Inclusion criteria included articles referencing women with SLE, PROs, and menstrual cycle phases. Database research conducted yielded 74 articles with 34 meeting inclusion criteria. Key findings from the review include: (1) biologic plausibility for phase\u2010linked activity: estrogen signaling via type\u2010I IFN pathways amplifies proinflammatory cytokine production whereas progesterone decreases this effect. Premenstrual decline may remove this protection. Furthermore, gene expression and peripheral immune cell phenotypes vary with phases of menstrual cycle. (2) Pattern of symptom fluctuation: across studies, premenstrual and menstrual phases are associated with increased pain, fatigue, and mood disturbances. Several observational cohorts report significant worsening of visual analog score pain or fatigue and disease activity scores during menses compared with postovulatory phases. Rheumatoid arthritis and fibromyalgia (FM) cohorts suggest similar findings; FM shows the largest increase in widespread pain with changes in menstrual cycle. Female athlete studies corroborate cycle\u2010related fluctuations in energy, mood, and pain sensitivity. Menstrual cycle phase is a clinically relevant modulator of impairment to quality of life in reproductive\u2010aged women with SLE. Recognition of cyclical patterns can improve the interpretation of patient\u2010reported outcome measure score, reduce misclassification of flares, and support personalized management strategies. Integration of menstrual phase data into routine clinical assessment and trial design is warranted.<\/jats:p>","DOI":"10.1002\/acr2.90111","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:03:01Z","timestamp":1792584181000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Phases of Menstrual Cycle on Patient\u2010Reported Outcomes in Females With Lupus: A Narrative Review"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2284-4031","authenticated-orcid":false,"given":"Alexis","family":"Roberts","sequence":"first","affiliation":[{"name":"University of North Carolina School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Sutton","sequence":"additional","affiliation":[{"name":"Department of Endovascular and Vascular Surgery Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathrine","family":"Constantacos","sequence":"additional","affiliation":[{"name":"Section of Pediatric Endocrinology, Department of Pediatrics Wake Forest University School of Medicine, Brenner Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaketha","family":"Gray","sequence":"additional","affiliation":[{"name":"Section of Adolescent Medicine, Department of Pediatrics Wake Forest University School of Medicine, Brenner Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onengiya","family":"Harry","sequence":"additional","affiliation":[{"name":"Section of Pediatric Rheumatology, Department of Pediatrics Wake Forest University School of Medicine, Brenner Children's Hospital"},{"name":"Department of Epidemiology and Prevention, Division of Public Health Sciences Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"e_1_2_3_2_1","volume-title":"StatPearls","author":"Justiz Vaillant AA","year":"2025"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/AITC202006020"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-021-00985-0"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2004.05.003"},{"issue":"6","key":"e_1_2_3_6_1","first-page":"778","article-title":"The variation in chronic widespread pain and other symptoms in fibromyalgia patients. 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