Hormone Therapy and Autoimmune Disease Risk in Postmenopausal Women, With Xuezhi Daniel Jiang, MD, PhD

Women develop autoimmune diseases at four times the rate of men, and the menopausal transition further increases that risk. It's a pattern every primary care physician and obstetrician-gynecologist recognizes, but the mechanism behind it has remained unclear. Xuezhi (Daniel) Jiang, a professor of obstetrics and gynecology at Drexel University College of Medicine and practicing ob-gyn specializing in menopausal medicine, had a hypothesis: If declining estrogen during menopause increases autoimmune disease risk, could hormone therapy potentially reduce that risk by replacing estrogen? What he found surprised him—and has important implications for how postmenopausal patients should be counseled considering hormone therapy. In this video interview at The Menopause Society 2025 Annual Meeting in Orlando, Jiang discusses what led him to investigate this connection and how he used a massive global health database to explore the relationship between hormone therapy and autoimmune disease development. In this segment, Jiang covers:

• Why women face dramatically higher autoimmune disease risk
• How menopausal transition affects autoimmune disease incidence
• The rationale for investigating hormone therapy as a potential protective factor
• Using the TriNetX database for large-scale research
• What questions this study aims to answer

Coming Up in This Series

• Part 2: Hormone Therapy Linked to Increased Autoimmune Disease Risk
• Part 3: Clinical Guidance: Counseling Patients Without Creating Hormone Therapy Phobia