CYP19A1 and rheumatoid arthritis: On the other hand, situations associated with an abrupt decline in global estrogen load, such as early menopause (102), post-menopausal stage (103), puerperium (104) and anti-estrogen agents [selective estrogen receptor modulators (105) and aromatase inhibitors (105, 106)], have been more consistently identified as risk factors for RA (95).