TNF and Onset: Beyond TNFα signalling, varying levels of testosterone in cis men correlate to the immune response after vaccination,25 and HRT in postmenopausal women can elicit immune changes as early as 1 month.34 Hormone differences are highly relevant in autoimmune conditions as well: While HRT in menopausal women may increase the risk of late-onset RA, hormonal oral contraceptives have been shown to reduce the risk of RA in women.28