6 prednisone side effects in women

Prednisone is a corticosteroid that reduces inflammation in the body. It’s used to treat many medical conditions, including asthma, certain types of cancer, rheumatoid arthritis, blood conditions, lupus, and immune system disorders. It’s well known that prednisone can have unwanted side effects, such as headaches, insomnia, irritability, dry and thinning skin, weight gain, and swelling of the legs and face. But did you know some of them affect women, specifically? 

“Unfortunately, prednisone can have a number of adverse effects in women,” says Soma Mandal, MD, internist and women’s health specialist at Summit Health in Berkeley Heights, New Jersey. The most common list of complaints among females taking this prescription medication include weight gain, mood swings, and high blood sugar, according to Dr. Mandal. Here, learn how long to expect the side effects to last and how to minimize their impact if you’re prescribed this medication.

6 side effects of prednisone in women

These are the most common side effects of prednisone in women.

1. Weight gain

Weight gain, swelling, and fat redistribution are some of the most common complaints among women who take prednisone, says Dr. Mandal. These side effects don’t happen to everyone, but they tend to worsen the higher the dose you take and the longer you take it. Prednisone is known to cause swelling of the face, along with redistribution of fat to your face. It can also cause fat deposits in the back of the neck; when this happens, it’s sometimes referred to as a “buffalo hump.” These changes are primarily due to fluid retention but also because prednisone can increase your appetite.

2. Mood swings

Mood changes and exacerbation of mental health issues may occur when you take prednisone. According to a 2023 study, some of the common mental health side effects of taking prednisone include depression, panic disorder, anxiety, and delirium.

Women, in particular, “experience mood swings and an increase in anxiety and depression,” Dr. Mandal notes. Additionally, prednisone may cause short-term irritability as well as sleep disruption in women, says Jared L. Ross, DO, a board-certified emergency medicine physician in Charleston, South Carolina.

3. Blood sugar issues

Glucocorticoids (another word for steroids), like prednisone, can cause an increase in fasting glucose levels. Hyperglycemia, or high blood sugar, can be concerning for anyone, says Dr. Mandal, but it’s an even greater concern for women who have insulin resistance, prediabetes, or diabetes. 

4. Menstrual changes

“Prednisone can both cause bleeding when it shouldn’t, and it may stop bleeding [during a period],” explains Megan Milne, Pharm.D., a clinical pharmacist who specializes in prednisone side effects. “Most concerning for women still expecting a period is when their periods don’t happen.” If you notice irregular periods or absent periods while on prednisone, contact your healthcare provider for medical advice.

Also, mismanagement of corticosteroid dosages or taking too much of the medication could result in menstrual changes, including skipping periods, according to MedlinePlus.

5. Skin problems

Unfortunately, corticosteroid use is known to have adverse effects on the skin. Research has found that topical and systemic use of corticosteroids increases your risk of skin rashes, rosacea, acne, dermatitis, itching, and hirsutism (excess hair growth on the face). Dr. Mandal says that you can expect skin changes if you are using prednisone, especially if you’re using it long-term. “I always caution my female patients to avoid chronic use since it can cause skin thinning, bruising, or dry skin,” she says.

6. Osteoporosis

Osteoporosis is a condition that makes your bones become weak and brittle. Women, in particular, are prone to osteoporosis as they get older. Although taking prednisone doesn’t cause osteoporosis if you just take it for a few days, anyone who’s taking it for a more extended period and/or at higher doses may be at risk for bone density loss.

What are the long-term side effects of prednisone in women?

Unfortunately, there are quite a few potential long-term side effects from prednisone, says Dr. Ross. He says the most common ones include weight gain, skin thinning, stretch marks, acne, hair thinning, and hair loss. Increased risk of infections, such as rare fungal infections and tuberculosis, are also common the longer you take it. 

One of the most serious side effects of long-term prednisone use is osteoporosis. “The bone loss from prednisone is one of the few permanent, irreversible side effects in women,” according to Dr. Milne. “It’s a concern for both men and women, but usually worse and more common in postmenopausal women.”

Other serious side effects from long-term prednisone use, such as diabetes, can lead to additional health problems and complications as well. 

How soon do prednisone side effects start in women?

“Prednisone side effects happen at different times, depending on the side effect,” Dr. Milne explains. Side effects of prednisone are usually divided into two categories: short-term side effects and long-term side effects. Short-term side effects can happen even after a single dose of prednisone if the dose is high enough. The dose required depends on the medical condition you’re taking prednisone for and its severity—the usual dose ranges from 5 mg to 60 mg daily. Even higher doses may be required for specific health issues, such as an acute multiple sclerosis flare. 

Prednisone side effects in women from long-term use will take longer to show up. For example, “serious side effects like osteoporosis can start happening in the first three months on prednisone but can continue to cause further bone loss over time,” Dr. Milne says.

How long prednisone side effects last depends on whether you are talking about short-term or long-term effects. “The short-term ones generally resolve within two to three days after stopping the medication,” explains Dr. Ross. “Long-term effects are typically permanent; however, there will usually be some gradual improvement over months to as long as a year after stopping an extended course of steroids.”

How to avoid prednisone side effects in women 

Prednisone side effects in women can be challenging, but there are ways to minimize them. Dr. Milne recommends that you:

• Follow the exact dosing advice given to you by your healthcare provider; never increase or decrease the dose on your own.
• Engage in weight-bearing exercise (like walking or low-impact aerobics) and consider taking calcium and vitamin D supplements to help keep your bones strong and lower the risk of bone density loss.
• Eat healthy foods and keep your weight in a healthy range.
• Quit smoking and avoid alcohol, both of which can increase the risk of prednisone side effects.

Prednisone contraindications in women

Prednisone is safe for most women to take, especially on a short-term basis. There are certain instances where prednisone is contraindicated. Anyone with a known hypersensitivity or history of allergic reactions to prednisone should not take it. The following groups may want to avoid taking prednisone:

• People who are pregnant. Prednisone is not known to increase the chance of miscarriage or pregnancy complications. However, use of prednisone during pregnancy may be linked to preterm delivery and low birth weight—although experts think that some conditions treated by prednisone may also be associated with preterm delivery and low birth weight. Before using prednisone, let your healthcare provider know if you are pregnant or planning to become pregnant. 
• People who are breastfeeding. According to LactMed at the National Library of Medicine, corticosteroids like prednisone are found in low amounts in breast milk. Although no negative effects have been reported among breastfeeding infants when exposed to corticosteroids, you may notice a temporary drop in milk supply when taking high doses. Talk with your healthcare provider about whether taking prednisone while breastfeeding is right for you.

Additionally, according to the FDA, people with the following conditions should exercise caution while taking prednisone:

• Hypothalamic-pituitary-adrenal (HPA) axis suppression
• Cushing’s syndrome
• Hyperglycemia (high blood sugar)
• High blood pressure
• Inflammatory bowel disease or ulcerative colitis 
• Existing mental health conditions, as this medication may exacerbate mood issues
• Existing infections  

Bottom line: Most side effects are treatable

Most of the time, prednisone side effects in women are uncomfortable but don’t require medical attention. Generally, treatment for any common side effects involves taking lower doses or stopping the medication—either way, under the supervision of your healthcare provider. But if you’ve been taking prednisone for more than a week or two, you will need to taper off it gradually to avoid withdrawal symptoms. Your doctor will provide you with a tapering schedule. If you’re experiencing side effects that don’t go away or are bothersome, reach out to your healthcare provider to determine if it makes sense to stop taking prednisone and how best to do it.