There are many causes for disease flares in JIA which may include changes in medications including interruptions or delay.  Emotional, social and physical stressors may be important in disease flares.  A potential association of puberty and hormonal changes and disease flare has not been evaluated formally in a research study. As such, at this time we do not have evidence that hormonal changes are related to JIA flares. There are many causes for joint pain that are separate from inflammatory joint disease.  It is possible that hormonal changes may be associated with joint and muscle aches.