Ankylosing spondylitis has often been considered more of a man’s disease, yet the reality is that it affects some women, too.
The genetic marker for ankylosing spondylitis, HLA-B27, is found equally in men and women. However, ankylosing spondylitis is two or three times more common in men than women, said Rodney Tehrani, MD, a rheumatologist at Loyola University Medical Center in Maywood, Ill.
Ankylosing Spondylitis Diagnosis in Women: Why the Difference?
Many experts believe several factors may explain why it’s harder to reach an ankylosing spondylitis diagnosis in women. Some women may have milder symptoms, so ankylosing spondylitis symptoms may not be as obvious. Progression also may be slower, and symptoms can seem like other ailments, such as rheumatoid arthritis or fibromyalgia. The area of discomfort also can interfere with making the correct diagnosis. Along with back pain, women also might experience soreness in the neck and peripheral joints, in contrast to men who mainly tend to note back pain.
When to Suspect Ankylosing Spondylitis in Women
Getting the correct diagnosis is critical to getting started on the right treatment. “Clinicians should suspect the disease in women who complain of back pain, particularly when associated with any or all of the following: morning stiffness or stiff back after resting, psoriasis, inflammation of the eyes, frequent canker sores, irregular nails, swelling of the joints, painful joints, particularly shoulders and hips, and frequent abdominal pain and diarrhea,” said Ali D. Askari, MD, chief of the rheumatology division at University Hospitals Case Medical Center and a professor at the Case Western Reserve University School of Medicine in Cleveland.
Symptoms also should be carefully studied. For example, back pain from ankylosing spondylitis typically lessens with movement and exercise and gets worse with rest — a feature that sets it apart from some other ailments, like degenerative arthritis.
The Progression of Ankylosing Spondylitis in Women
Anyone with an ankylosing spondylitis diagnosis is naturally concerned about what comes next, but “there is no set course for this disease,” Dr. Tehrani explained. “It is variable in every individual, whether male or female.”
Most often, people with ankylosing spondylitis experience flares — painful episodes — mixed with times of remission when symptoms lessen. As the disease progresses, some of the vertebrae in the spine may fuse together, which makes the back more rigid and at greater risk for fracture.
How Ankylosing Spondylitis in Women Is Treated
Treatment options are similar for women and men. Medications for ankylosing spondylitis symptoms include non-steroidal anti-inflammatory drugs (NSAIDs) as the first line of attack to help address stiffness, neck pain, and back pain in women. When something stronger becomes necessary, most doctors turn to disease modifying anti-rheumatic drugs like corticosteroids and sulfasalazine. Biologics or TNF blockers are the latest additions to the treatment option arsenal.
Exercise also is important to retaining flexibility and keeping pain at bay. For example, Pilates has been shown to improve physical capacity and endurance in ankylosing spondylitis. A physical therapist can offer other suggestions.
Maintaining good posture, using heat to reduce soreness and using cold to lessen swelling also can help. Those with very serious cases might need to consider surgery.
Regardless of your symptom level, it’s important for women — and for men, too — to see a rheumatologist at least once a year to make sure you aren’t developing any other issues
Source Everyday Health