In the past decade, we have learned that ankylosing spondylitis affects men and women equally. Despite this, women still face longer delays in getting diagnosed. Therefore, recognizing the early signs of ankylosing spondylitis in women is of utmost importance in seeking timely treatment.
What Is Ankylosing Spondylitis?
Ankylosing spondylitis (AS) is a type of arthritis that causes inflammation in certain areas of the spine. “Ankylosing” means stiff, “spondyl” refers to the spine, and “itis” means inflammation. This disease triggers inflammation in the spine and large joints, causing stiffness and pain.
It can damage the joint where the spine connects to the hipbone, known as the sacroiliac joint. It may also cause bony bridges to form between the vertebrae in the spine, fusing those bones together. Additionally, bones in the chest can also fuse.
Ankylosing Spondylitis and Female Hormones
There is some evidence that female hormones, especially estrogen, influence ankylosing spondylitis. However, we need more research to understand this relationship completely. Some studies suggest that estrogen has anti-inflammatory effects that may reduce the severity of ankylosing spondylitis (AS) symptoms and influence immune responses.
AS presents differently in men and women, with women experiencing higher disease activity and a greater likelihood of developing related conditions. Men often show more severe joint damage, possibly due to hormonal differences, particularly estrogen’s protective role. The decline in estrogen during menopause may worsen AS symptoms, as lower estrogen levels can increase inflammation in postmenopausal women.
Ankylosing Spondylitis Female Symptoms
Symptoms of ankylosing spondylitis (AS) can vary from person to person. Some common early signs include:
- Frequent, dull pain and stiffness in the lower back and the joints connecting the spine and hips.
- Back pain worsens in the mornings and at night but can feel better with a warm shower or exercise.
- Pain may occur on one side of the body.
- A low-grade fever.
- A loss of appetite.
- A general feeling of discomfort.
The Spondylitis Association of America notes that women with AS may experience symptoms differently than men. For instance, a woman might first feel pain in her neck or other areas instead of the lower back.
Treatment for Ankylosing Spondylitis in Women
Treatment approaches are the same for both men and women. However, women can respond differently to them. Therefore, medical professionals have tailored treatment plans. Some of these treatments include:
Medications
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These are commonly prescribed to relieve pain and reduce inflammation. Examples include ibuprofen and naproxen.
- Biologics: These newer medications target specific parts of the immune system. Anti-TNF (tumor necrosis factor) drugs like etanercept (Enbrel) and adalimumab (Humira) are often used. However, studies suggest that women may respond less effectively to these treatments than men.
- Corticosteroids: These provide short-term relief during flare-ups and can be given as injections into affected joints or taken orally.
- Disease-Modifying Antirheumatic Drugs (DMARDs): These drugs can slow the progression of the disease and are sometimes used alongside other treatments.
- Janus Kinase (JAK) Inhibitors: This newer class of medications is considerable if other treatments are ineffective.
Hormonal Treatments
Some studies suggest that estrogen therapy might help improve symptoms in women with AS, especially those experiencing active disease. However, more research is needed to confirm this effect.
Physical Therapy and Lifestyle Modifications
In addition to medications, physical therapy and lifestyle changes are important parts of managing AS. They are helpful in improving flexibility, strength, and overall quality of life.
Closing Note
Ankylosing spondylitis in women is a chronic condition. With time, it can result in severe conditions like spinal fusion. Therefore, its management is effective in preventing its progress.
Visit Dr. Raza Jafri at Genesis Pain Clinic. Our board-certified pain management specialist has extensive experience in interventional pain management and is skilled in ultrasound for diagnosis and needle-guided procedures. Dial (913) 871-9888 to book an appointment.