Ankylosing spondylitis in women: Symptom, reason, treatments

Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects the spine and joints and can cause pain and stiffness. Although more common in men, women can also develop AS often with symptoms that are harder to detect. In this article, Zextrasure will explore ankylosing spondylitis in women, its symptoms, risk factors, and available treatment options.

1. What is ankylosing spondylitis in women?

Ankylosing spondylitis (AS) is a chronic inflammatory condition that primarily affects the spine and sacroiliac joints, so it leads to pain, stiffness, and possible loss of mobility. Although AS is more frequently diagnosed in men, it can also affect women, and the symptoms may vary between genders. 

In women, AS is often diagnosed later than in men, partly because the symptoms may be subtler or less typical, leading to delays in recognition and treatment.

Research by the Spondylitis Association of America has shown that historically, the prevalence of AS in males was much higher than in females, with a ratio of 10:1. However, more recent studies suggest that this gender disparity has narrowed, with the male-to-female ratio now estimated at 1.03:1. This shift indicates a growing recognition of ankylosing spondylitis in women, although the condition may still be underdiagnosed in this group.

Ankylosing spondylitis in women is a condition that affects both men and women

2. Symptoms

Ankylosing spondylitis (AS) affects both males and females, though some symptoms may differ in their presentation and severity. The primary symptom of AS is pain or stiffness in the lower back or hips, often exacerbated by prolonged periods of inactivity or rest. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD), this pain can vary in intensity, with some individuals experiencing mild discomfort while others suffer from chronic, debilitating pain.

In addition to joint pain and stiffness, other symptoms may include:

• Inflammation and pain in various joints
• Difficulty breathing deeply due to inflammation of the tissues connecting the ribs
• Loss of appetite
• Unexplained weight loss
• Persistent fatigue

A 2018 review highlighted certain symptoms that tend to be more prevalent in females, such as:

• Psoriasis-related symptoms may present as Red, scaly patches of skin that may itch or burn; Dry cracked skin that is prone to itching or bleeding; Thickening, ridging, or pitting of nails
• Symptoms of inflammatory bowel disease (IBD), including abdominal discomfort and diarrhea
• Enthesitis-related symptoms, such as unusual bone growths, pain, and stiffness, particularly during movement

Symptoms of ankylosing spondylitis are inflammation and pain in various joints

3. Causes and risk factors 

While the exact cause of ankylosing spondylitis in women is unknown, a combination of genetic and environmental factors likely plays a role.  

• HLA-B27 gene: Most people with AS have this gene, which is associated with an increased risk of developing the condition. However, not everyone with the gene develops AS.  
• Family history: A family history of AS can increase your risk.  

• Infections: Some studies suggest that certain infections, particularly those affecting the gut, may trigger AS in people with a genetic predisposition.  
• Smoking: Smoking may increase the risk of developing AS and worsen symptoms.  
• Gut inflammation: Inflammatory bowel diseases like Crohn's disease and ulcerative colitis are more common in people with AS, suggesting a potential link between gut health and the development of the condition.

Many causes can lead to the condition of ankylosing spondylitis

See other:

• Is gout hereditary? Exploring the genetic factors

• What to know about tricompartmental Osteoarthritis

4. Affect of ankylosing spondylitis in women

Ankylosing spondylitis (AS) can affect women in various ways, often with unique characteristics compared to its presentation in men. Here are some of the key ways ankylosing spondylitis in women:  

• Atypical Pain Patterns: Women may experience pain in areas beyond the lower back, such as the neck, shoulders, hips, knees, and ankles. This can sometimes lead to misdiagnosis.  
• Increased Fatigue: Women with AS often report higher levels of fatigue compared to men.  
• Higher Prevalence of Peripheral Joint Involvement: Women are more likely to experience inflammation and pain in joints outside the spine.  
• Potential for Delayed Diagnosis: Atypical symptoms and less severe radiographic changes can contribute to delayed diagnosis in women.  

5. Treatment 

The treatment process for ankylosing spondylitis in women is generally similar for both men and women, aiming to reduce inflammation, relieve pain, and improve mobility. The main treatment approaches include:

Medications:

• Nonsteroidal Anti-inflammatory Drugs (NSAIDs): These are commonly used to reduce pain and inflammation in the joints. They are often the first line of treatment.
• Disease-Modifying Antirheumatic Drugs (DMARDs): These drugs can help slow the progression of AS by reducing inflammation. Methotrexate and sulfasalazine are commonly prescribed.
• Biologic Agents: For moderate to severe cases, biologics such as TNF inhibitors (e.g., infliximab, etanercept) or IL-17 inhibitors (e.g., secukinumab) may be recommended to target specific molecules involved in the inflammatory process.
• Corticosteroids: These can be used in the short term to reduce severe inflammation but are not generally used for long-term treatment due to potential side effects.

Physical Therapy

Physical therapy plays a crucial role in managing AS. The goal is to maintain or improve spinal flexibility and joint mobility. Therefore, Regular exercise can also help reduce pain and improve posture, potentially preventing the spine from fusing in an abnormal position.

Surgery

Surgery is typically reserved for severe cases of ankylosing spondylitis in women where medications and physical therapy are not enough to control symptoms or when joint damage becomes irreversible. Surgery options may include:

• Joint Replacement: If joints like the hips or knees are severely damaged, joint replacement surgery may be recommended.
• Spinal Surgery: In rare cases, surgery may be necessary to correct deformities or relieve nerve compression in the spine, especially if fusion has occurred.

Surgery is the last resort when ankylosing spondylitis in women worsens

6. Complications

The complications of ankylosing spondylitis in women can vary in severity and frequency, impacting various systems in the body. These complications can arise in anyone with the disease and may differ in presentation for males and females.

• Eye Inflammation (Uveitis): AS can lead to inflammation of the eyes, known as uveitis, which can cause redness, pain, and potential vision loss if not treated promptly.
• Spinal Fusion: The continuous inflammation of the spinal joints can lead to the fusion of vertebrae, resulting in stiffness and decreased flexibility. This can significantly impact mobility and quality of life.
• Compression Fractures: In severe cases, the inflammation and erosion of the vertebrae can result in compression fractures, which can lead to chronic pain and reduced spinal stability.
• Reduced Lung Capacity: The rigidity of the rib cage and spine can limit chest expansion, reducing lung capacity and making breathing difficult.
• Cardiac Issues: AS can cause inflammation of the aorta (the root of the major artery from the heart), leading to potential cardiac complications such as aortic regurgitation or aortic root aneurysms.
• Fatigue: Chronic pain and inflammation often result in persistent fatigue, which can significantly impact daily life and overall quality of life.

The complications of ankylosing spondylitis in women can vary in severity and frequency, impacting various systems in the body

7. FAQs

Can ankylosing spondylitis cause sciatica?

Ankylosing spondylitis in women can cause sciatica. The inflammation associated with AS often affects the spine and sacroiliac joints, which can lead to nerve compression, particularly in the lower back and hips. This compression may irritate the sciatic nerve, resulting in symptoms like pain, numbness, and tingling sensations in the lower back, hips, and legs—classic signs of sciatica.

Can ankylosing spondylitis cause scoliosis?

Ankylosing spondylitis in women can lead to scoliosis. As ankylosing spondylitis progresses, chronic inflammation can lead to the fusion of the vertebrae in the spine. This fusion can result in an abnormal curvature of the spine, leading to scoliosis. The stiffness and inflexibility caused by the fusion of spinal vertebrae may also contribute to the development of this condition.

Above is a comprehensive overview of ankylosing spondylitis in women. This is an issue that can directly affect women, so it is important to thoroughly understand it and choose the most appropriate treatment method to prevent potential complications in the future.