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8 Things All Women Who Have Ankylosing Spondylitis Need to Know

Everyday Health discusses key facts for women with Ankylosing Spondylitis (AS) to be aware of according to experts including HSS rheumatologist Susan M. Goodman, MD.

The experts explained how the disease might progress differently in women compared to men, how treatment may differ between the sexes and how the condition might affect pregnancy and childbirth.  In 2009, doctors began using the umbrella term axial spondyloarthritis (axSpA) to refer to inflammatory arthritis that causes pain and swelling primarily in the spine and sacroiliac (SI) joints. There are two subtypes of axSpA: Nonradiographic axSpA (nr-axSpA), which means joint damage is not visible in x-rays; and Ankylosing Spondylitis (or radiographic axSpA), which means joint damage can be seen in x-rays. This new way of defining axSpA made it possible for the disease to be more visible in women, who tend to have fewer radiographic changes — damage that can be seen in x-rays — said Dr. Goodman. “Women are less likely to have radiographic damage, so if your screening procedure is an x-ray, you’re less likely to be able to confirm a diagnosis in a woman. MRIs have really changed that, and now we’ve seen more of a gender parity,” she noted.

AS is also often wrongly diagnosed as chronic back pain caused by minor trauma, bad posture, or poor body mechanics, said Dr. Goodman. Most doctors don’t routinely screen for inflammatory arthritis since lower back pain is so common. “I think that combination — normal x-ray, no consistent screening for inflammatory back pain, and I personally think that there is a tendency to disregard women’s musculoskeletal complaints — has been a real problem over time,” she said. Additionally, the fact that many women have lower back pain during pregnancy can make it difficult to sort out who may be experiencing symptoms of AS, cited Dr. Goodman.

Women with axSpA are also more likely to have elective C-sections and give birth to babies who are small for their gestational age, according to the Spondylitis Association of America (SAA). “If the sacroiliac joints are fused, it can be very hard for labor and delivery,” mentioned Dr. Goodman. “But in most cases, this really isn’t a problem, because one of the things that happens around the time of delivery is you release a lot of hormones that relax the pelvic ligaments and structure.” Not only that, but young women of childbearing age are also unlikely to have had the disease for a long time or developed fusion of the SI joints, she added.

Read the full article at Everydayhealth.com.