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Autoimmune diseases, particularly rheumatic diseases, affect anyone, from very young children to the elderly; however, women in the prime of life are the most likely to be involved. Women are two to three times more likely to develop rheumatoid arthritis (RA) and nine times more likely to develop lupus (SLE) than men. Other diseases, Scleroderma, Sjogren's Syndrome, antiphospholipid syndrome (APS), inflammatory myositis, and fibromyalgia, are also common in women compared to men. RA often strikes between 35-50, while lupus usually develops between 15-44 years which is the crucial age for women in terms of career and starting a family. Hence, every woman needs to be aware of rheumatic diseases. Genes, female sex hormones, environmental factors, and increased immune system plasticity are possible reasons for increased frequency of these diseases in women.
Symptoms of rheumatic diseases
Symptoms of rheumatic diseases vary widely from one illness to another and among patients with the same condition. Rheumatic diseases affect multiple organs and may range from mild to life-threatening. Arthritis is one of the common symptoms. One experiences pain with or without swelling in their joints and stiffness, especially in the mornings. Other symptoms include red rashes over the body, recurrent ulcers in the mouth, excess hair loss, skin tightening, pale or blue discoloration of fingertips on exposure to cold.
Some may present with unremitting fever, loss of appetite, and weight loss, while some may have decreased blood counts.
Treatments of rheumatic diseases
Treatments would depend on the patient's symptoms and the severity of the disease. Many patients require long-term therapy with various immunosuppressive drugs, some of which require monitoring for the development of adverse effects.
As most of rheumatic diseases affect women in their reproductive years, the possible effects of the disease and their treatments on pregnancy and the effects of pregnancy on the condition needs to be addressed. Therefore, all affected women should consult a rheumatologist if they consider becoming pregnant. Unlike those without rheumatic disease, they can have good outcomes when pregnancy is well planned, especially when the disease is inactive.
How to reduce risk of osteoarthritis
Older women often experience knee and hip pains, especially after a period of rest. This condition is known as osteoarthritis. The cartilage in the joints undergoes degeneration due to increasing age, obesity, and wear and tear. Osteoporosis is another condition which affects women after menopause. The bone density decreases with falling estrogen hormone levels, and bones become brittle and break easily with trivial trauma. Physical activity, adequate intake of calcium and vitamin D can lower the occurrence of this condition.
Women often delay consulting a doctor because of several factors like lack of awareness about the disease and dependence on spouse or family members for help. Most women attribute the symptoms, especially joint pain and fatigue, to their work or household activities and ignore their symptoms. Rheumatic illnesses are chronic and can involve multiple organs. Hence, it is essential to consult a rheumatologist early within" the window of opportunity" to achieve early remission of disease and prevent long-term effects.
The article is contributed by Dr Sunitha Kayidhi, Consultant Rheumatologist and Clinical Immunologist, Yashoda hospitals Hyderabad.
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