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Women with Arthritis
An estimated one in three adults -- nearly 70 million Americans–has
arthritis, one of the most prevalent chronic health problems in this country
and the nation’s leading cause of disability in people over age 15.
But what is not well understood is that arthritis strikes more women than
men.
The various forms of arthritis and related conditions can affect anyone,
no matter what your race, gender or age. However, it is especially important
for women to be educated about these diseases since they affect women at
a much higher rate than men. Sixty percent of all people who have arthritis
are female, and several of the more common forms are more prevalent in women.
Researchers believe that female hormones may play some role in arthritis
because women are affected so much more frequently than men. Hormones also
appear to affect arthritis symptoms in certain cases, such as pregnancy.
Osteoarthritis, also known as degenerative joint disease
or OA, is the most common form of arthritis. More than 21 million Americans
have osteoarthritis with approximately 16 million women affected. Women usually
develop OA after age 40. It causes damage to cartilage and bones, causing
joint pain, swelling, stiffness and loss of function.
Rheumatoid arthritis (RA) usually strikes women between
the ages of 25 to 50, but can occur in children. RA is a systemic disease
that can affect the entire body. An abnormality in the body's immune system
causes it to work improperly, leading to inflammation in the lining of the
joints and other internal organs. Chronic inflammation can lead to deterioration,
pain and limited movement. More than 2 million American adults have RA, with
women outnumbering men 3 to 1.
Fibromyalgia is a syndrome characterized by widespread
musculoskeletal pain. It is associated with generalized muscular pain and
fatigue, loss of sleep, stiffness and sometimes depression and/or anxiety.
Fibromyalgia is a form of soft tissue or muscular rheumatism, which means
no joint deformity occurs. An estimated 3.7 million Americans have fibromyalgia;
the figure may actually be higher since some of its symptoms may be found
in other conditions such as chronic fatigue syndrome (which is also more
common in women).
Lupus (systemic lupus erythematosus) is an inflammatory
disease that may affect the joints, skin, kidneys and other parts of the
body. Almost 240,000 Americans -- 90 percent of whom are women -- have this
arthritis-related condition. It usually affects women of childbearing age
and is more common among African-American women than Caucasian women. Some
studies indicate that it may also be more common among Asian and Latino populations.
Osteoporosis is a disease whose name literally means "bone
that is porous." It causes bones to lose mass and become brittle, which
can lead to rounded shoulders, loss of height and painful fractures. It affects
approximately 28 million Americans; four of every five people affected are
women. Postmenopausal women and those with a small or thin frame, a family
history of osteoporosis and habits such as smoking and drinking are at higher
risk for osteoporosis.
Many other arthritis-related conditions and connective tissue disorders
also affect more women than men. Raynaud’s phenomenon, scleroderma,
Sjögren’s syndrome and polymyallgia rheumatica may not be as
prevalent, but are still health problems that should be treated in conjunction
with an experienced health-care team.
The Society for Women’s Health Research has documented a number of
gender-specific facts about how all forms of arthritis affect women.
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Of the 70 million Americans estimated to have some form of arthritis,
41 million are women (58.6%) and 28.9 million are men (41.3%). (Women are
even more likely than men to develop osteoarthritis.
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Based on a major survey where the Centers for Disease Control and Prevention
(CDC) tracked a large sample of women (24,201) from 1989 to 1991, the prevalence
of arthritis increases with a woman’s age. In the CDC study, 8.6
percent of women aged 15-44 years had arthritis compared to 33.5 percent
of those aged 45-64 and 55.8 percent of women aged 65 and over.
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According to the CDC study, arthritis is the most common self-reported
condition that affects women (22.7 percent of the survey’s respondents),
ranking ahead of high blood pressure (8.1 percent), ischemic heart disease
(3.7 percent), and other conditions affecting women.
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Among the conditions reported responsible for activity limitations,
women in the CDC study most frequently mentioned arthritis, followed by
orthopedic deformity and ischemic heart disease.
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Men have significantly larger knee cartilage volumes than women, even
after adjustments for bone and body size differences, suggesting men are
naturally more protected from arthritis of the knee than women.
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Compared to men, studies find that women with arthritis are less likely
to be referred to orthopedic surgeons for joint replacement. Once referred,
however, women are equally likely to undergo the procedure.
Treating Arthritis
Health-care providers need a better understanding of arthritis in order
to help women access diagnoses and appropriate treatments sooner. If you
think you have arthritis or if you have been diagnosed with it, you can take
steps to manage it. There is no cure for arthritis, but there are many ways
you can take control of your health in order to feel better and improve our
quality of life. The treatment plan you design with your health-care team
may include recommendations such as these.
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Exercise to lessen pain, increase movement and reduce fatigue.
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Alternate periods of rest with activity. Pace yourself to help protect
your joints from the stress of repeated tasks and to help reduce fatigue.
Learn ways to use your joints without putting undue pressure on them.
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Use hot or cold compresses on joints for short-term pain relief and
to help prepare for exercise.
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Work with your primary care provider to determine the best over-the-counter
or prescription medications that may help slow the progression of arthritis
and ease pain.
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Always work closely with your health-care team to find the best medication,
diet and exercise program for you.
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Visit your health professional each year for a comprehensive physical
exam.
Preventing Arthritis
Arthritis is a serious health condition, but can be treated or possibly
prevented. Many of the habits that are recommended for a healthy lifestyle
play a role in preventing some types of arthritis and related conditions.
Some common tips for prevention include:
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Eat a healthy, well-balanced diet to help maintain your recommended
weight. Women who are overweight have a higher risk of developing osteoarthritis
in the knees.
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Talk to your doctor about taking vitamin and mineral supplements. Having
insufficient levels of vitamin D decreases the amount of calcium your body
can absorb. That coupled with lower calcium levels as you age can help
contribute to osteoporosis.
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Exercise regularly to strengthen muscles around joints and help increase
bone density. Exercise may reduce wear and tear on your joints, which can
help prevent injury and reduce the risk of osteoarthritis. Increased bone
density also can help stave off osteoporosis.
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Avoid smoking and limit your alcohol consumption to help avoid osteoporosis.
Both habits weaken the structure of bone, which puts you at higher risk
for fractures.
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Discuss hormone replacement therapy (HRT) with your primary care provider
if you are postmenopausal. Many women lose bone mass during the pre- and
postmenopausal years when their ovaries stop producing estrogen. One of
estrogen's functions is to help keep calcium in the bones and maintain
bone mass. Lowered estrogen level is a major cause of osteoporosis in women
after menopause.
Fitting Arthritis In With Life
Arthritis does not just affect your joints and tissues -- it affects every
aspect of your life. People with arthritis are at higher risk for serious
conditions such as premature death, heart disease, obesity, depression and
anxiety. Work with your health-care team, family and friends to find ways
to deal with arthritis in key areas of your life such as:
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Pregnancy: Arthritis is an additional factor to consider
when starting a family, but the majority of women with arthritis have entirely
healthy pregnancies in spite of their condition. Women with arthritis may
notice changes in their disease during pregnancy. For instance, women with
RA often have some improvement in their arthritis during pregnancy, but
the arthritis may worsen (flare) after the baby is born. Work closely with
your rheumatologist and obstetrician to review all medications taken during
pregnancy and to monitor changes in your arthritis as your pregnancy progresses.
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Relationships: Joint pain, stiffness or disease activity
may make intimacy difficult for a woman with arthritis. Remember that open,
up-front communication is the best policy in any relationship. Work with
your partner to discover new ways to express your feelings for each other,
and take advantage of the times when you are feeling well.
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Attitude and self-image: The medications sometimes
prescribed for arthritis can lead to side effects such as nausea, skin
rashes, weight gain or other complications. In addition, arthritis itself
can contribute to joint deformity, other physical changes or profound fatigue.
Living with a chronic condition is not easy, and can lead to depression
or anxiety about things ranging from how to pay for medical care to how
to find enough energy to cook dinner. No matter how bad the picture may
seem you do have a choice about how to deal with it. Surround yourself
with excellent health-care providers and supportive family and friends.
Decide every day that you will have the best attitude possible, and rely
on your family and friends to help you keep that attitude.
Sources: Arthritis Foundation, The Society for Women’s Health Research,
National Institute of Arthritis and Musculoskeletal and Skin Diseases
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