Ankylosing spondylitis (AS) is a form of arthritis that affects the spine. People with AS may experience hormonal or bone density changes that can affect their experience during menopause.
Research suggests that AS can affect hormones associated with ovarian function. These changes may affect menopause or menstruation in certain individuals.
This article will explore how AS affects menopause and menstruation, as well as what symptoms it may cause in females. Keep reading to learn more.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
Individuals with AS may find that it affects their experience with menopause.
A
Estrogen levels also decrease during menopause. Therefore, individuals with AS who are going through menopause may be at a greater risk of developing osteoporosis. This condition can cause bone loss and increase the risk of bone fractures.
Researchers have also found that levels of vitamin D decrease in people with AS. Since menopause also causes vitamin D deficiencies, individuals with AS who are going through menopause may experience more negative effects of vitamin D deficiency.
Estrogen deficiencies
Progesterone is another hormone crucial for supporting menstruation. At healthy levels, progesterone helps thicken the lining of the uterus. This thickened lining increases the chance of a fertilized egg successfully implanting in the body.
When progesterone levels are low, it may
- irregular menstrual cycles
- certain forms of cancer
- miscarriage
- premature labor and delivery
Females with AS may experience a range of symptoms. Some of the more common AS symptoms include:
- pain in tendons and ligaments
- unusual tiredness
- stiffness and pain in the neck, back, or buttocks
In addition to common AS symptoms, females may experience less low back pain and more pain across the upper back and neck. Pain can also spread to other regions of the body.
Females with AS are also more likely to have the following complications than males with AS:
- irritable bowel disease (IBD)
- psoriasis
- peripheral arthritis
A
Healthcare professionals once believed that AS affected more males than females. Newer research suggests that non-radiographic axial spondyloarthritis (axSpA), a subtype of axial spondyloarthritis along with AS, affects men and women equally. However, three times as many males are diagnosed with AS as females.
Females are still more likely to receive a late AS diagnosis or a misdiagnosis. Researchers believe this may be due to how the disease presents differently in males and females.
A healthcare professional
If diagnostic tests confirm AS, healthcare professionals can refer females with this condition to other specialists for treatment.
Females with AS may have different symptoms than males and
X-ray images from women with AS generally show less damage than images from males with this condition. Blood tests from females with the condition may reveal fewer signs of AS.
Individuals living with AS and menopause may require a specialized treatment plan to address both conditions.
Medications for AS typically include:
- anti-inflammatory drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
- biologics
- targeted drugs that act on the immune system
Certain medications can also help reduce menopause symptoms. These
- hormonal birth control at a low dosage
- hormone replacement therapy (HRT)
- selective serotonin reuptake inhibitors (SSRIs)
Both menopause and AS can increase the risk of osteoporosis or bone loss. Calcium and vitamin D supplements
Self-management
Physical therapy and exercise can assist with menopause and AS. Physical therapy can improve the symptoms of AS and increase spinal mobility. Exercise can improve mental health and help promote bone health.
Other self-management approaches for preventing bone loss
- eating a healthy diet rich in fruits, vegetables, and whole grains
- reducing alcohol intake
- limiting or avoiding caffeine
- avoiding or quitting smoking
People living with menopause and AS should speak with a healthcare professional to learn more about ways to manage their symptoms.
People who have symptoms of AS, menopause, or changes in their menstrual cycle should speak with a healthcare professional. They can assess symptoms and suggest options for managing these conditions.
Similarly, people with existing AS and menopause should always speak with a healthcare professional if they develop any new or changing symptoms.
It can be helpful to keep a diary of any new or existing symptoms and note how long they have been occurring. Having a record of symptoms can help healthcare professionals make a diagnosis and determine the appropriate treatment.
Ankylosing spondylitis is a type of arthritis that causes inflammation in the spinal joints. This condition can also affect sex hormones and vitamin D levels, which may worsen menopause symptoms.
Medical treatment and self-management may improve the symptoms and quality of life for people with AS and menopause.
Self-advocacy during the diagnostic process is also helpful, as females are misdiagnosed more often than males or diagnosed with AS later.