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Rheumatoid Arthritis in Women
Bess Schear, now age 48, once aspired to be a professional chef, but now she is happy just cooking for her husband, Howard, and their closest friends.
But she's not complaining because there was a time when she didn't even think this type of informal cooking was possible. Diagnosed with rheumatoid arthritis (RA) as a newlywed at age 23, Schear was forced to give up her dream of becoming a chef because it became increasingly harder to lift stockpots and chop veggies, even with the help of her sous chef.
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"If I was chopping something hard like a winter squash, my hands would hurt and the joints in my feet would also hurt because there is a lot of standing involved in being a professional chef," recalls the Staten Island, N.Y, resident.
About 1.3 million American adults have rheumatoid arthritis, and most of them are women like Schear who develop the disease in what should be the prime of their lives. RA is an autoimmune disease that occurs when the body engages in friendly fire against its own joints. Untreated, it can affect all aspects of a woman's life from dating and starting a family to raising that family and succeeding at work.
Rheumatoid Arthritis: Striking Women in Their Prime
"RA often strikes women who are in their 30s and 40s who have heavy work and home responsibilities," says Androniki Bili, MD, MPH, of Geisinger Health System in Danville, Pa. "We are looking at women who have young children and who are bread winners or equal partners in bringing in income."
RA is not only more common among women, it also may take a tougher toll on their bodies and psyches, according to a study published in Arthritis Research & Therapy. According to these findings, women had more severe RA symptoms and were less likely to be in remission than their male counterparts, despite similar treatments.
"Women experience musculoskeletal diseases worse than men because they are physically smaller and have smaller muscles," says study author Tuulikki Sokka, MD, PhD, of Jyvasyla Central Hospital in Finland.
The fact that women can become pregnant is likely the reason that they are disproportionately affected by autoimmune diseases like RA and lupus, explains David Pisetsky, MD, chief of rheumatology at Duke University Medical Center in Durham, N.C.
"Women's immune systems are built differently than men's," he says. "Women can get pregnant, which means that in essence, there is a foreign person in the mother and they don't respond [by launching an attack against it], so the same mechanism that allows pregnancy may also allow autoimmune disease."
Rheumatoid Arthritis in Women: The Pregnancy Puzzle
Since RA strikes women during their childbearing years, pregnancy concerns can be an issue.
"In the majority of patients the disease improves during pregnancy, which is a blessing because most of the RA medicines are either toxic to the fetus or their safety during pregnancy has not been established," Bili says. "Oftentimes, we are able to withdraw medications for RA during pregnancy." Women with RA tend to flare within months after giving birth.
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