Have you ever heard of ankylosing spondylitis? It’s a condition in which the joints in the spine and pelvis become inflamed, stiff, and eventually fuse together. So, many people think that it’s more common in men. But is that really the case? Recent research suggests that there are some important differences in the way the disease affects both men and women. Today, let’s talk about what these differences are and why they happen.
Is this really a 'men's disease'?
In the past, the prevailing view among doctors and researchers was that ankylosing spondylitis (AS) was a disease that mostly affected men. One reason for this was that most of the research conducted at the time involved male patients. So the results came out that way.
But now the situation is different. New studies show that the risk of developing this disease is almost equal for both men and women. Over time, the gap between the rates of men and women suffering from this disease has gradually narrowed.
But there is another side to this. At the genetic and cellular level, there are some differences. For example, research has found that male patients with AS have higher levels of Th17 and IL-17A, which are specific types of cells that cause inflammation. However, female patients with AS did not have these cells at the same level. This suggests that there are differences between men and women in the biological processes that contribute to the development of the disease.
Who is most affected by diagnostic delays?
Here's a very important point. Although the age at which symptoms begin is not much different between men and women, the diagnosis of the disease occurs significantly later in women .
Consider this: A 2017 study found that it takes an average of 8.8 years for a woman to be diagnosed with the disease, but it takes an average of 6.5 years for a man to be diagnosed. That's not a small delay, right?
Why does this happen? There is no single test to diagnose AS. Your doctor, especially a rheumatologist, will make a diagnosis based on your symptoms, medical history, a physical exam, and several tests, such as X-rays. Because the disease is often thought of as a "man's disease," it can sometimes be too late for a woman to suspect it when she has these symptoms.
Differences in the impact of the disease: women vs men
Even after the disease is diagnosed, there are clear differences in the way it affects the body. Let's look at these differences in a table. This will make it easier for you to understand.
| Affected sector | Men | Women |
|---|---|---|
| Changes in X-rays | The damage and changes in the spine and joints may be more obvious and serious . | The damage and changes visible on X-rays are relatively less in men. |
| Joint Fusion | Joint stiffness and erosive damage occur more severely and rapidly. | Although joint degeneration and erosion occur, it is not as severe as in men. |
| Delay in diagnosis | The disease is usually diagnosed at 6.5 years of age. | On average, the diagnosis of the disease can be delayed by up to 8.8 years. |
| Hospitalizations | The severity of the disease appears to be associated with a higher likelihood of hospitalization and referral to clinics. | Because diagnosis is delayed, data on healthcare utilization may be underestimated . |
What could be the reasons for these changes?
There may be several reasons for this.
1. Severity of the disease: As we discussed earlier, men's disease is more severe than what is seen on X-rays. Because of this, they experience more discomfort. Therefore, they may need to see a doctor more often, go to clinics, and even be hospitalized.
2. Delay in diagnosis: This is another major issue. Because women are diagnosed late, they also start seeking health services late. Therefore, when looking at research data, it may seem that women are less likely to go to the hospital for this disease. But the real reason may be that their disease is diagnosed late.
The most important thing is that because of the perception in society that this disease is a 'male disease', when a woman experiences symptoms such as back pain and morning stiffness, it is too late to suspect that it could be AS. As a result, delayed diagnosis is a serious problem.
Therefore, whether you are a woman or a man, if you have long-term back pain, stiffness and pain in the back, neck, and hip area when you wake up in the morning, do not ignore it as a normal backache, but definitely see your doctor and talk about it. The sooner the disease is diagnosed, the greater the chance of treatment and control of the disease.
Take-Home Message
- Ankylosing spondylitis (AS) is not a disease that only affects men. It can affect both men and women.
- The way the disease affects the body and the severity of symptoms can differ between men and women. Men are more likely to have severe joint damage that is often visible on X-rays.
- Women may experience a significant delay in diagnosis. It is important to be aware of this.
- Regardless of your gender, if you have long-term back pain and morning stiffness, do not ignore it and seek medical advice immediately .
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