Arthritis In Women
(continued)
What Are the Risk Factors For OA?
OA is probably a disease of multifactorial origin. Hereditary factors may
be the most important, but in most patients with OA a specific cause is never
identified. Other things which may increase your risk of getting OA or of worsening
your existing OA include: being overweight, chronic stress across joints, multiple
microfractures in the related bone, major joint trauma (think skiing accidents),
or other metabolic or inflammatory injuries. And yes, cracking your knuckles
does increase your risk of arthritis of the fingers. It is unknown (i.e. the
research is conflicting) what the relationship is between estrogen (either in
birth control pills or in hormone replacement therapy) and arthritis. Because
of the gender differences in OA and RA incidence, hormones have long been suspected
to have a role in disease origin and progression. As a result, rheumatologists
tend to avoid recommending oral contraceptives and estrogen replacement therapy
(ERT) for fear of causing the disease to worsen. This is unfortunate because
women with these conditions are in great need of the other benefits of ERT.
Furthermore, we know that certain arthritic conditions (such as RA) actually
go into remission in pregnancy, during which hormone levels are very high.
What Are the Risk Factors For RA?
Like OA, there is no known cause for RA. It is believed to have genetic, hormonal,
environmental, and other factors. A decline in RA rates since the 1950's suggests
that birth control pills may play an important preventive and ameliorative role.
Evidence also exists to show a cyclic increase in RA symptoms during menses.
The transition into menopause can also exacerbate symptoms. Pregnancy, on the
other hand, can cause symptoms to go into remission or to improve. A symptomatic
flare may occur at 6-8 weeks postpartum, however.
Never having had children is an independent risk factor for RA. Pregnancy
has a protective lifelong benefit. It is unclear if RA alters fertility, although
some studies show that it may slightly increase tragic pregnancy outcomes such
as miscarriage and perinatal or neonatal deaths.
Family history plays an important role in RA. Those with a first degree relative
with RA (i.e. someone in your immediate family) have a three to four-fold increased
risk of developing the disease, regardless of gender.
As with most chronic illnesses, lower socioeconomic
status is associated with worse disease progression and outcomes in both men
and women.
Like OA, RA incidence increases with increasing age. American black and white
populations are equally affected, but certain Native American populations are
at greatly increased risk.