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Arthritis In Women

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.

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 Arthritis is the major cause of disability and chronic pain in Americans. 

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