LIVING YOUR STRENGTHS
RECOGNIZING DIFFERENT WOMEN’S HEALTH By Ann-Marie DePalma
A
s women, our bodies are constantly changing. From the moment we get our first period to menopause and beyond, our bodies are undergoing constant evolution. Whether for better or worse, hormones and other factors play a role in how we experience daily life. Let’s examine a few of these. We know a lot about the effects of estrogen and progesterone on our reproductive system, but did you know that there are estrogen receptors in the temporomandibular joint? Numerous studies, particularly the OPPERA study, have shown that estrogen can influence the inflammatory response and pain modulation for TMD patients. Since many TMD patients are women in their childbearing years, this sheds light on a previously unknown connection. As a TMD myself, I can attest to estrogen’s role – I often experience a “TMJ headache” prior to my period as well as during pregnancy when my symptoms decreased. The OPPERA study (Orofacial Pain: Prospective Evaluation and Risk Assessment) funded by the National Institute of Dental and Craniofacial Research set out to identify risk factors for the development of Temporomandibular Disorders (TMD). Beyond the findings on estrogen and its role in TMD, OPPERA opened the door to many other investigations that are still ongoing in the TMJ/TMD research arena. Women also experience several autoimmune disorders ranging from rheumatoid arthritis to multiple sclerosis, to inflammatory bowel diseases to psoriasis. A recent study from Stanford University found that somewhere between 24 – 50 million Americans are affected by autoimmune disorders with as many as 4 out of 5 patients being women. There are an estimated 100 different types
18
of autoimmune disorders. Autoimmune diseases are a result of the body’s immune system overreacting, attacking and damaging the body’s own tissues. The exact causes of autoimmune disorders are unknown but there are theories as to what triggers them. Medications, genetics, and infections along with risk factors such as smoking, environment, or obesity are all indicated in the autoimmune disease development. Depending on the autoimmune disorder the symptoms can be varied but common symptoms include fatigue, joint and muscle pain and/or swelling, and dermatological or digestive issues. One of the common antidotally found autoimmune disorders in women in dentistry is Hashimoto’s Thyroiditis or other thyroid disorders (hypo or hyperthyroidism or thyroid nodules). For example, with Hashimoto’s, patients can experience fatigue, constipation, weight gain, depression, dry skin, and sensitivity to cold. I have heard from several women in dentistry who have or are experiencing issues with their thyroid. Another type of autoimmune disorder that I had never heard of until my own experience is polymyalgia rheumatica (PMR). PMR is an autoimmune, inflammatory disorder that can cause muscle pain and stiffness. This pain and stiffness is primarily seen in the larger muscle groups such as the shoulders or hips and appears on both sides of the body. The predominant patient population is Caucasian females after the age of 50. I began with shoulder and hip pain that didn’t resolve even with physical therapy. There were days when I had difficulty going up and down stairs or getting up from a seated position! PMR symptoms can occur suddenly or come on
dew.life