AS does not normally interfere with love-making. However, there are cases when it obviously can do, especially when the hips are involved or when the condition is in a flaring stage. However, there are some people who have lost a considerable amount of spinal posture which can also produce difficulties during love-making. Good dialogue between partners should surmount any problems, and don't forget a sense of humour. Tiredness can be involved with the condition and this therefore should be borne in mind and not be confused as some other signal.
There have been times, even during the last half of the century, when it was thought that women never developed AS. As a result they had a very raw deal and their problem was very often misdiagnosed as a gynaecological one. This is very odd when one considers that one of the first descriptions of a spondylitic patient was by a Londoner, Dr Benjamin Travers. In 1824 he described a girl with onset at 16 years of age who had ankylosed below the first dorsal vertebra by the time she was 19 years old. It is now thought that about 2.5 men get the condition for each woman.
The main differences in the sexes is that women tend to have more peripheral joint disease (reminiscent of children) and perhaps less aggressive spinal disease. Thus women were often mislabelled as having "seronegative arthritis" or one of the other inflammatory joint diseases. In general, the approach to treatment is the same in both sexes, although of course particular care should be paid towards women who may be of child-bearing age.
Generally speaking, pregnancy in AS is not a problem. In some types of arthritis, especially rheumatoid arthritis, the condition goes into remission during the pregnancy period. This unfortunately is not true with AS. As most births are during one's earlier life, the condition very often has not reached the stage when it could influence a difficult birth. However, where hips are involved, a caesarean operation might be necessary. It is usually advisable to stop taking anti-inflammatory drugs during the first 12 weeks and last 4 weeks of pregnancy. Try and increase your exercise programme at this time, in an attempt to reduce any tendency of increased pain due to not taking the anti-inflammatory agents. The restarting of your drug regime after birth does depend on whether you are breast-feeding.
It is important that all people with AS remain physically active. The most obvious sporting activity of benefit is swimming, since all of the muscles and joints are exercised in the horizontal position. It also helps to maintain lung capacity, which in the condition generally falls below normal. However, most people with AS can continue to take part in a sport of their choice. The notable exclusion is contact sports, such as boxing, wrestling, judo and rugby. It could be advantageous, if you do not already participate, to take up a sport, such as badminton or volleyball.
Most people with AS will find an increase in pain and stiffness during prolonged car driving. It is therefore important to keep breaking one's journey to walk around. Many people make frequent stops at motorway service stations and limber up. Many people with AS have stiff or rigid necks, others have noticeable neck restriction. This presents problems for drivers, especially at junctions. One must experiment with fixing an assortment of additionalmirrors. Most car accessory shops will have a selection. Some helpful ones available are small mirrors attached to suction pads which can be located around the windscreen and dashboard. Most modern cars now come equipped with head restraints. It is important that these, if adjustable, are appropriate and effective for each person's head position. Spondylitics with neck involvement can suffer severe injury to their necks, even in the event of a small impact. It is difficult to know at what stage the spondylitic driver should inform the driving licence authorities and driving insurance companies of the condition. In general, we advise that you should do so when there is severe neck involvement or peripheral joint involvement, especially the hips. The society feels that the licensing authorities are very willing to continue renewing all spondylitics' driving licences. At the time of writing this booklet not one of our members, as far as we are aware, has had their licence withdrawn. In some severe cases licences are issued for a few years and then revised. A few of these more severe spondylitic drivers qualify for the orange badge scheme.