About 1.3 million Americans suffer from rheumatoid arthritis (RA), with women being 2.5 times more likely than men to develop the disease. Unlike previous decades, people with rheumatoid arthritis have access to a wide variety of effective drugs.

Many of these drugs help to suppress the immune system, reduce inflammation, and relieve joint pain and stiffness. However, many rheumatoid arthritis drugs have side effects that are of particular concern to women.

Learn more about three of these side effects and how you can reduce your risk of developing them.


The problem: It's not unusual for people with RA to suffer from anemia. According to the National Anemia Action Council, chronic inflammatory conditions such as RA can cause an insufficient supply of iron for red blood cell production and bone marrow suppression.

But, in some cases non-steroidal anti-inflammatory drugs (NSAIDs) may also be the culprits. These medications widely used to treat rheumatoid arthritis can cause stomach and intestinal bleeding, which may lead to chronic severe anemia.

Possible precautions: Speak to your doctor about the risks of any NSAID you're taking and about taking an iron supplement. Opt for the lowest possible NSAID dose to combat your rheumatoid arthritis symptoms.

Also, watch out for symptoms of anemia such as fatigue, dizziness, heart palpitations, chest pain, black or bloody stool, and rapid heart rate or breathing. Seek immediate medical attention.

Irregular Menstrual Bleeding

The problem: Many women find that their RA symptoms are worse around that time of month when they have their period. Hormones such as estrogen and progesterone play a role in the immune system, which may account for the effects on rheumatoid arthritis.

However, rheumatoid arthritis drugs called corticosteroids can also interfere with the menstrual cycle. These drugs also affect female hormones, and they may cause either heavy bleeding, or in some cases amenorrhea, the absence of a period.

Possible precautions: There's a pile of research that indicates you should take the lowest possible dose of corticosteroids to manage your arthritis symptoms; speak to your doctor to make sure that you are. He may also recommend adjusting the dose of rheumatoid arthritis drugs when you're menstruating.

Also, weight loss, therapeutic exercises such as strengthening and flexibility, and fish oil supplements may reduce the amount of corticosteroids you need to take. 


The problem: Women are already more at risk for osteoporosis than men, making up 68 percent of those afflicted with the disease. They're also more likely to suffer from rheumatoid arthritis, which increases the risk of osteoporosis, a disease characterized by brittle bones and fractures.

In rheumatoid arthritis, lack of mobility, pain and the immune system's attack on bones -particularly around the joints - all contribute to osteoporosis. However, corticosteroids, commonly prescribed rheumatoid arthritis drugs also weaken bones, further increasing your risk of osteoporosis.

Possible precautions: Again, make sure you're taking the lowest possible dose of corticosteroids to control your rheumatoid arthritis symptoms.

Also, doctors often recommend that women taking these rheumatoid arthritis drugs also take a calcium and vitamin D supplement daily to avoid some of the side effects. Or, you may need to take a bone-protecting medication such as risedronate (Actonel®), or raloxifene (Evista®).