Traditionally first recognized as a "man’s disease," ankylosing spondylitis is two to three times more frequent in men than women.

Some studies indicate that men with AS are more likely to have their spines fuse into a solid bone when fusion is present. However, this also means that once the inflammatory process has died down, men may feel less pain than women experience, where the fusing may not occur or take much longer to take place. The average age of onset does not differ significantly between the sexes.

Depression in Men
Having a chronic disease like spondylitis puts someone at greater risk for developing major depression. One British study showed that 37 percent of people with spondylitis suffer at least one bout of depression during a lifetime.

Many cutlures severely stigmatize people with depression and do not encourage recognition of the condition. This explains why some people with depression go untreated for a very long time. In fact annually, it is estimated that at least six million men in the U.S. suffer from a depressive disorder. Research shows that both men and women develop the standard symptoms of depression, but they often experience depression differently and may cope in different ways.

Men tend to be more willing to acknowledge fatigue, irritability, loss of interest in work or hobbies, and sleep disturbances, rather than feelings of sadness, worthlessness, and guilt. Some men deal with depression by throwing themselves compulsively into their work, attempting to hide their depression from themselves, family, and friends; other men may respond to depression by engaging in reckless behavior, taking risks, and putting themselves in harm's way.

Fortunately, depression is a treatable disease. Over 80 percent of people recover from depression given an appropriate diagnosis and treatment, including medications and short-term psychotherapy ("talk" therapies), or both.

Fertility in Men
Spondylitis is disease of young people, and the average age of onset is 26 years -- prime time for starting a family. If this is your situation, it is important to talk with your doctor about fertility issues, specifically how your medication may adversely affect your ability to father a child.

For example, the prescription drug sulfasalazine (azulfidine), which is often prescribed to treat the painful swelling of the extremities in spondylitis, is known to cause low sperm count in one-third of the males who take the drug, according to Allan Metzger, MD, Los Angeles, CA. Fortunately, there are no known permanent problems regarding reproduction in men who take this medication. Sperm can be banked prior to beginning the medication, or a patient can go off sulfasalazine for several months before trying to start a family. The drugs methotrexate (rheumatrex) and cyclophosphamide (cytoxan) are two other examples of medications that may adversely fertility in men.

The newer the drug, the less likely that it has been tested with regards to fertility, pregnancy, and lactation. Currently, there is a lack of data on the effects of anti-tumor necrosis factor (TNF-a) drugs and COX-2 inhibitors in this arena.

Links to Additional Information

http://www.nlm.nih.gov/medlineplus/menshealthgeneral.html - MedlinePlus is a goldmine of health information from the world's largest medical library, the National Library of Medicine. The "Men’s Health" section contains detailed disease descriptions, and the latest updates on medical news, research, nutrition and statistics as relating to men.

http://menanddepression.nimh.nih.gov - The National Institute of Mental Health (NIMH) talked with men about their experiences with depression. Interviewees include a retired U.S. Air Force First Sergeant, a firefighter, a writer, a publisher, a national diving champion, a lawyer, a police officer, a student, and others.

http://www.rxlist.com - This database of approximately 5,000 product names is updated every several days. Search for medications by name to find patient fact sheets on correct dosage, side effects (including fertility information), etc.