Dry eyes, dry mouth, fatigue, and joint pain—these seemingly common ailments may not be simply caused by aging or stress, but rather early warning signs of Sjogren's Syndrome. Experts warn that this chronic autoimmune disease is particularly common in women, but is often misdiagnosed or has delayed treatment due to its often subtle symptoms and slow progression.
Dr. Liu Huini, Medical Director and Senior Consultant Rheumatologist at the Asia Arthritis & Rheumatology Centre, explained in an interview with Lianhe Zaobao that Sjogren's Syndrome is caused by the immune system abnormally attacking the glands that secrete tears and saliva, resulting in reduced tear and saliva production. Patients then experience the typical symptoms of dry eyes and dry mouth. If the disease progresses further, it can also affect other glands such as the nasal cavity, throat, skin, and even vagina. In severe cases, it can even affect the joints, lungs, kidneys, and nervous system, causing inflammation and pain.
"Sjögren's syndrome is easily misdiagnosed primarily because its symptoms are vague and overlap with other diseases. Common symptoms such as fatigue, joint pain, dry eyes, and dry mouth can also occur in many other conditions. These signs are easily mistaken for aging, menopause, stress, depression, or common illnesses such as allergies or fibromyalgia syndrome."
Furthermore, Sjögren's syndrome typically progresses slowly, and the clinical presentation varies from patient to patient, making it difficult to identify a clear pattern of symptoms early on. This often results in delayed diagnosis, with a diagnosis only made when more serious or specific complications develop.
Most women with Sjögren's syndrome do not experience impaired fertility. However, several factors can affect the chances of conception. For example:
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The proportion of female patients is far higher than that of male patients.
Among patients with Sjögren's syndrome, the proportion of women is 6 to 11 times higher than that of men. Dr. Liu Huini points out that this is related to hormonal differences. Women are more prone to complications such as vaginal dryness, thyroiditis, Raynaud's phenomenon, fibromyalgia, or depression, which seriously affect their quality of life.
"Many women believe that vaginal dryness is just a natural phenomenon of menopause, but it may actually be related to Sjögren's syndrome," Dr. Liu Huini reminds. Persistent dryness or discomfort during intercourse should be addressed by seeking medical attention as soon as possible.
In addition to dry eyes and dry mouth, Sjögren's syndrome can also cause the following symptoms:
· Dryness of the nose, throat, skin, or vagina, leading to itching, irritation, or painful intercourse;
· Persistent fatigue that does not improve with rest;
· Joint pain, stiffness, and swelling;
· Swelling of the parotid glands (in front of the ear or under the jaw);
· Tooth decay, gingivitis, or oral ulcers due to reduced saliva;
· If the lungs, kidneys, or nervous system are involved, more widespread health problems may occur.
Treatment Can Improve Quality of Life
Regarding treatment methods, Dr. Liu Huini points out that there is currently no cure, but most patients can maintain a good quality of life after receiving proper treatment. The focus of treatment is on relieving dryness, reducing pain, preventing complications, and monitoring overall health.
Common treatment methods include:
① Moisturizing and Lubricating: Using artificial tears, oral lozenges, moisturizing lotions, and vaginal lubricants.
② Drug Treatment: Medications for dry mouth include pilocarpine or ceviceline; joint pain and inflammation can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids; if the condition is severe or systemic, immunosuppressants may be necessary.
③ Dental Care: Regular checkups to prevent cavities and gum disease.
④ Lifestyle Management: Maintaining indoor humidity, adequate hydration, and good oral hygiene.
Dr. Liu Huini added that while complete remission of Sjögren's syndrome is rare, with consistent monitoring, adherence to medication as prescribed, and lifestyle adjustments, the condition can remain stable long-term.
Rheumatologists are the "key partners" in managing Sjögren's syndrome. They are responsible not only for accurate diagnosis and developing personalized treatment plans, but also for monitoring for organ involvement or risks such as lymphoma, and guiding patients on how to manage fatigue, maintain oral hygiene, and ensure mental well-being in daily life.
Furthermore, doctors also provide counseling and pregnancy management for women planning to become pregnant, assisting them in a safe pregnancy. Dr. Liu Huini emphasized that through proper treatment and self-care,
