What are the symptoms of EDS in women?
The main symptoms are the same in women and men: flexible, unstable joints, pain, fatigue and skin that bruises easily. Women and girls tend to have more flexible joints than men and boys. Women with hypermobile EDS also often have:
- Heavy or painful periods
- Bladder leaks, or needing to pee urgently
- Prolapse, where the womb, bladder or bowel drops down
- Pain during sex
Studies suggest between 20% and 75% of people with hEDS have at least one pelvic floor problem. Pregnancy adds strain to loose joints and the pelvis, so tell your midwife or doctor about EDS early.
Vascular EDS makes pregnancy much riskier, because the womb and arteries can tear. If vascular EDS runs in your family, see a genetic counsellor before trying for a baby.
EDS symptoms in adults and children
People are born with EDS, but symptoms usually show in childhood. Children with hEDS may have leg pain often called growing pains, pain from repeated tasks such as handwriting, and poor co-ordination.
Most children are very flexible, so doctors are cautious. The 2017 hEDS criteria are for adults. Children with troublesome hypermobility are usually given a hypermobility diagnosis and checked again once they stop growing.
Joints tend to get a little less flexible with age. Long-lasting pain, fatigue, headaches and gut problems often become the main issue from the teenage years into the forties. Many adults are only diagnosed then.
Can you see EDS? Signs in the face, eyes, skin, hands and feet
Usually not. Most people with hypermobile EDS look like anyone else. Some signs you can see do help doctors, especially with the rarer types.
| Where | What doctors look for | Most linked with |
|---|
| Face | A thin nose and lips, large or prominent eyes and small earlobes | Vascular EDS |
|---|
| Eyes | A fold of skin over the inner corner of the eye | Classical EDS |
|---|
| Eyes | Dry eyes, strong short-sightedness and loose eyelids | Hypermobile EDS |
|---|
| Skin | Soft, velvety skin that stretches and snaps back, with wide, thin scars on the forehead, chin, knees or shins | Classical EDS |
|---|
| Skin | Thin, see-through skin with visible veins, especially on the chest | Vascular EDS |
|---|
| Skin | Stretch marks without weight change, and easy bruising | Hypermobile EDS |
|---|
| Hands | Little fingers that bend back past 90 degrees and thumbs that touch the forearm | Hypermobile and classical EDS |
|---|
| Hands | Hands that look older than your age | Vascular EDS |
|---|
| Feet | Flat feet, and small bumps of fat on the heels when you stand | Hypermobile and classical EDS |
|---|
| Mouth | Crowded teeth and a high, narrow roof of the mouth | Hypermobile EDS |
|---|
None of these signs means EDS on its own. Doctors look at the whole picture, including your history and your family.
Is it hypermobility, HSD or EDS?
Flexible joints on their own are common and usually harmless. Around 1 in 30 people have hypermobile joints, and most do not have EDS.
Hypermobility spectrum disorder (HSD) is when flexible joints cause problems such as pain, sprains or dislocations, but you don’t meet the criteria for a type of EDS. HSD can affect your life as much as hEDS, and it is treated the same way.
Doctors often start with the Beighton score. You get 1 point for each of these:
- Each little finger bends back more than 90 degrees (1 point per hand)
- Each thumb bends back to touch the forearm (1 point per hand)
- Each elbow bends backwards more than 10 degrees (1 point per arm)
- Each knee bends backwards more than 10 degrees (1 point per leg)
- You can put your palms flat on the floor with your knees straight (1 point)
A score of 5 or more out of 9 suggests widespread hypermobility in adults up to 50. The cut-off is 4 over 50, and 6 in children before puberty. Shoulders, neck, jaw, hips and ankles aren’t in the score, but they can be hypermobile too.
When should you see a doctor about EDS symptoms?
See a GP or family doctor if you have several troublesome symptoms. They may refer you to a rheumatologist or a genetics service. You don’t usually need to worry about a few mild symptoms that aren’t causing problems.
Get medical help straight away for the vascular EDS warning signs above, or for sudden pain or bleeding you can’t explain, chest pain, trouble breathing, fainting when you stand, or sudden changes in your vision.