Do women have more severe arthritis, or are we just more open about it?

Well, I have Lupus, which is a lot like RA and I find that my doctor is the only one I really "complain" to, more so to get a better treatment regiment than anything else. My friends and family hardly hear a peep out of me unless it's a really awful day, but even then I keep it to myself a lot of the time. For me, talking about it with them doesn't help anyway, because they don't understand what I'm going through anyway.

But if I tell the doctor about every time I have a flare, it's more likely to get a response. Lately though, I haven't been as vocal because they're not really helping me either.

As for men not talking about it as much, I've noticed that men are more inclined to play it off with their doctors to be tough and then being more "complainy" around the people who help to take care of them. Then again, I think (and I know its' kind of wrong) that men complain more about pain and colds and all that more than women anyway. Or maybe I just keep running into guys who are wimpy when it comes to sickness and women who are tougher. ::shrugs:: who knows. Anyway, those are my 2 cents.

Hi Christine,

This is an interesting post that you made. As a Physical Therapist who has spent thirty one years talking with hundreds of patients about their musculoskeletal complaints, I have found that in most cases women tend to be much more descriptive of their pain complaints than men. ( Not to be confused with "they talk too much"). During evaluations women tend to use many words to describe their pain and bring up multiple functional activities that reproduce their pain. Take shoulder joint pain for example: women may describe their pain as sharp, burning, stabbing etc. and they tend to describe all of the different movements/activities that make the pain worse. Men tend to say "it hurts in my shoulder when I raise my arm". If men come in during the Fall of the year, many will say "it doesn't hurt when I hunt, but I think it would get better if I had a few days off from work". 

With regard to whether physicians listen to female patients, sometimes too much information clouds the issue. Physicians are looking for specific pieces of information that will guide them into differentiating a shoulder problem form a neck problem that may be referring pain into the shoulder area. The more precise and concise any patient can be the better chance they will have for an accurate diagnosis and treatment.

During the study you mentioned, I don't know exactly what they were measuring but if it is a patients verbal response to a particular test the results will vary tremendously between sexes, age groups and nationality. Part of my career was spent in a setting where we treated a large multinational population. Pain response from one group 

varied greatly form another group with similar injuries. 

Finally, to address functional activities during pain is easy. Women Win!!! This may vary to some extent but women will tend to carry on their daily activities with pain much more than men. Soap Operas are only on about three hours a day but sporting events can go on forever. (just a thought).

Obviously,this response does not represent any scientific research, just observations made of human beings acting in human ways. If we all had tails to wag life would be easier. No wag: unhappy, wagging:happy

Thanks

Chuck

I believe there may be several reasons for this disparity. First and foremost, I feel that women as a whole are more likely to discuss the way they feel physically and mentally. Women are more willing to admit to feeling depressed and being in pain. Men may think that if they admit to being depressed that they risk appearing weak and after all, men are not supposed to admit to being in pain or being depressed. Also, being in the medical field, I do know that hormones play a huge role in women's physical well being during their menopausal and post menopausal ages. As our hormones decrease, we see a big change in our bodies. My mind and they the way I think is still young, but I cannot change the fact that my body is getting older. I have to face the fact that I cannot do the same things that I did in my teens and 20's. I cannot take for granted that I will consume the correct amount of vitamins without taking supplements, that I will stay the same weight without exercising, my skin will stay supple without hydration, that I do not need bifocals to read, etc. etc. There are many benefits to growing older like grandchildren, becoming wiser about life and just understanding that you can slow down and enjoy life and what it has to offer. It is all in your mind and how you perceive yourself. If you can keep a positive self image, you can keep getting up in the morning and enjoying life to its fullest! That's my two cents.

I think men under report symptoms because they are trying to be macho.

They probably have the same amount of pain as women do.

Great article, Christine! And great breaking down of the issues.

I think it's currently impossible to tell.  As you said, using the same tool to measure the issues may affect the validity of the results - am I the only one who's hearing shades of the gender bias in diagnosing heart attacks which was finally discovered to present differently in men and women?  Well, the gender bias in pretty much measuring anything...  it's quite possible that women may be more willing to share information about pain (physical and emotional), but the impact of hormones can't be ignored. At minimum, I think this study and the problems with its design may lead to more studies regarding the issue and hopefully, they wil be able to iron out the kinks that may have affected the results.

I just want to say thanks to everyone for your interesting comments and varying perspectives.  It has certainly been an interesting topic to ponder and I look forward to future research and discussion.  The interplay between mind, body, genetics, gender, environment and culture and their individual and collective influences on the body have always been fascinating for me. 

Christine

My Grandma and my Dad both had RA. I do not remember my Grandma complaining, she would say her rumatism was acting up, but she continued to do everything she liked including crocheting and piecing quilts until she was 90 years old. My Dad had bad RA and suffered a lot but he still tried to do the things he liked until he just could not anymore. He did not really complain either but I have no idea what he told his doctors. My opinion, for what it is worth, is that women are much more specific in their descriptions of pain or issues with their health. I also feel, after dealing with this disease personally for 35 years, that women have a tendency to just keep on going even when they are sick and/or in pain. We know what we need to do and we just keep on doing it especially if we have young children and/or a job. I had both. Interestingly where I live even thought I see men at my rheumatologist I do not personally know any with RA but I do know women that have it. The men I know who complain of arthritis have OA. Since it is an auto-immune does that mean that women are more likely to get it due to the amount of and/or the way we deal with stress?

I am a man that lives with RA.  My joints and body hurt almost daily.  I do have periods of time that I go through remission and I can almost live a life that I forget I have RA.  Like anyone with RA I have flare ups and periods of time where I feel absolutely awful.  I try and answer all of my questionnaires as truthfully as I possibly can.  I also am straight forward with my rheumatologist and tell him my pains and suffering that I experience.  I think I do a fairly good job of describing the pains to him and what I am going through. 

I really don't buy that men are too macho to tell what is hurting when dealing with RA.  I have accepted that I needed help to get my life back to a more normal state of living.  Without fully describing my symptoms I don't feel I would get the care I need to fully function and be able work to support my family.

My mother has severe RA and she does not complain as much as she cries and feels the pain of her symptoms.  I can see her swelling and her nodes and hear the pain in her voice when she is describing the pain she is going through.  I see this disease fully taking her life from her.  She is not as active anymore.  Stays home a lot more, cooks less, cleans less and lays down a lot more. 

We were diagnosed about 6 months apart from one another.  She was diagnosed in the spring and I was diagnosed in the fall.  Some items of interest are we had about the same RF.  Our blood work came back about at the same levels but her joint damage is much more severe.  She had the symptoms a lot longer before she was diagnosed then I did.  Her being diagnosed a few months prior helped me get a quicker diagnoses which I believe was the key to the way I feel and the way she feels.  We are also on about the same medications and I have responded a lot better to the meds than she has responded.

I also believe that me staying active and seeing my physical therapist helps me a lot compared to my mother's activities.  I have been able to scratch the prednisone since I have started seeing my PT and my swelling has been drastically reduced in my elbows (my main problem area).  I also have two small boys under the age of 4 that keep me going.  I almost feel that I have to keep going to help out with my boys.  I don't think it is all on gender that determines pain and comfort but how active and how your perceive your condition as huge determining factors.

My feeling is if you perceive this condition as it is taking your life, it will take your life and you will have more pain.  If you perceive the condition as it is something you can live with you will have less pain and hang ups.  I am not saying you won't have your ups and downs but you will manage to live your life more pain free.