According to the Mayo Clinic, Rheumatoid Arthritis impacts two million people in the United States (1), and it is two to three times more likely to occur in women than men (2). (Lupus is nine times more likely in women than men (3)).
Only women in Hawaii were in the lowest prevalence group for having RA, and men in only two states, Missouri and West Virginia, were in the highest group (4). There was no location in the United States in which men had a higher incidence rate of RA than women.
RA isn’t the only disease that is more common in women. Many autoimmune diseases are. RA, Lupus, and Multiple Sclerosis impact 8.5 million people in the United States, about 6.7 million of which are women (3).
One article offers several explanations for why RA is more prevalent in women than men, none of which are completely satisfactory: 1) Environment, 2) Genes, 3) Behavior, 4) Various aspects of the whole organism, and 5) Hormones (5).
Several of the articles I came across attempt to clarify the fact that being a woman doesn’t increase your risk of developing RA, despite the fact that the disease is more prevalent in women.
Most studies point to female hormones as having a significant impact on disease, however, this finding is tenuous because many women with RA go into remission during pregnancy, a time when an increase in hormones would suggest that the opposite is likely to occur (6).
It is also suggested that when it comes to the remission of RA, men are more likely to achieve a remission state than women are (7).
According to the same article: “The differences in the male to female ratio of autoimmune diseases is the single most bizarre clinical fact about these diseases. It has not received a great deal of research attention so far, but finding the answer will teach us a great deal about these diseases” (5).
Some have gone as far as to suggest that gender differences such as muscle mass and strength may be part of the reason why men seem to suffer less often and less severely from RA than women, but to me, this idea merely reinforces already existing gender disparities that have been socially created; that men are stronger than women and therefore are more immune to the disease, or are more capable of dealing with it than women are (8).
So why has there not been a lot of research given a fact that may seem glaringly obvious to some? There actually has been a fair amount of research, but other than saying RA is more prevalent in women than men, and that most likely, hormones, in some way, shape, or form, are the cause of this disparity, there isn’t much research that goes beyond those typical findings.
And unfortunately, the sociologist in me believes with a high degree of certainty that if Rheumatoid Arthritis (and Lupus and Fibro) and others that are so-called “women’s diseases” were more predominant in men (instead of women), that we would be much farther on the road to a cure. I hate to say that, but I think that’s the truth. (Or you can blame it on my liberal education)
From a sociological perspective, disparities when it comes to treatment by the medical profession are not at all surprising, especially as far as gender is concerned. Women’s symptoms are typically psychologized, meaning that doctors are more likely to tell women that their symptoms are “all in their head,” that they are depressed as opposed to being physically sick, and are treated as being overly emotional (9, 10).
But just imagine for a second…Imagine if legions of American men were walking around in constant and unending pain. I can’t imagine them getting brushed aside to the degree that women do.
It’s kind of crazy, but in a way, we have to fight to get these diseases acknowledged and diagnosed. And this may be one avenue that accounts for many of these diseases being “worse” in women than men. It takes us far longer to get a proper diagnosis.
So in honor of women’s history month, I wanted to provide a feminist perspective on RA. Clearly, there is something going on here. I don’t think that these issues and differences can or should be easily explained away.
(One interesting thing to note about lupus: Recently, while discussing celebrity Nick Cannon coming out to the public about his diagnosis with lupus nephritis, the Lupus Foundation of America suggested that men with lupus have a worse prognosis than women. I had never heard that before. (11))
Disclaimer: While this article focuses on gender, it does not discount the other disparities that occur as far as health is concerned. This is just focusing on a piece of that disparity.
3. Whitacre, Caroline C., Stephen C. Reingold, and Patricia A. O’ Looney. 1999. “A Gender Gap in Autoimmunity.” Science 283 (5406): 1277-1278.
4. Theis, Kristina A., Charles G. Helmick, and Jennifer M. Hootman. 2007. “Arthritis Burden and Impact Are Greater Among U.S. Women than Men: Intervention Opportunities.” Journal of Women’s Health 16 (4): 441-453.
6. Brennan, P., and A. Silman. 1995. “Why the Gender Difference in Susceptibility to Rheumatoid Arthritis?” Annals of Rheumatic Diseases 54: 694-695.
8. van Vollenhoven, Ronald F. 2009. “Sex Differences in Rheumatoid Arthritis: More Than Meets the Eye…” BMC Medicine 7 (12): np.
9. Verdonk, Petra, Yvonne W.M. Benschop, Hanneke C.J.M. De Haes, and Toine L.M. Lagro-Janssen. 2008. “Medical Students’ Gender Awareness.” Sex Roles 58: 222-234.
10. Heritage, John, and Douglas W. Maynard. 2006. “Problems and Prospects in the Study of Physician-Patient Interaction: 30 Years of Research.” Annual Review of Sociology 32: 351-374.
Other Helpful Resources About Gender And Autoimmunity
Published On: March 12, 2012