How RA Affects Men and Women Differently
Lene Andersen | May 5, 2017
There are many individual differences in how people experience rheumatoid arthritis (RA). It is possible to generalize some of these differences, especially based on gender. Many studies include that gender as a variable, and this means that it is possible to identify the differences between men and women and how they are affected by RA.
More women get RA
Women are more likely to get RA, with up to three times more women than men having the disease. Forty-six genes have been identified as involved in the development of rheumatoid arthritis, several specific to the X chromosome (women have two X chromosomes, men have an X and a Y). Environmental factors such as smoking and vitamin D deficiency also play a role and may be related to the rise of RA in women.
Women get RA earlier
RA in adult women is possible after the onset of menstruation and is especially prevalent in women during the childbearing years between age 30 and 50, peaking around menopause. This potentially speaks to a hormonal influence in RA, which is supported by the fact that many women find symptoms worsen with their cycle. In men, the condition most often develops after age 45.
Blood test differences in men and women
Some of the common blood tests used in the diagnosis and management of RA include the RF factor and the anti-CCP. Women are more likely to have seronegative RA, with fewer testing positive for the RF factor. As well, women are less likely to have higher concentrations of anti-CCP antibodies, although this is not the case for women who share RA with a brother.
Prognosis of RA may be worse in women
Studies of outcome measures, such as patient and doctor assessment, blood tests, and a disability Index indicate that RA is somewhat worse in women. However, conclusions are tentative at best, as some of these results may be affected by the measurement tools used. Physical function is usually lower in women, which may be a result of RA, or could be related to men better being able to compensate due to greater muscle strength.
Additional autoimmune diseases
When you have a one autoimmune diseases such as RA, you may be more likely to develop additional autoimmune diseases. Conditions that can commonly occur with RA include lupus, Sjögren’s syndrome, and hypothyroidism. When certain autoimmune diseases such as lupus and multiplesclerosis (MS) occur together with RA, it may complicate the treatment of both the conditions, but much progress has been made in this area.
Mortality and RA
Untreated RA has an increased risk or of mortality, mostly due to systemic inflammation in organs such as the heart. Historically, this has led to a 10-year shorter life expectancy compared to the general population. Men are particularly vulnerable to systemic manifestations, having a higher mortality rate. New treatments have vastly improved RA outcomes, for joints and other systems in the body, as well as reduced mortality rates.
RA and osteoporosis
When you have RA, you are at a higher risk of developing osteoporosis. A more sedentary life style, taking steroids, and low levels of vitamin D may all contribute to lowering bone density. Women are in general at higher risk of getting osteoporosis after menopause due to lower levels of estrogen. One study showed that women with RA are twice as likely to develop osteoporosis as women in the general population. Talking to your doctor about measures to improve your bone health can help.
Improving RA outcomes
You can improve your experience of RA by using the tools available to reduce its effects. This includes aggressively treating the condition to minimize effect of inflammation on joints and other systems. Lifestyle changes can also contribute, such as stopping smoking, eating a healthy and balanced diet, and staying as physically active as possible. As well, stay on top of preventative care for heart disease, osteoporosis, and cancer.