Is Rheumatoid Arthritis Worse in Women Than it is in Men?

by Nathan Wei

Posted on Friday 30th of January 2009

Rheumatoid arthritis is the most common inflammatory form of arthritis and affects approximately 2.1 million Americans. For years, it has been common knowledge that rheumatoid arthritis is more common in women than it is in men. The ratio has ranged any where from 60-70 per cent women greater than men.

Now... a new Finnish study has proposed that rheumatoid arthritis tends to affect women much more aggressively than it does men.

In the study, women tended to complain much more of symptoms like aches, pains and tiredness even when they appeared to have the same level of disease as men.

Details of their study of over 6,000 patients from 25 countries was published in the January 2009 issue of Arthritis Research and Therapy.

In this study, men and women were asked to complete questionnaires about their disease and underwent x-rays and multiple laboratory tests to assess how advanced their arthritis was.

The lead researcher, Dr Tuulikki Sokka, stated, “The level of rheumatoid arthritis appears to be pretty much the same in both sexes but the symptoms of joint tenderness and things like that appear to be worse in women. We found that women tell us they have more severe symptoms."

While it is tempting to hypothesize it is because women are “weaker”, which is what the Finnish researchers posited, it is more likely that other factors account for this finding.

It may be that muscle mass plays a role and that damage due to rheumatoid arthritis may become much more apparent and symptomatic because of this factor.

Hormonal imbalance may play a role since rheumatoid arthritis is not only more common in women but it tends to go into remission in women who become pregnant. This is a phenomenon that still defies explanation.
Women also tend to be less reticent to voice their complaints.

Another possibility voiced by British researchers commenting on the study suggested that women may actually have more severe disease than men do.

Measurements of disease activity are not gauged according to gender. In clinical trials, measurement of disease activity is the same whether the patient is male or female. This may skew results in a study of this magnitude.

Women may actually suffer from a more severe variant of the disease.

This hypothesis is supported by another observation.

The British researchers commented that when they looked at the data, they noted that women tended to have more erosions (destruction of bone) than men did."

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