Given that rheumatoid arthritis is a disease that medical professionals are still working to understand and do not know too much about, available knowledge about why it affects females more is limited and often speculative. That being said, there are some theories as to why it affects women more and researchers are continuously looking for answers.
RA is also often thought of as a disorder that affects older adults. While this population tends to encompass the majority of people who are affected by RA, the disease can also target people in the younger population. In fact, children can even get RA, though this is less common. The disease also gets worse with age which is just additional bad news for women. RA can also increase the risk of developing osteoporosis, something that women already have a heightened chance of developing.
Learning why RA disproportionately affects women can help us to better understand how to effectively treat it. RA affecting more women than men is not completely unprecedented. Many autoimmune diseases have imbalances in how they affect men and women. With RA, women are about 3 times more likely to develop the disease than men are.
One article talks about some of the theories as to why arthritis in general is more common among the female population. While not all of these theories are relevant for people with RA, some of them could certainly play a role.
The current theories
Women have been hearing about how their hormones will affect their life since they were little girls. Hormones may also play a role in our RA development. As with osteoarthritis, pregnancy hormones seem to have a protective effect in the development of RA. Women who are pregnant often report that their RA symptoms go into remission. This leads researchers to believe that estrogen is involved in the pathology of RA development. This would explain why there is an increase of RA in the postmenopausal age group of women, even though past studies have been conflicted on this data.
Some studies have also shown that women who have never been pregnant are at an increased risk of developing RA. Additionally, some oral contraceptives have been shown to have a protective effect against developing RA.
Genetics seem to play a role in almost everything and RA is no different. Though the causes are not fully understood, RA likely results from a combination of genetic and environmental factors. Most of the genes that have been studied in regards to RA are known or suspected to be involved in immune function.
According to one article, some recent studies have shown that the X chromosome (of which men have 1 and women have 2) has been linked to 14 new genes that could play a role in RA. This could play a role in why RA affects more women than men. Unfortunately, the article did not post a link to the study revealing this information, so validity is hard to establish. Additionally, while the inheritance pattern for RA is unclear, people who have a close relative with RA are more likely to develop the disease themselves.
Obesity can have a negative impact on RA and women are also more likely to be obese than men. Being overweight or obese can result in a lot of pressure being placed on the joints in the body which can exacerbate RA symptoms and contribute to joint deterioration. The positive side to this is that this is a modifiable factor. Although losing weight can be a huge challenge, the benefits it can have on your life are monumental, RA or not. If you have RA and are obese or overweight, talk with your healthcare provider about developing a plan to lose weight in a healthy way that will not make your RA symptoms worse.
What all of this clearly reveals is just how expansive the lack of information we have is on why RA disproportionately affects women compared to men. This may sound somewhat hopeless, but it is not. When we identify a lack of knowledge about something in science, it creates questions which are how all great research projects start. So, what this really means is that there is hope that we will begin to find more answers as researchers investigate these important questions.
In the meantime, the available information can be confusing. It does not exactly leave room for specific advice as to how women can work to decrease their chances of developing RA or manage it once they have it. While some factors may be out of your control, there are also things that you can do to lead a healthier life overall, and hopefully this will reflect positively on your joints as well.
There is not a lot of new advice here. It is the same song we have always heard. Eat healthily, stay hydrated, and exercise moderately. Sleep and stress management are important as well. Additionally, many people tend to neglect their healthcare appointments when the roller coaster of life takes over. When you are worried about work, your kids, your parents, and who knows what else, your personal health may fall to number 10 on your priority list. Even though you may be feeling fine in the moment, it is important that you see your healthcare provider for your routine check-ups. This can help you monitor changes in your health, prevent conditions from developing, and pick up on things that may be developing early on. For RA this can be beneficial. If you pick up on it early, you can start treatment sooner and hopefully prevent some of the joint damage.
Making the changes to lead a healthier life can be tough, but it is not impossible. A good place to start is with a thorough evaluation of your baseline. Take a look at your sleep habits and how you manage stress. If you think you could be getting better sleep, see if you can make some changes. Good sleep hygiene starts with avoiding caffeine in the evening, going to bed and waking at the same time every day, as well as avoiding the addictive screens of your cell phone right before bed. As for stress, it is probably safe to say that almost every American has room for improvement in this category. Reach out to your loved ones for support and do not be afraid to seek professional help if you think you need it. Exercise can be extra tricky. The key is to start slow and listen to your body. If you already have RA try to engage in some lower impact activities such as yoga and swimming to help preserve your joints. This is another lifestyle change that your healthcare provider can help you make safely and effectively. Just make sure that you find something you enjoy so that it is easier to stick to a routine!