Gout and Women

Is Gout More Common in Men or Women?

Although gout is widely considered a male disease, gout in women is not that uncommon. A 2008 US health survey found that 4% of women in their 60s and 6% of women in their 80s had gout. Among gout patients under the age of 65 there are as many as 4 times more men with gout than women. After the age of 65, the gap narrows a notch, for every 3 men with gout; there is 1 woman with the disease. The average age when women develop gout compared to men is usually about 7 to 12 years greater. The incidence of gout in women peaks at 80 years of age or older.

Women comprise about 5% of all gout patients but the incidence in women has doubled in the past 20 years. Since gout is considered as a “men’s disease”, gout is often misdiagnosed in women or the diagnosis is delayed quite often. Even though women can have the same blood uric acid levels as men, women still have a lower risk of developing gout than men. Women with blood uric acid levels over 5 mg/dc had a significantly lower risk of developing gout than men with totally identical uric acid levels.

Signs and Symptoms of gout in women

In a large study that examined gout by gender, the researchers found that obesity, high blood pressure, old age, alcohol consumption and the use of diuretics were considered risk factors to men as well as women. Other gender differences found by the study were that a higher amount of women over men suffered from high blood pressure and were treated with diuretics increasing the risk of developing gout.

Furthermore, if women drank more than 7 ounces of spirits which is roughly 5 drinks in the period of a week, then this doubled the gout risk in men and tripled it in women! Drinking lots of beer? Again this only doubled the gout risk in men but increased the risk of developing gout in women by 7 times! If you were an obese man or woman, the risk of developing gout was 3 times as much.

 

Menopause and Gout

Where men and women differ is in something called menopause that only occurs in women after the age of 51 on average. What happens is a woman’s body drastically cuts its production of the hormone estrogen. It is believed that estrogen may help the kidneys remove uric acid, so after menopause, a woman’s blood uric acid levels begin to increase. For most menopausal women, gout symptoms usually begin in the large toe and then affect the ankles, knees and wrists.

The onset of gout may occur at any point in the menopausal process as the kidneys continue to lose the support of the estrogen hormone. Taking estrogen as a hormone therapy appears to maybe lower the development of gout in women but the association was not statistically significant. Rock star gout researcher Hyon Choi has stated that estrogen is believed to lower uric acid levels in the blood and that hormone therapy can protect women against gout.

70% of women who develop gout are also more likely to suffer from a pre-existing joint disease, in particular, osteoarthritis compared to 37% of men. In addition, studies indicate that women who had a family history of the disease are more prone to develop the disease. Women are also more likely to develop tophi over men although bodily location may be different.

Treatments are the same in women as in men; the prescription medications used to treat the disease are usually allopurinol, colchicine, febuxostat and NSAID’s, avoid alcohol, discontinue diuretics if possible, maintain ideal body weight, exercise and follow a healthy diet. For those who want to dig deeper, there is a 2010 study that further discusses 14 studies done between 1977 and 2007 and points out many more statistics and differences between women and men gout patients. 

Adequate sleep is crucial for maintaining good health, particularly during postmenopause when sleep deprivation is prevalent. It has been associated with various health issues, including elevated serum uric acid levels known as hyperuricemia, which can increase the risk of gout and even life-threatening conditions like heart disease. A recent study published in Menopause, the journal of The North American Menopause Society (NAMS), suggests that postmenopausal women can potentially reduce their risk of hyperuricemia by engaging in weekend catch-up sleep.

Dr. Stephanie Faubion, NAMS medical director stated, “Elevated serum uric acid levels are associated with multiple cardiovascular disease risk factors, whereas sufficient, good-quality sleep has proven health benefits. This study shows that weekend catch-up sleep of just 1 to 2 hours was linked with a lower prevalence of hyperuricemia in postmenopausal women with insufficient sleep. Although the mechanisms responsible for these findings remain unclear, a weekend nap may be just what the doctor ordered.”