Guest Article: Arthritis and the gender bias – why women face the heat more

Guest Article: Arthritis and the gender bias – why women face the heat more

Women may face severe symptoms, greater joint deterioration, and slower treatment responses.

Dr Syed Imran

Mumbai: Arthritis isn't just a single disease; it's a term that covers over 100 different conditions affecting joints and their surrounding tissues. It's a leading cause of pain and disability worldwide. While it affects people of all ages, genders, and races, studies and my experience indicate a startling gender disparity in its prevalence and severity.

What stands out in my years of practice is that arthritis disproportionately affects women more than men. This isn't just a statistic; it's a reality that many of my female patients live with every day. They often experience more severe symptoms, a higher degree of joint deterioration, and even a slower response to treatments.
Why are women more affected with arthritis?

Women are more commonly affected by arthritis than men, and several factors contribute to this disparity:

a    Hormonal Differences: Estrogen, a female hormone, plays a significant role in the development and severity of arthritis. Post-menopausal women, who have lower estrogen levels, are particularly susceptible to developing arthritis.
b    Genetic Factors: Certain genetic factors that predispose individuals to autoimmune diseases (like rheumatoid arthritis) are more common in women. This genetic predisposition can result in a higher incidence of arthritis among women.
  Biomechanical Variations: Women have wider hips and a different knee alignment than men, which can impact the way joints are used and potentially lead to increased wear and tear. This biomechanical difference can contribute to the development of osteoarthritis, particularly in the knees.
d    Immune System Differences: Women's immune systems function differently from men's, partly due to hormonal influences. This difference can make women more susceptible to autoimmune conditions, including certain types of arthritis like rheumatoid arthritis.
  Increased Longevity: Statistically, women live longer than men. Since age is a significant risk factor for many types of arthritis, the longer life expectancy in women could contribute to a higher incidence of arthritis.
  Physical Activity Levels: Women may engage in different types and levels of physical activity compared to men, which can affect joint health and the risk of arthritis.
   Obesity: Women have higher rates of obesity compared to men, and obesity is a known risk factor for arthritis, particularly osteoarthritis.

Lifestyle changes and medical treatments to deal with arthritis in women

lifestyle changes and treatments for arthritis, particularly in women, play a crucial role in managing the condition. Here's an overview:

Lifestyle changes

1.    Exercise regularly: Regular physical activity strengthens muscles around joints, improves flexibility, and can reduce pain. Activities like walking, swimming, or yoga are gentle on the joints.
2.    Maintain a healthy weight: Excess weight puts additional stress on weight-bearing joints, like hips and knees. Losing weight can relieve this pressure and improve symptoms.
3.    Balanced diet: A diet rich in fruits, vegetables, whole grains, and lean proteins can help reduce inflammation. Omega-3 fatty acids, found in fish and flaxseeds, are particularly beneficial.
4.    Quit smoking: Smoking increases the risk of certain types of arthritis and can exacerbate symptoms. Quitting smoking can improve overall health and joint health.
5.    Manage stress: Chronic stress can aggravate arthritis symptoms. Techniques like meditation, deep breathing, and mindfulness can help manage stress levels.
6.    Adequate rest: Balancing activity with rest is important. Good sleep helps in the healing and repair of joint tissues.

Medical Treatments

1.    Medications:

a    Pain relievers: Over-the-counter pain relievers like acetaminophen can alleviate pain.
b    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These reduce both pain and inflammation. Available over-the-counter or by prescription.
c    Disease-Modifying Antirheumatic Drugs (DMARDs): Used for rheumatoid arthritis, DMARDs slow the progression of the disease.
d    Biologic response modifiers: Typically used in conjunction with DMARDs, these target parts of the immune system that trigger inflammation and damage joints.

2.    Physical therapy: A physical therapist can develop an exercise regimen to keep joints flexible and strengthen the muscles around the joints.
3.    Joint assistive aids: Braces, shoe inserts, or other devices can help support the joints and reduce strain.
4.    Surgery: In severe cases, joint repair, joint replacement, or joint fusion surgeries might be necessary.
5.    Alternative therapies: Acupuncture, tai chi, and massage therapy might provide additional relief for some women.

As we continue to grapple with the complexities of arthritis, particularly in women, our approach must be multifaceted. It requires collaboration between healthcare providers, researchers, patients, and society at large. My hope is that through increased awareness, targeted research, and personalised care, we can alleviate the burden of arthritis, especially for the women who disproportionately suffer from it.

This article has been authored by MBBS, D ortho, DNB orthopedic surgery, fellowship in joint replacement, fellowship in revision joint replacement (Germany); consultant Orthopaedic, arthroscopy and joint replacement surgeon Dr Syed Imran.