RA occurs in both men and women, but it’s a little more common in women.
Some people say that rheumatoid arthritis (RA) causes worse symptoms in women, but this isn’t entirely true. Statistics show that RA is more common in women and that they develop symptoms earlier, compared to men. However, there’s no evidence that women inherently have more aggressive forms of the disease.
Why do women get rheumatoid arthritis more often?
It’s not always obvious why diseases can happen differently among different genders. This is especially true when it comes to autoimmune diseases like rheumatoid arthritis.
The Progression Theory
Rheumatoid arthritis is generally progressive. The longer you have it, the more damage it can do. For women who get diagnosed at earlier ages, they will likely have more severe symptoms as they age than someone who only got diagnosed a few years prior.
For example, imagine two people: a woman who develops rheumatoid arthritis at age 40 and a man who develops it at age 65. Given the way that RA progresses, these two individuals are likely going to have different symptoms at age 80. The woman, who has been accumulating joint damage for 40 years, will likely have more severe symptoms and complications.
The Immune System Theory
The strength of someone’s immune system depends on many factors, including age, reproductive status, nutrition, their microbiome, and—yes—sex. A 2016 study from the Nature Reviews Immunology Journal found that both sex chromosomes and sex hormones appear to affect the immune response.
This is all to say that women generally have stronger immune systems than men. As a result, their immune systems may be more sensitive. This is one reason why women tend to get autoimmune diseases (including RA) more often.
“If there is something there that is tickling here or there, [the immune system] starts getting angry and starts attacking it quickly,” says Iris Navarro-Millan, MD, rheumatologist at the Hospital of Special Surgery. “It starts identifying things [like] your joints as foreign intruders.”
She continues: “Men’s immune systems tend to [let] them pass. ‘Eh, it’s okay. You can hang out there.’ But women’s immune systems [are] going to just go straight and attack it, even if it’s your own organ.”
The Hormone Theory
Female sex hormones tend to cause changes in joint laxity, meaning the way that the tendons and ligaments can stretch and move around. Joint laxity means you have increased mobility and range of motion, but too much laxity can cause an unstable joint.
Women can experience changes in their joint laxity throughout their lifetimes due to things like pregnancy and menopause. The increased joint laxity during pregnancy, for example, may affect joint health.
How can I get help for my RA?
The exact cause of RA may not yet be understood, but the benefits of early treatment are crystal clear. Those who learn their diagnosis early and start treatment as soon as possible have a better chance of slowing the progression of their RA. This means potentially less joint damage, fewer complications, and an overall better quality of life.
If you’re having symptoms of rheumatoid arthritis like joint pain, swelling, and stiffness, talk to your doctor and/or a rheumatologist. They can help you find out what’s going on, whether it’s RA or something else.
Dr. Navarro-Millan is a rheumatologist at the Hospital for Special Surgery.
- Klein SL. Flanagan KL. Sex differences in immune respones. Nature Reviews Immunology. 2016 Aug;16:626-38.
- Rheumatoid arthritis: causes, symptoms, treatments and more. Arthritis Foundation. (Accessed on August 25, 2021)
- The menopause-arthritis connection. Arthritis Foundation. (Accessed on August 25, 2021)
- Why women are at higher risk for getting arthritis. New York, NY: Hospital of Special Surgery. (Accessed on August 25, 2021)