What Your Gender Means for Your Rheumatoid Arthritis

While women are three to four times more likely to develop RA overall, the disparity is muted in younger and older patients. “Rheumatoid arthritis has three peak ages: We see a peak in younger people around 30, then again around 50, and then there’s another peak of elderly onset RA that affects people in their 80s,” says Howard L. Feinberg, D.O., a professor of rheumatology at Touro University California College of Osteopathic Medicine. “The higher ratio of women to men with RA is in that 50s peak age group, which is also the most common group that gets arthritis.”

“思想是雌激素可能导致类风湿性关节炎的发病率增加以及妇女的其他自身免疫疾病，虽然我们尚未知道如何，”德克萨斯州休斯敦风湿病学中心的风湿病学家。“雌激素可以为疾病表现出一种有利的环境。”然而，棘虫单独解释一切 - 毕竟，ra确实发生在男性和绝经后妇女中，其雌激素水平显着降低。“我们怀疑环境triggerssuch as smoking or certain viral infections are also at play,” says Dr. Feinberg.

It seems to change in tandem with the flux of hormones she experiences, says Dr. Bose, though again the connections aren’t fully understood. For instance, the risk of developing RA is lower during pregnancy, when estrogen and progesterone levels are higher, and among women who breastfed for at least a year. On the flip side, RA risk rises after delivering a baby, and it’s higher in women who began menstruating at an early age, have an irregular cycle, or have never given birth. Finally, the risk goes down in postmenopausal women.

If youRA,决定尝试有一个孩子，先和你的医生交谈。“对于女性来说，如果你有活跃的疾病，不建议怀孕，所以我们劝告它，”博士博士说。“我们只有一些安全的药物，如低剂量泼尼松和羟基氯喹，可在怀孕期间使用;其他人必须在未来几个月停止。“一种common RA medication称为甲氨蝶呤可以减少精子数量;男人应该在试图怀孕之前一个月停止服用它。甲氨蝶呤和RA药物leflunomide（arava）是非常胎毒性的，并且应该在考虑怀孕的任何患者中避免所有费用。苏氟碱也可以降低男性的精子计数。

有证据表明，即使他们的疾病水平相同，ra对女性的经验比男性更痛苦，但专家正试图了解差异的来源。“男人和女人可能会用不同的症状，”Bose博士说。“女性往往是更多的声乐;男人可以更具抵抗开放，他们通常会遭受痛苦。“这也是患者个人和医学史的功能。“在有很多的人抑郁症或焦虑- - 译文或女人 - 他们的痛苦会很高。“

In general, the男性和女性的骨质疏松症风险较高, thanks to elevated levels of inflammatory cytokines, small immune-cell proteins that also cause bone to wear away, says Dr. Bose. What’s more, steroids—a common RA treatment—can cause bone loss. But women overtake men after menopause, when their chances of getting osteoporosis naturally climbs, due to a significant drop in the levels of bone-building estrogen. This means postmenopausal women who have RA are especially vulnerable to bone loss and fractures.

“Just having RA is a risk factor for cardiovascular disease due to increased inflammation,” says Dr. Bose. But younger men are at a higher risk than premenopausal women. “They tend to have other risk factors, such as high blood pressure, high cholesterol, diabetes, and weight gain.” Conversely, if you’re a premenopausal woman with RA, your higher levels of estrogen help to protect you from increased heart risks. “However, this protection will disappear in the decades after menopause, and at some point, the woman’s risk becomes the same as a 70-year-old male’s,” says Dr. Bose.

Bose博士说，如果有RA，那么减少耀斑和进展风险，以及发展耀斑和进展的风险，以及发展其他疾病的方式是妥善治疗您的疾病。此外，在可能的情况下，最小化类固醇的剂量和持续时间，以避免相关的副作用。最后，采用你所知道的习惯是健康和长寿的关键，说：“戒烟;每天至少吃4个低脂肪乳制品的均衡饮食;保持足够的维生素D水平;重量轴承exercises将钙调入骨骼;并管理压力。“