It was once thought thatgout, the so-called “disease of kings,” typically spared queens. But in the last 20 years, cases of gout have more than doubled among women. Today, 2 million women – and 6 million men – in the U.S. have this inflammatory form of arthritis that causes joint swelling and telltale pain at the base of the big toe.
Natural Gout Protection and Potential Triggers
Gout occurs when high levels of uric acid build up in the bloodand form needle-shaped crystals in the joints, causing pain, swelling and redness. Estrogen, a female hormone, protects women. It naturally causes uric acid to be flushed out in their urine. When women lose estrogen after menopause, the level of uric acid in their blood starts to rise.
“The clock starts ticking after menopause in women,” says Brian F. Mandell, MD, rheumatologist at the Cleveland Clinic in Ohio and board member of The Gout & Uric Acid Education Society. “
这就是为什么，他说，很少看到绝经前的妇女或妇女雌激素替代治疗痛风。60岁之前患有痛风的女性通常有其他危险因素，包括服用利尿剂或有肾脏问题史。
But there’s more at work than just hormones. A study published in 2017 inBMC Musculoskeletal Disordersfound that in addition to being older, women with gout were more likely than men to have other conditions – including high blood pressure, diabetes, kidney disease andobesity. The research also showed that taking diuretics was more of a risk factor for women, while men had more dietary triggers.
这些发现表明，除了降低尿酸药物外，还可以帮助管理女性痛风。For example, the study authors reported that weight loss has been shown to decrease gout flares and can improve the management of associated comorbid conditions, such asosteoarthritisand diabetes.
How Gout Manifests in Women
Women tend to develop gout in their knees, toes, wrists and ends of their fingers.
“In women, gout likes to travel to those distal finger joints where they may already have some osteoarthritis-related damage,” explains Theodore Fields, MD, a rheumatologist at The Hospital for Special Surgery in New York City.
Sudden and severe attacks of gout——会在半夜把你弄醒——是最常见的第一症状。但与男性相比，随着时间的推移，女性痛风更有可能出现在多个关节。
“In women, it seems there is a greater prevalence of the initial episode of gout being in multiple joints. It may not always be the typical swollen great toe. In the hands this is often misdiagnosed as inflammatory osteoarthritis when it may actually be attacks of gout,” Dr. Mandell says.
Treating Gout is Key to Overall Health
Atypical symptoms unfortunately can lead to misdiagnosis. But recognizing gout in women is critical for both heart and kidney health.
A 2010 study published in theAnnals of Rheumatic Diseaseslooked at 9,642 people over age 65 with gout and 48,210 matched people without gout. Results showed that women with gout were about 39% more likely to have a heart attack than the control group. In comparison, men with gout were only 11% more susceptible to cardiovascular disease.
The culprit? Physicians think high levels of uric acid increase inflammation and make blood platelets “stickier,” which can lead to blood clots.
The good news is uric acid-lowering medications are highly effective. It was once thought thateating a low-purine dietmight be enough to stave off attacks, but Dr. Fields explains this method alone usually fails to lower uric acid levels enough.
“有一个巨大的误解，痛风是一种饮食疾病，”他说。“饮食会使痛风恶化，但它实际上是一种遗传疾病。”
The bottom line for women:
- Gout can show up in unusual places, so talk to your doctor.
- Take your medication as prescribed.
- Pay special attention to your heart and kidney health.
Author:Carolyn Sayre
Related Resources:
- ZERO FLARES: Wipe Out Gout Toolkit
- Gout Diet: Dos and Don’ts
- Treatments for Chronic Gout
- 5 Good Foods for Gout