Incidence of Rheumatoid Arthritis Increasing, in Women Especially
Recent study finds more Rheumatoid Arthritis – Women Harder Hit
Science Daily reported this spring that Mayo researchers found an increased incidence of Rheumatoid Arthritis, especially in women. “Between 1 and 2 million Americans suffer the effects of RA, a chronic inflammatory disease that targets joints and which contributes to work-related disability, increased morbidity, and shortened survival. Up to one-half of all RA patients become unable to work within 10-20 years of follow-up and those with the disease have a 60% to 70% higher mortality risk than those in the general population. Furthermore, studies show that RA treatments alone account for $9 billion in excess health care costs with direct and indirect costs expected to exceed $39 billion annually.”
The study published in Arthritis and Rheumatism “comprised 466 patients, 69% of whom were female and 66% of whom were rheumatoid factor positive.” All were adults diagnosed with Rheumatoid Arthritis between 1995 and 2007 according to the 1987 American College of Rheumatology diagnosis guidelines.
Increase in Rheumatoid Arthritis an unhappy surprise
Previously, it was estimated that 1.3 million Americans had RA and it was believed that RA cases had been declining since the 1950’s. The new numbers increase the estimate to 1.5 million. The lead Mayo researcher Sherine Gabriel said, “This modest but statistically significant rise is unlikely to have occurred by chance alone.” While the incidence of Rheumatoid Arthritis in men had dropped slightly, RA incidence increased by 2.5 percent a year in women.
It is interesting that the increase in RA occurred was across all age groups. Some have proposed that the disproportional increase in women with RA may be due to changes in birth control formularies or the fact that fewer women have quit smoking than men. The age statistics make me wonder whether those explanations are adequate.
Why are there more women than men with Rheumatoid Arthritis?
Most theories hypothesize that the hormone estrogen is part of this puzzle. More women do develop Rheumatoid Arthritis symptoms during the months after childbirth or during the pre-menopause years.
A study published in 2003 explored reasons for the larger number of women diagnosed with Rheumatoid Arthritis in comparison to men. Irregular menstrual cycles correlated with an increased risk of RA. And women who breastfed longer than twelve months were less likely to develop Rheumatoid Arthritis.
Intriguing!
- In a 2008 video on ABC News about Rheumatoid Arthritis in women & men, a rheum doctor says, “Actually it’s very interesting, more women develop rheumatoid arthritis. The ratio is really about four to one. And it is thought to be related, although it’s not completely understood to estrogen levels putting women at risk for rheumatoid arthritis. Having said that, I have many many men in my practice who are real men with rheumatoid arthritis.” Why does she say “real” men?
- Did anyone notice? Only 66% of those in the study about RA were Rheumatoid factor postitve? It didn’t seem to bother anybody! That’s one positve change – doing a study that’s more reflective of real RA populatuions.
Recommended reading:
- Do Men Get Rheumatoid Arthritis, Too?
- Can I Delay Treatment for Rheumatoid Arthritis? part 1
- Meeting the New Rheumatoid Arthritis Specialist
- Does Rheumatoid Arthritis Pain Really Hurt That Much?
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Very informative, thanks for posting. I think that the estrogen component is important and I hope that science will be be able to define the relationship between it and RA soon! For me, taking nutraceuts that actually help remove excess estrogen has helped to ease my “monthly” RA flare that seems to be associated with my period. I think science is close to the RA-estrogen relationship. I’ll be eager to see what they determine.
As far as to why more women then men get RA, I think that the differences in the ways that men and women deal with stress on a physiological level plays a major role, but much like the estogen component, it is only a piece of a much larger puzzle. Hormones, stress, environment, diet, etc. all play a role and no one aspect by itself will be a silver bullet for determining cause or cure to RA. It will require all of the pieces being put together and then examined as a whole, rather than piece by piece.
Excellent, valuable post, going to repost on my blog if you don’t mind ;).
I am very curious about the estrogen connection. I know my hormones were messed up. I did pursue bio-identical hormone treatment, but didn’t get it under way until after RA started. I hope they are studying this connection thoroughly. I wonder about the increased use of birth control pills since the 1950’s. Also the estrogenic effects from plastics (BPA) and additives in our food. Estrogen is stored in fat, so if there’s an excess amount of fat there is more estrogen being in the body. I’m waiting impatiently for all the answers as to why women are more susceptible.
As for the “real men” comment, these must be the ones that don’t eat quiche.
The real men thing really made us laugh yesterday. Then last night I remembered some comments I’d made about the Chopra stuff. I said something like “Lets see what Dan & Terry say to this!” I guess I was doing the same thing. I was saying Real Men have RA. Its not a “girly” thing. It was just funny on the vid clip with the lady doc saying it!
As for research, they ar e studying evreything. I think its just that RA is so much more complex of a disease than others – its hard for us to imagine how complicated it really is when we see cancer & aids treatments advancing…
Anybody else have this, or am I just the only one this happens? It seems that every month close to my period, my RA symptoms get way worse, and it’s already bad.
Laurett,
My RA symptoms are the same all the time, but I have heard a couple of other ladies say the same as you. :C
I have no family history of auto-immune diseases, RA or anytime of arthritis. I breastfed 3 babies 14+ months each time. I don’t smoke, never have. And have always had regular cycles. Never was on hormonal birth control. I don’t see any changes monthly. From everything I have read it seems like I would be in the “lower” risk category. About the only thing that fits with statistics is, I was diagnosed when my youngest baby was 20 months or so. It IS very interesting that the numbers of people with RA is increasing, and I wouldn’t be surprised if its related to the estrogen hormone. And I think it is so crazy so many more women are affected than men. Good post! It is making my brain go million miles an hour trying to figure this out. This is one complicated puzzle.
Hi Lauren, if nursing babies would protect, I should be immune to RA. :O I have 5 kids who were born at home so that’s a lot of nursing yrs added up. When we look at these statistics we are looking for patterns that can tell us where to look for clues. they aren’t clues in themselves – obviously – by your example. In these discussions I always want to bring up the infants. There are babies that develop forms of this disease & some go on to have full blown RA as adults. Babies aren’t stressed, or breastfeeding or giving birth or eating gluten… it’s obviously more complex than that.
😀 That probably didn’t help at all.
I breastfed all four of my children for 13 months! And I have RA. Hmmm….that is a nixer for me! : )
yep. Didn’t help me either, Jackie. :no:
“Real Men” – because to be a man with this disease, is to be a real man. You don’t have the luxury of being soft, you need to be tough! I’ve read/heard about several sources saying that generally speaking, male RA tends to be more severe. There are also many sources I’ve come across that do not acknowledge any difference in severity. So I’m not sure what to believe (though it’s all bad anyway and I’m certainly not trying to compare illnesses like the skit from SNL). I wonder if there are ways of statistically supporting that claim?
Another “fact” I find interesting is the ratio of women to men. Here the source you use says 4:1 – I’ve seen 2:1 and 3:1 also, so what’s the real fact here?
Michael, I agree. There is some confusion about the ratio. Maybe because it’s in flux.
First, I like the way you explain the “real men” comment! I like this – I guess we warrior ladies are facing this thing like a real man too!
On severity, there is a study 2009 quoted all over that says its more severe in women, but I have read that the occurance of dangerous RA secondary dx such as vasculitis is more common in men. One problem: there is more than 1 way to judge severity.
No, I know you aren’t trying to one-up us! LOL. Can I tell you I think the researchers think of the symptoms as less severe because they are mainly studying women & see the supposed hysterical aspect of this pain? This is one reason I’m so glad there are several men who leave feedback on this blog. I hope for doctors & researchers to read and be enlightened.
http://abcnews.go.com/Health/PainArthritis/story?id=4561355
here’s an abc link that says 3:1…lol
I think the lady dr. is saying “real men” b/c of the estrogen implication, no?
Excellent post. Probably there are multiple reasons for men and women developing RA, and hopefully someday soon we will have answers and be able to live longer, healthier lives without so much disability. I have the gene. I breathed the same pesticide the mosquito truck spewed out regularly and the same air coming from the oil and chemical refineries in the industrial area where I grew up, but I can’t remember even one person getting RA. Lung problems, yes. RA, no. I hadn’t lived there in 40 years when I was diagnosed with full blown RA on my 65th birthday. Now I have two neighbors who have always lived in this rural area who have RA so bad they are on biologics, too. The only thing we have in common with this disease is the oil industry. When they were kids, safely standards were not as strict as they are now and during drilling some of the oil would seep into the soil and into the ground water. Open pit mining and coal fired power plants are also important industries here. Could those things have anything to do with this? Is the incidence of RA any higher for men and women who are exposed to those things? The only thing good about my diagnosis is that it happened so late in my life. That’s rare. I feel so sorry for anyone who has this, but especially for men and women who can’t take needed breaks several times during the day because of so many responsibilities of home and family.
yes, that late onset RA is rare. And also hopefully more mild as a course. But obviously not always 🙁
Some studies have linked increased RA to pesticides or living near a highway or smoking – all environmental hazards that could be triggers. I would think men have a greater exposure to them but now more women smoke… I think RA existed long before these things did, but they are somehow triggers now – that is a puzzle.
I have said it over and over again until i am disgusted. I was healthy until I got the flu shots, and then everything went downhill from there. I never got well again. I kick myself every day that I listened to them and got that damned thing. It was definitely the catalyst…it would not surprise me in the least that there are a lot of woman out there that were cajoled into taking that shot and could say that they got sick, but just stayed home and figured that it was normal and would go away. In fact, I have met a few.
This is so interesting. I had always been healthy and strong, ate right, did not smoke, exercised. Not sure why I now have RA and Hashimoto’s. Auto Immune diseases do run in my family, but I wonder what else triggered it. Has anyone looked into or read anything about all the hormones and antibiotics that are used now in factory farmed foods. I know the foods we grew up on were so much healthier. I am wondering if the intake in those foods caused some of the increase in autoimmunity problems in some people.
I eat only organic now, and will have a significant flare up if I do not. Strange.
Thank you again Kelly for all that you do to help those of us with RA!
Thanks, Kristen. I did all those wonderful things and have a half dozen dx anyway, including those two. Maybe we were too healthy. LOL. 😉