On World Arthritis Health, Dr Siddharth M. Shah says that Rheumatoid Arthritis impacts the immune system attacks its joints and organs. It results in inflammation, destruction, and damage of the involved joints, tissues, or organs. Like most autoimmune problems, rheumatoid arthritis also affects women more commonly than men. 

Rheumatoid Arthritis is an autoimmune condition that predominantly affects the joints in one’s body. It may also affect other parts like the skin, lungs, eyes, heart, blood vessels, and bones. A dysfunctional immune system characterises autoimmune disorders. The body’s immune mechanism, which is supposed to fight against harmful bacteria and viruses, attacks its joints, tissues, and organs. In the case of rheumatoid arthritis, the immune system attacks its joints and organs. It results in inflammation, destruction, and damage of the involved joints, tissues, or organs. Like most autoimmune problems, rheumatoid arthritis also affects women more commonly than men. Statistically, it occurs three times more in women than men and is typically seen amongst 30 to 60-year-olds.

What causes the gender differences in rheumatoid arthritis? Rheumatoid arthritis not only affects women more but also causes a severe disease manifestation in them. Although the exact cause of rheumatoid arthritis is unknown, genetic, hormonal, environmental, and lifestyle factors are assumed to play a role. The gender differences can be attributed to genetic (X chromosome) and hormonal factors. Women’s immune systems are stronger and more reactive; this might help explain a greater prevalence of autoimmune problems. The X-linked genetic factors can also be held responsible for severe disease in women.

Hormonal factors are thought to play a role because the disease is influenced by pregnancy, childbirth, breastfeeding, menopause, and the menstrual cycle. These significant bodily changes fluctuate the hormonal balance in the body. Generally, normal levels of female hormones Oestrogen and Progesterone protect against rheumatoid arthritis.

• Sometimes, women who have rheumatoid arthritis may experience disease remission during pregnancy. The condition is also known to flare up post-childbirth.
• Breastfeeding has been found to reduce the risk of getting rheumatoid arthritis.
• The disease may appear after having a baby or around menopause.
• Women may experience worsening symptoms during the second week of their menstrual cycle when the hormonal levels are low.

The disease severity is greater, and its progression is faster in women. Research suggests that women may experience more physical pain for the same painful stimulus as compared to men. Rheumatoid arthritis is also known to cause more disability in women as they have lesser muscle strength than men. In contrast, the male hormone Testosterone suppresses the immune system, which is primarily responsible for the disease, explaining the less severity of symptoms in men.

How to deal with Rheumatoid Arthritis?

• It is best to seek timely treatment from a specialist and follow up regularly
• Avoid smoking as it worsens the symptoms
• Moderate alcohol consumption may have some beneficial effects as it tends to reduce exhibitory symptoms by reducing inflammatory activity
• Maintain a healthy body weight as being overweight can worsen your rheumatoid arthritis
• Regular exercise has been found to improve rheumatoid arthritis
• Frequently consume fish rich in Omega-3 Fatty Acids to gain protection against rheumatoid arthritis

Although there is no cure for rheumatoid arthritis, modern medical treatments can help keep the disease under control and achieve remission. The importance of early diagnosis and appropriate treatment of rheumatoid arthritis in women cannot be stressed enough, as they are likely to have a severe disease with rapid progression. Hence, proper, timely medical care helps limit disability and improves the quality of life.

(Dr Siddharth M. Shah is Consultant Orthopaedics & Joint Replacement Surgeon, SL Raheja Hospital, Mahim)