Gout: age and experience
People we spoke to, like Sue, mentioned that gout is often perceived as being an older man's disease. Around 2-3% of adults in the UK...
Gender and gout
Gout is often thought of as being a man’s condition. It affects over four times more men than women and can happen in men at any age (Kuo et al Ann Rheum Dis 2015). Women can get gout but rarely before the menopause. This is because a female hormone (oestrogen) that is released during the female reproductive cycle increases removal of uric acid by the kidneys. Uric acid levels rise in women after the menopause meaning that their chances of getting gout are increased.
Perceptions of gender and gout
A number of people we spoke to did not realise that women could get gout. Men had often met other men with gout but had never heard of women who had it. Sam has not come across another woman with gout. She would like to talk face-to-face with another woman of a similar age to discuss their experiences.
Pat was surprised to be diagnosed with gout because she thought it was more of a man’s condition. She works as a nurse but had not met any female patients with gout.
Not many people knew why there are more men with gout than women. Jeff wondered if it might be because women are ‘more sensible’ while Naresh questioned whether the immune system might play a role. Carole knew that women tended to get gout after the menopause, and this had also been her own experience. Several of the women we spoke to said they’d had hysterectomies. They were not all aware that gout is less likely to affect women before the menopause. One woman wondered whether taking HRT had influenced when she got gout.
Dealing with the pain and diagnosis
Many people felt that gout had a similar impact on men and women in terms of the pain and restrictions it caused, but some thought that men and women might deal with it differently. Several thought that women might cope better with, or be less likely to moan about, the pain of gout. Peter felt that men were more likely to keep the diagnosis to themselves rather than telling other people about it. Ray thought that men might go to their doctor sooner, meaning that women would put up with the pain for longer. In contrast, Alastair and Ian thought that men might be less willing to visit their GP about gout.
Ian did not tell his first GP about all the attacks he was getting. He now wonders if he should have asked his GP for more information about treatments.
Some women, for example Jacqui, were not diagnosed straight away despite the fact that their GPs recognised the symptoms as consistent with gout. Jacqui wonders if gout is under-diagnosed in women because their GPs do not always consider gout as a possibility. Sam’s GP told her it was ‘very unlikely’ that she would have gout and seemed ‘more surprised than me really’ with the diagnosis. This left Sam feeling uncomfortable about the diagnosis and questioning its accuracy.
When Jacqui first visited her GP, the GP said that she would have diagnosed a man with the same symptoms with gout.
Sam’s GP did not think that she would have gout but tests showed that her uric acid levels were high.
Younger women with gout were particularly likely to find their diagnosis difficult to accept. Sam had not met anyone of her own age who had gout, even on internet forums for people with gout.
Information for women with gout
As a younger woman with gout, Hazel, aged 32, has had problems that do not apply to men or older women. She has found it difficult to find information about younger women with gout and believes that GPs do not know much about it either. She feels that it is important for health professionals to discuss issues such as pregnancy with younger women with gout. Hazel has attacks every month just before her period. She would like to get pregnant but is worried about treatment for gout and attacks during pregnancy, and breastfeeding. She is trying to find information before she becomes pregnant, but feels unhappy about having to delay starting a family because of gout.
Hazel has had several issues related to being a younger woman with gout. She has found it hard to find relevant information and has concerns about gout and pregnancy.
Other people’s perceptions
Tony said that the lifestyle often associated with gout, such as excessive eating and drinking alcohol, was also seen as more common in men in the past. Several men thought that it might be easier for men to talk about having gout because it is seen as a man’s condition. They believed that women might be more self-conscious about mentioning it.
Some women felt comfortable with their diagnosis, but the perception of gout as a male condition caused embarrassment and anxiety in others. Jacqui felt uncomfortable that people might think she had been drinking too much alcohol because they did not understand the other causes of gout. Several women felt that gout had affected their identity as a woman and how they felt about themselves.
Val felt that having gout, and not being able to wear the shoes she wanted to, made her feel older and less feminine.
Some women did not mind telling other people that they had gout. It did not bother Carole, for example, because she saw gout as something that was not her fault. Other women, though, did not like talking about having it. A few said that they had arthritis rather than gout so that people would not assume they ate lots of red meat and drank too much alcohol.
Sam felt that having gout as a woman was not normal. She did not like talking about it to other people.
Pain and ongoing symptoms from gout
Nearly everyone we spoke to felt that gout was intensely painful, although Peter and John Z both had aching joints rather than the extreme pain...