The Impact of RA on Men

The Impact of RA on Men

I’m the only male Patient Advocate and Moderator on www.rheumatoidarthritis.net and the corresponding Facebook page. There is a great page on RA and Women’s Health on our website but no corresponding page for men. Of all the people who visit the Facebook page, only 15% of the people reached were men and only 9% of the people who actively engaged by liking, sharing, or commenting on posts were men. All of this is not too surprising given the fact that the ratio of women to men with RA is about 2 to 1.[1] But with approximately 1.5 million people in the United States with RA[2], that would mean that almost half a million men suffer from RA.

When it comes to autoimmune diseases like multiple sclerosis, lupus, scleroderma, rheumatoid arthritis, and Sjogren’s syndrome, women seem to bear the brunt of these diseases in terms of proportion of people impacted. Genetics, behaviors, and hormones are proposed as reasons why more women get these diseases.[3] However, there may be some differences in how RA impacts men. Since I’m a man with RA, this topic is of personal interest.

Researchers tend to find that women fare worse with RA than men in terms of severity of symptoms. But those differences may actually be a result of the measures used and not from the disease itself.[4] It has also been found that men respond more favorably to biologic treatments than women and are more likely to achieve disease remission status.[5] While some studies show that men are more likely to be treated earlier and more aggressively[6], other studies demonstrated that there were no differences in between the proportion of women and men taking corticosteroids, methotrexate, and biologics.[7] Men are more likely to suffer from infections due to immune suppressing medicines used to treat RA.[8] Erectile dysfunction can be a unique side effect of RA for men. But women also experience sexual dysfunction from the disease.[9] There is a higher mortality rate for men with RA.[10]

Despite all the studies conducted on gender differences in RA, one researcher from Finland reviewed the literature and argues that a strong research base using gold standard methods does not currently exist to demonstrate dramatic gender differences.[11] More research into this area is needed as it may provide better diagnosis and treatment options for both men and women.

Fathers, and any parent with RA for that matter, also have unique challenges. Children may not understand the disease and might believe that arthritis is something only old people get. As my children experienced me dealing with RA symptoms over time, it reinforced in their minds that this was a serious condition. It’s less of a battle these days getting my teenaged children to help with tasks that I simply cannot do anymore such as mowing the grass and doing yard work. This education is an ongoing process – just the other day one my children made a comment about me being an “old man with arthritis.” Sometimes the disease takes a toll on my ability to attend my daughter’s soccer games. I can no longer wrestle on the floor, play roller hockey, coach sports, or take them snowboarding.

Another aspect of RA that could be unique to men is pressure to be a primary wage earner for a family. While this tradition has shifted in the modern era due to globalization, educational opportunities, double family incomes, and changes in cultural norms, the pressure on men to provide for their families remains embedded in their persona.[12] I’m the primary breadwinner in our family as my wife and I planned for this many years ago so she could stay at home with our children when they were young (she now works outside the home). In this context, rheumatoid arthritis brought added pressure and questions like “What would happen if I become disabled?” and “Can I keep up with the pace of work?” Of course, this pressure to provide income can apply to anyone, male or female, single or married.

Rheumatoid arthritis impacts more women than men in terms of shear numbers. And the disease may impact women more in terms of severity and response to treatment. But RA is not just a women’s disease as there are large numbers of men battling RA. Understanding similarities and differences of how the disease impacts both genders is critical to proper diagnosis and treatment.

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