Managing Arthritis

Tips for women: Managing arthritis as your body changes

Three women living with arthritis

Arthritis doesn't play fair, striking without discrimination. Yet statistics reveal a significant sex and gender bias. "Arthritis is a female-predominant disease," says Dr. Mary De Vera, senior scientist at Arthritis Research Canada, Canada Research Chair in Health Outcome and Treatment Adherence, and an associate professor in the faculty of pharmaceutical sciences at the University of British Columbia. 

One in four Canadian women live with arthritis, compared to one in six Canadian men. Nearly 60% of women over age 65 have arthritis, but the gender gap exists across all age groups, particularly those with a diagnosis of rheumatoid arthritis (RA) and lupus. For many women, arthritis follows them through every stage of life, impacting their work, social roles, relationships and activities.  

For women hoping to start a family, their arthritis diagnosis can be a hurdle to overcome in pregnancy; however, progress in understanding newer treatments like biologics gives women hope that previous generations didn't have. 

The gender divide extends beyond disease prevalence; women experience pain differently than men and researchers are working to understand more. Looking at women and arthritis from all angles, there's even ongoing research looking at the links between arthritis and social-cultural norms such as gender roles. Could there be a connection between arthritis and stereotypical gender-associated chores, work or clothing? Time (and research!) will tell.  

Dr. De Vera shares a few factors that have been connected to higher rates of arthritis in women.  

Follow the clues 

Double X 

Researchers are looking into the X chromosome as a possible link between arthritis and women. Cisgender women typically have two X chromosomes which could lead to double the impact if arthritis is linked to the X chromosome. 

Narrowing it down to rheumatoid arthritis (RA), Arthritis Society Canada is funding research initiatives by Dr. Cecilia Greenwood at the Lady Davis Institute for Medical Research. Dr. Greenwood is looking into how the X chromosome influences RA risk, considering that perhaps certain genes on the X chromosome are activated when they should be inactive. Discoveries from this research could help identify people who may be at risk of developing RA so that they can receive earlier treatment.  

Hormonal Influence 

Estrogen, known for its anti-inflammatory properties, plays a role in joint health. In menopause, a woman's estrogen levels decline, posing a potential trigger for increased joint inflammation and arthritis flare-ups. Additionally, menopause often results in weight gain. "Research is looking into joint stress related to menopausal weight gain and how that contributes to more arthritis flares in women than in men," says Dr. De Vera. 

Though there are still unanswered questions around why women are impacted by arthritis more than men, progress is being made in understanding the disease and can offer insight into how to live well with arthritis through all stages of life while your body changes. 

Tips to manage arthritis when your body changes 

Prenatal and Pregnancy 

1. Be informed: Understand the role of disease activity. It's important to understand the benefits and risks of pregnancy with arthritis as well as the risks and benefits of continuing arthritis treatments vs stopping medications before pregnancy. To learn more, check out these helpful resources related to pregnancy and parenting with arthritis provided by Canadian Arthritis Patient Alliance (CAPA). 

This study (Jethwa et. al, The Journal of Rheumatology, 2019) shows that 60% of women with RA experience improved symptoms during pregnancy, while 40% experience adverse effects (including flares and uncontrolled disease activity associated with negative reproductive health outcomes for both the mother and baby). This might include conditions like hypertension, pre-eclampsia, pre-term delivery and small gestational age.  

But good news! "We know more now about the impacts of arthritis medications during pregnancy," encourages Dr. De Vera. "With the progress in biologics, women considering or currently using biologics can take comfort that research has shown they are safe across all trimesters."  

2. Involve your healthcare providers: "It's important to see a healthcare provider before and during pregnancy for guidance and counselling around safe medications and to develop a plan to ensure a healthy and safe pregnancy for both mother and baby," says Dr. De Vera.  

3. Don't do it alone: Cultivate a support network and ask for help when you need it. "I always encourage patients to be advocates for kindness for oneself," says Dr. De Vera. For moms and moms-to-be living with the unique challenges of chronic illness, Dr. De Vera suggests checking out helpful resources at Mamas Facing Forward.


1. Healthy lifestyle: The dip in estrogen levels associated with menopause is linked to a higher risk of onset of osteoarthritis and gout. Weight management and healthy eating habits help prevent joint stress and gout flare-ups that can be triggered by the consumption of certain foods. Visit Arthritis Society Canada's online modules for more information on Eating Well and Staying Active

2. Hormone therapy: More research is needed to know if hormone therapy is helpful in reducing joint pain, but it could complement healthy lifestyle choices like quitting smoking cigarettes or implementing mindfulness meditation practices that have been linked to positive outcomes.  

As women face the challenges of arthritis across different life stages and need to adapt as their bodies change, Dr. De Vera reminds us that life is on a spectrum – with arthritis and in general. "There will be good days and hard days. There will be opportunities to adjust and adapt. It's important to ask for the right support – to communicate well what it is you need to feel supported, loved and valued," she says. 

For a more in-depth discussion on women and arthritis, Dr. De Vera shares valuable insights in our Arthritis Talks webinar