Gout? Isn’t that something men suffer from? Do woman get gout? 

It is. And more and more women are getting diagnosed with gout as well.

In the last 20 years, cases of women with gout have more than doubled. According to the Arthritis Foundation, “...Two million women – and 6 million men – in the U.S. have this inflammatory form of arthritis that causes joint swelling and telltale pain at the base of the big toe.”

What is gout?

Gout is, as noted, a form of arthritis. Gout occurs when high levels of uric acid increase in the blood and form needle-shaped urate crystals in the joints or a joint’s surrounding tissue.

How does uric acid get produced? 

When your body breaks down purines — naturally-occurring substances in your body and in some foods — uric acid is produced. The normal function includes this uric acid being dissolved in the blood, transferring to the kidneys, and then getting eliminated through your urine.

The body could be out of balance and develop gout by producing too much uric acid, or by excreting too little of it in the urine.

What does gout feel like?

A flare-up can swell the joints making it painful to walk or move, and can increase stress and frustration levels, which may then exacerbate other menopause symptoms like insomnia, night sweats, hot flashes, etc. Definitely not the direction to head in if you can possibly avoid it.

Joints may also swell, radiate heat, and flush red in color as well. A gout flare-up may also feel as though a joint is on “on fire," like a joint-specific, localized hot flash of sorts.

If left untreated, gout pain may worsen and joint damage could ensue. Best to get it checked.

Is gout hereditary? If your family history includes gout, The Mayo Clinic notes you’re more likely to develop this disease. 

In men, gout is often described as a sudden, severe attack, usually in the night, with intense pain in one of the joints, commonly the big toe. But this isn’t always the case with women.

In women, it can be a sudden attack, but it may also develop more slowly over time and in multiple joints. Brian F. Mandell, MD, a rheumatologist at the Cleveland Clinic in Ohio and board member of The Gout & Uric Acid Education Society, shares:

“In women, it seems there is a greater prevalence of the initial episode of gout being in multiple joints. It may not always be the typical swollen great toe. In the hands, this is often misdiagnosed as inflammatory osteoarthritis when it may actually be attacks of gout.”

Women frequently experience gout in the ends of their fingers, wrists, knees, and toes and are more prone to gout after menopause.

Ready to focus on your health in midlife and menopause? Work with a Gennev Menopause Health Coach.

Gout in women. What’s estrogen got to do with gout?

Estrogen in premenopausal women and those on estrogen replacement therapy helps to flush the uric acid out of the system, according to the Arthritis Foundation. After menopause, uric acid levels tend to rise. 

If a person with a uterus develops gout before going through menopause, it’s usually due to other conditions such as having a history of taking diuretics, high blood pressure, diabetes, kidney disease, and obesity.

What about nutrition? Can diet manage gout and minimize flare-ups?

When it comes to diet, gout, and overall health, definitely get into your doctor’s office to talk about your health specifically. Especially if you have other health conditions.

Foods to avoid, limit, or moderate regarding gout

Some of the foods recommended to moderate or minimize may have health benefits that outweigh the risk for gout (like the omega 3s in sardines may be more important to brain health than sardines' risk of gout). Knowing your levels, getting screenings, and having regular conversations about your health with your doctor or nutritionist will be your best way forward.

• Avoid gland or organ meats such as liver, kidney, and sweetbreads.
• Limit serving sizes of beef, lamb, and pork.
• Note and understand that some seafood including anchovies, shellfish, sardines, and tuna do have higher purine levels than other kinds of seafood.
• Limit or avoid sugar-sweetened foods (cereals, baked goods, candies, even some salad dressings), and limit the consumption of naturally-sweetened juices, like fresh-squeezed fruit juices.

On alcohol and gout

The topic offoods to avoid in menopause like alcohol comes up regularly in our content since it can spike the intensity and frequency of symptoms such as… hot flashes, headaches or migraines, and mood swings (well, rage, really). It’s especially important to note for those prone to developing or who are actively managing gout.

Researchers out of the Boston University School of Medicine examined data on 2,476 female and 1,951 male participants in the ongoing Framingham Heart Study, which has followed residents of Framingham, Massachusetts, since the late 1940s. Over an average of three decades of follow-up, 304 cases of gout were reported, with one-third of those cases occurring in women.

Further reporting from the Framingham Heart Study shared that:

“Drinking 7 or more ounces of spirits a week -- roughly five drinks -- doubled the gout risk in men and tripled it in women. Heavy beer drinking was associated with a doubling of risk among men and a sevenfold increase in risk among women.” [emphasis ours]

Foods to include

We recommend weight loss,if you need it, for healthy menopause weight management. “Being overweight increases the risk of developing gout, and losing weight lowers the risk of it. Research suggests that reducing the number of calories and losing weight — even without a purine-restricted diet — lower uric acid levels and reduce the number of gout attacks. Losing weight also lessens the overall stress on joints.”

Recommended eats & drinks:

• Complex carbs. Eat more fruits, vegetables, and whole grains. Avoid foods and beverages with high-fructose corn syrup, and limit consumption of naturally sweet fruit juices.
• Water. Stay well-hydrated in menopause by drinking water.
• Fats. Skip or cut back on saturated fats from red meat, fatty poultry, and high-fat dairy products.
• Proteins. Focus on lean meat and poultry, low-fat dairy, and lentils as sources of protein.

Talk with your doctor, or one of our doctors, and your menopause health coach, about specific concerns about gout, joint pain, and other forms of arthritis. Talk with them sooner rather than later if obesity, high blood pressure, diabetes figures into your current state of health and well being.

Your health, mobility, and well being are worth it.

Join the Gennev Community Forums to weigh in on this topic, ask questions, and understand more about menopause with others on the path.