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Gout is a form of arthritis in which uric acid crystals build up in the joints, causing intense pain, swelling, and inflammation. Uric acid is a byproduct of the biological process by which the body breaks down purines. Purines are found in many foods and also naturally produced in the body. In most people, the kidneys can filter out any extra uric acid and excrete it with the urine. For individuals with gout, however, this process is flawed. The kidneys are either overwhelmed by an overproduction of uric acid or are not equal to the task of filtering it out. As uric acid concentrations in the blood increase, deposits form in the joints. The joints of the big toe are usually the first and most severely affected
Men's bodies naturally produce more uric acid, increasing their likelihood of developing problems. Furthermore, women's kidneys are more efficient at clearing excess uric acid from the blood stream. It seems that renal function is facilitated by estrogen, the female sex hormone. Higher estrogen levels stimulate the kidneys to excrete more uric acid in the urine.
As women go through menopause , hormone levels drop off sharply. Estrogen levels decrease to less than a tenth of what they were. Because of this, the kidneys become less efficient at ridding the body of excess uric acid, and as a result, gout can develop over time. As many women are opting not to use hormone replacement therapy while going through menopause and beyond, women are developing gout at younger ages. However, most women still don't develop gout until later in their lives. The rate of gout increases steadily decade by decade until, after age eighty, the vast majority of new gout sufferers are women. Several factors can alter a woman's likelihood of developing gout after menopause. In particular, being obese, hypertensive, or taking diuretics can all increase a woman's gout risk until it's comparable to that of a man.
Women, when they do develop gout, usually do so because their kidneys are no longer excreting uric acid sufficiently fast. Gout in men is more likely to be due to overconsumption of purine-rich foods or natural overproduction of uric acid. Women are more likely to notice initial symptoms in joints other than the big toe, including in the upper body. They also tend to have more uric acid deposits around their joints. These nodules under the skin, known as tophi, are usually not painful but can be unsightly. Women also have a higher rate of co-morbidity. Women with gout commonly also have hypertension, heart disease, and renal failure. This could indicate that healthy women are at a lower risk of developing the disease than are healthy men.
Menopause doesn't have to lead to gout for women. In fact, preventing the development of gout can be fairly simple. Eating a healthy, well-balanced diet low in foods that contain a lot of purine and exercising can in many cases stop the disease before it starts. Especially important in avoiding gout is changing protein intake, since many foods high in protein are also high in purines. Try to get most of your protein from dairy and vegetables and limit your portion size when eating red meat or seafood. Staying active will help alleviate many of the symptoms of menopause as well as decreasing your chances of gout.
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