Gout isn’t just for men who drink too much — women get it, too

I left the doctor’s surgery with a slight limp and a racing mind. What I thought was muscle injury pain under my left big toe has just been diagnosed as gout.

Until that point, my experience with gout had been largely theoretical, shaped by references from literature and history. Perhaps gout was part of what made King Henry VIII ill-tempered enough to divorce and behead a few wives?

The sole woman I knew of that had suffered from gout was the late 17th Queen Anne of Great Britain, and then, this was only thanks to Olivia Coleman’s Oscar-winning portrayal of her in Yorgos Lanthimos’s The Favourite.

And now, I had it, too — not the gout-afflicted stereotype of a portly older gentleman in hobbling pain after a lifetime imbibing too much red wine, but a moderately active woman in her mid-thirties.

It is estimated that between 2 to 3 per cent of the UK population have gout, and it’s more common in men: 4% of men have gout versus just over 1% of women.¹ Despite prevalence increasing among women, little is known about their experiences with gout.²

Women are less likely to receive allopurinol, a first-line medication for gout, and to have a procedure done called joint aspirations that can help establish a diagnosis

Gout is all too often “unexpected” in women by their doctors as it’s perceived to be a man’s disease, concluded a landmark study in 2015.³ The authors write that “women may not currently be getting optimal treatment in that diagnosis may be missed and treatment not started promptly.”

We’re also less likely to receive allopurinol,⁴ a first-line medication for gout, and to have a procedure done called joint aspirations that can help establish a diagnosis.

My diagnosis is probably an after-effect of pregnancy and pandemic weight gain.

I gave birth to my son in January 2020, as the spectre of coronavirus lockdown was just beginning to loom. The next six weeks were a blur, and one day, I received a letter from the NHS instructing me to shield at home.

Thanks to my asthma, I was one of over 4 million people in the United Kingdom identified as vulnerable to Covid-19. Cue then another six weeks of not leaving the house, no longer breastfeeding, and coping with the extremities of fear, boredom, and guilt by eating and drinking too much. I now weigh 15 pounds more than I did when I was 9 months pregnant.

Correct diagnosis is critical because gout is one of the few forms of arthritis that can be treated

Gout is one of the most common forms of inflammatory arthritis, caused by excess uric acid crystals accumulating in joints like fingers and toes.⁵ Being overweight causes more uric acid to be produced and reduces the amount that can be removed by the kidneys.⁶ Plus, obesity can further affect how the body breaks down sugar, which then can also lead to high uric acid levels.⁷

Cisgender women are also more likely to get gout after menopause,⁸ perhaps due to changes in exposure to oestrogen.

Correct diagnosis is critical because gout is one of the few forms of arthritis that can be treated.⁹ Uric acid levels in the body can be reduced either through lifestyle changes or medication, or a combination of both.

I have struggled with a deep sense of shame at my gout diagnosis. Whether it’s a pregnancy or a pandemic after-effect, I worry that people will think I am greedy and lazy, just like the stereotype of the overweight, red-nosed and gout-stricken gentlemen of old.

Gout may be a medieval disease, but it still affects people in our modern times – including women like me

What has helped has been the realisation that gout may be a medieval disease, but it still affects people in our modern times – including women like me.

My own symptoms are mild — I get intermittent pain in my left big toe. Due to my asthma, I can’t take non-steroidal anti-inflammatory drugs like ibuprofen or naproxen to relieve the pain. Instead, I rest, elevate, and cool my foot whenever an attack strikes, and have been reducing my alcohol and sugar intake.

If the attacks get worse, I will move onto a prescription for colchicine, an effective drug for reducing inflammation during gout episodes.

I got lucky with my quick diagnosis because the doctor I saw was an older man who has also been affected by gout.

But as incidences of gout increase¹⁰ – and the number of women affected grows – getting us the care we need will depend on demolishing the antiquated myth that gout only affects men who eat and drink too much.

Featured image is a black-and-white line drawing of an educational model of a foot, that shows the bones and muscle. The background is a bright yet slightly-dark blue

Page last updated May 2022