Gout on the Increase after the Menopause

We usually think of gout sufferers as older, overweight men who are fond of their drop of alcohol – commonly port wine.  This was certainly the picture 50 or 100 years go.  But times (and the causes of disease) have changed.  Gout continues to occur more often, but women are quite often the victims.  Serum urate levels are closely associated with gout.  They increase with age in women, whereas they are not significantly different between middle-aged and older men.  To investigate this more fully, Boston University researchers have conducted an analysis of relevant data from the Nurses' Health Study and published their findings in the Annals of the Rheumatic Diseases.         

At baseline, 0ver 92,500 women without gout had their age, their age at menopause, and postmenopausal hormone use recorded, along with known risk factors for gout such as body mass index, diuretic use, high blood pressure, alcohol intake and dietary factors. 

During the next 16 year, 1,703 new gout cases were recorded. The incidence rate of gout increased five-fold from age of 45 to age 75.   Compared with premenopausal women, postmenopausal women had a higher risk of gout (1.26-times higher).  Women whose age at menopause was less than 45 had a risk 1.62-times higher than women whose age at menopause was 50–54 years.  Postmenopausal hormone users had a 0.82-times lower risk of gout than women not using hormone replacement therapy.   

These findings, obtained in a prospective study rather than a ‘snapshot’ analysis, show clearly that menopause increases the risk of gout, whereas postmenopausal hormone therapy modestly reduces it.  If you think you may have gout, see your doctor.  Don’t start hormones or herbal treatment until you’ve had the diagnosis confirmed (e.g. a serum uric acid level), and your treatment is under a doctor’s watchful eye.