Men are from Mars, women are from Venus.
Most of us think that’s probably the case when the heart is involved, but you may be surprised to learn that it may also be true when it comes to a diagnosis of rheumatoid arthritis.
Women are about three times more likely to get RA than men for reasons that are not well-understood, though this increased risk may be linked to women’s X chromosomes, female hormones or a combination of the two.
[See: 7 Surprising Things That Age You.]
Some studies likewise show that women tend to have slightly more disease activity and functional impairment compared with men, but these differences may be a reflection of the way disease activity has been measured rather than representing true disparities in disease manifestation.
Men may respond better to drug therapy for rheumatoid arthritis, and they appear to be more likely to experience disease remission than women, especially in the first two years after diagnosis. They are also more prone to infections from the immune-suppressing effects of many RA medications.
Rheumatoid arthritis is an incurable autoimmune disease that can cause chronic joint pain, muscle weakness, fatigue and physical disability, and it requires aggressive, lifelong treatment with powerful medications that can cause unpleasant side effects.
For both men and women, a diagnosis of rheumatoid arthritis is a life-changing event that requires emotional and physical adjustments, and it is often accompanied by depression. How do men cope with the disease and do they use different coping strategies than women?
No one knows for sure.
“Because RA is more prevalent among women, there isn’t much research on men with RA specifically,” notes Patricia Katz, a psychologist and professor of medicine and health policy at the University of California, San Francisco.
A recent small study in Britain has addressed this lack of research head-on by conducting focus groups of men with RA, with the specific aim of exploring how men experience their disease and determining some of the strategies men use to cope with their diagnosis.
The study’s researchers found that rheumatoid arthritis is not a very macho disease.
Many of the participants indicated that RA symptoms challenge their masculinity, particularly when they need to ask for help performing previously routine tasks, like lifting heavy objects or opening a jar. This is especially true when they have to ask for help from their wives or partners. Men are supposed to be physically stronger than women, after all, and RA can cause significant muscle wasting and weakness.
Some of the men indicated that they find it easier to pay someone to do a manual job than to ask for a favor from friends or family. And they can be particularly affected by the inability to carry out typical “male jobs,” like mowing the lawn.
Lauren Holleb, a psychologist and assistant professor in the College of Science and Humanities at Husson University in Bangor, Maine, isn’t surprised by these findings.
“In general, men in our society may be more concerned about being viewed as ‘weak,'” she says.
The study also found that functional impairment robs men of a sense of power and control, and can lead to a loss of independence that can be “soul destroying” and cause men to feel as if they’ve been robbed of their dignity.
[See: Am I Just Sad — or Actually Depressed?]
These negative, helpless feelings lead many men with RA to try to conceal their disease in public, like putting on a brave face when shaking hands with another man with a strong grip, an action that can be particularly painful on joints, or by resorting to risky behavior to accommodate their social life, like skipping their medication so they can drink more than is recommended when out with friends, on a date or on holiday.
In an effort to feel normal, men may choose to ignore their disease and push the limits of physical exertion, irrespective of the consequences, which often include incapacitating pain and debility.
Others prefer to withdraw from friends and family to avoid dealing with the difficult emotions that RA raises and the depression that often accompanies the disease, or because they cannot participate in the various activities they enjoyed before their diagnosis.
When it comes to seeking support, the results are mixed. Some men feel they can talk to family members or friends about the issues they face living with RA, whereas others don’t like to complain and prefer to just “get on with it.”
“Men with RA tend to be less open [than women] to talking about pain, which may make them less likely to seek help,” Holleb says.
And even if they see their rheumatologist regularly, they may be hesitant to discuss their emotions. One of the participants in the British study indicated that his doctor thought he was “too stoic.” Others may be willing to talk to their physicians about their disease, but only if the doctor broaches the subject first.
“Given that men may be even less likely to bring up how they are feeling to their physician, the physician ]or] care team must initiate this discussion,” Holleb says.
This can be problematic, however, because rheumatologists have limited time with their patients and as a result, they frequently do not discuss emotional issues or coping strategies with their patients.
So, what’s a man with RA to do?
One study is not enough to make definitive recommendations, and more research is clearly needed. But the design of the British study may provide a clue to helping men deal with the unsettling emotions that RA can cause.
[See: How to Practice Yoga When You Have Arthritis or Another Chronic Condition.]
In the study, the men were put in small focus groups, where they were presented with questions that they could discuss with other men who share their disease. As it turns out, this may be a beneficial form of therapy for men with RA.
“It may be particularly helpful to interact in a group setting where they can meet other men with whom they can relate, who are also have similar concerns,” Holleb says. “This may allow men to feel more comfortable sharing their experiences, when they are not alone and realize that their experiences with RA do not make them any less strong,” Holleb says. “Rather, seeking support can actually make one stronger and more resilient,” she adds.
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How Do Men Cope With Rheumatoid Arthritis? originally appeared on usnews.com
