It is a little known fact that gout, commonly considered as a condition that affects men, can also occur in women.
Gout is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis - or, in common language, a red, swollen joint, most often in the big toe. While it is known that the disease is due to an accumulation of uric acid in the blood, and uric acid deposits like crystals formed in the joints, the exact causes of this phenomenon are still unclear.
According to Dr Placide Kamali, a gynecologist at CHUK, joint aches are one of the first symptoms, normally followed by swelling, especially if one sits a lot.
Gout used to be called a rich man's disease because it was connected to excessive consumption of red meat and alcohol. Other conditions known as a precursor to gout are high blood pressure, obesity, weight gain, weak kidneys and high levels of medicine use.
Gout mainly affects men because the female hormone estrogen plays a powerful role in keeping uric acid levels down. Yet as a result, once women hit menopause and their estrogen levels decrease, they become also more prone to gout. Nevertheless, the disease is still rare in women. "I have gotten one or two cases in a space of two years, but here in Rwanda it is most prevalent in men," Kamali explains.
He adds that while age may be an important factor for women to get gout, even poor eating habits can cause the ailment. "If in Rwanda the incidence of gout in women is very low, it is because women here don't consume that much meat or alcohol, as compared to those in places like in the USA."
Dr Kamali points out that certain medical treatments can also increase the risk of gout. "Some medication used to treat cancer could result into gout because it tends to increase the levels of uric acid," he says, adding however that such treatment is not common in Rwanda.
Gout most commonly affects the joints of the big toe, causing constant ache, with a bigger risk for the aches to occur at night. Other symptoms might be redness and inflammation (which can easily be mistaken for skin infection), as well as swelling and difficulty of movement.
While it is rare condition among women in Rwanda, it is better to be safe than sorry, and the first thing to do according to Dr Kamali is to watch your diet. "If a woman has a very high level of alcohol consumption, she is at risk," he warns. Fructose-rich beverages, such as sugar-sweetened sodas and orange juice, are also associated with an increased risk of gout among women.
Though its exact causes are unknown, the symptoms of gout such as the pain and swelling can be treated, although it requires discipline on the part of the patient. "Treating gout is like treating high blood pressure or HIV," Kamali explains. "The medication has to be taken constantly but this does not mean the disease goes away, it simply reduces the spread. When you stop taking the medication, gout could even get worse."
Apart from medication, the doctor also recommends for gout sufferers to adjust their diet and to take regular exercise.
Kamali also warns that if the disease is detected late, gout leaves scars so that even though there is no pain anymore, finger knuckles for instance can remain swollen, leaving the fingers deformed.