How Rheumatoid Arthritis Hits Women Harder Than Men

Aug 19, 2025 By Lisa Lombardi / Health Central

Women with rheumatoid arthritis experience worse outcomes than men and need specialized treatment plans, according to a new study.

We already know that women are two to three times more likely than men to have rheumatoid arthritis (RA). Now, a new study suggests that they’re hit harder by the condition as well.

The study, published in The Journal of Rheumatology, analyzed reports from both clinicians and patients and found that women with RA have higher disease activity, a greater need for biological disease-modifying anti-rheumatic drugs (bDMARDs), and more day-to-day difficulties with basic physical functioning over time than men.

“The most important finding is that female patients with RA have a significantly higher disease activity and experience more functional impairment over time compared to male RA patients,” says study co-author G. Hazal Koc, M.D., a Ph.D.student in the department of rheumatology at Erasmus University Medical Centre in Rotterdam, Netherlands.

This proved true even though both men and women had similar baseline disease activity level and treatment regimens. “Our study underscores the need for sex-specific management approaches because current standardized treatment protocols may not fully address the specific needs of female patients,” says Dr. Koc. “Women required more treatment adjustments, including higher use of biologic DMARDs, but still, they have a higher disease activity compared to males.”

Life Impact

The Everyday Life Impact

Women struggle more with RA “not only biologically, but also in terms of daily functioning,” Dr. Koc says. Even after controlling for objective inflammation, women reported challenges with things like dressing, grooming, eating, and walking. This finding is not surprising to doctors who treat RA and women who live with the condition, says Nandini Setia, M.D., a board-certified rheumatologist with Articularis Rheumatology Specialists in Sandy Springs, GA, who was not involved in the study. “We observe this in our daily practice,” she says.

The new research reinforces the importance of not defaulting to a one-size-fits-all treatment plan for RA, Dr. Koc notes. “Standard measures of disease activity may not fully capture the burden experienced by female patients, reinforcing the importance of not only treating the disease, but also the patient.”

Treatment Shortfalls

Treatment, But Not Relief

This isn’t a case of women being undertreated, according to the researchers. The female participants in the study were more likely to receive biologic dMARDs than men, and had more frequent treatment escalations. Despite this approach, though, their outcomes were still worse, with more inflammation, pain and biomarkers of active disease. This highlights “a need for new strategies or adjunctive interventions (e.g., physical therapy, pain management) tailored to women,” Dr. Koc says.