Gout is a disease that affects men, women and children. As Dr. Eliseo Pascual Gómez, an expert in the treatment of gout, explains in what is considered the 5th Top Expert in the World, women suffer less than men. Hormonal changes play an important role in this pathology, since they determine the levels of uric acid in the blood.
Uric acid has two origins, an internal origin originating from the degradation of nucleic acids (an essential component of genes), and following the degradation of precursors present in food. It is eliminated by the kidney; 100% of the uric acid that reaches the kidney is filtered but on its way through the tubules to the urinary system most of it is reabsorbed. These are expensive molecules to synthesize and after reabsorption they are reused.
Rheumatology specialists point out that uric acid levels in blood depend on the balance between formation and excretion. In children, excretion is easy and their uric acid levels are low and they do not suffer from gout. During puberty, hormonal changes occur in children that cause the renal tubules to reabsorb more uric acid, resulting in lower renal excretion and higher blood levels. Young people can suffer from gout, although it usually starts later. Hippocrates wrote that “Men do not suffer from gout before they begin their sexual life”. The hormonal changes of puberty in girls include a rise in estrogens, which facilitate the excretion of uric acid by the kidney, and their blood levels during their fertile life are lower than those of men. Women at that age do not suffer from gout, as Hippocrates also noted: “Women do not suffer from it while menstruating”. After menopause, estrogens decrease, the kidney reabsorbs more uric acid and its level in the blood rises, without reaching the levels of men. But after this point they can suffer from gout, always with less probability than men.