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Discover Women's Health Research

Autoimmune Disease: Rheumatoid Arthritis Overview

Overview

Rheumatoid Arthritis and Women's Health

Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation. People with rheumatoid arthritis experience pain, swelling, and stiffness in their joints. Peripheral joints (e.g., in the fingers, wrists, and feet) are commonly affected, but proximal joints (e.g., in the shoulders, hips, and lower back) may become involved as the disease progresses. This inflammation is typically symmetric, and over time it can lead to the loss of cartilage and bone.1 Rheumatoid arthritis can also cause inflammation in other areas of the body, such as the heart and lungs.

Aside from the characteristic inflammation, people with rheumatoid arthritis may experience other signs and symptoms, such as fatigue, loss of appetite, and a low-grade fever.2 Rheumatoid arthritis can also increase the risk of cardiovascular disease and type 2 diabetes mellitus.3 In addition, women with rheumatoid arthritis have a longer time to conception than women who do not have this condition.4

Certain alleles of the HLA-DRB1 gene encode an amino acid sequence called the shared epitope, which has been associated with the development of rheumatoid arthritis. The shared epitope may explain how interactions between certain genetic and environmental factors can lead to rheumatoid arthritis. For example, cigarette smoke, which is a significant risk factor for rheumatoid arthritis, has been shown to interact with the shared epitope.5 Hormones—particularly estrogen—may also play a role in the development of this condition;6 , 7 however, the role of hormones is complex and not fully understood. Rheumatoid arthritis occurs approximately two to three times more often in women than in men. In addition, women with rheumatoid arthritis may experience reductions in disease activity or even remission during pregnancy, a period of high estrogen exposure.2

Rheumatoid arthritis shares signs and symptoms with other types of arthritis and conditions that affect joints;8 however, the presence of anticitrullinated protein antibodies in the blood can help distinguish rheumatoid arthritis from similar conditions.9 Treatment generally includes the use of antirheumatic drugs, and women with rheumatoid arthritis who are pregnant or breastfeeding can receive pregnancy- and lactation-compatible antirheumatics.

NIH Research Highlight

Researchers at the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) are investigating the genetic factors that determine who is at risk of developing rheumatoid arthritis and how severe the condition will be. Identifying these genetic factors will help researchers develop new treatments. In addition, understanding what happens at the molecular level may help researchers design new tests for diagnosing rheumatoid arthritis and identify which treatments are best for specific patients.10

References

  1. Chauhan K, Jandu JS, Brent LH, et al. Rheumatoid Arthritis. StatPearls Publishing; 2023. Updated May 25, 2023. Accessed October 21, 2025. https://www.ncbi.nlm.nih.gov/books/NBK441999/
  2. Overview of rheumatoid arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Updated November 2022. Accessed October 21, 2025. https://www.niams.nih.gov/health-topics/rheumatoid-arthritis
  3. Kattamuri L, Duggal S, Aparece JP, Sairam S. Cardiovascular risk factor and atherosclerosis in rheumatoid arthritis (RA). Curr Cardiol Rep. 2025;27(1):31. doi:10.1007/s11886-025-02198-8. https://pubmed.ncbi.nlm.nih.gov/39831939/
  4. Saulescu IC, Panaitescu AM, Gica N, Gradinaru E, Opris-Belinski D. Pre-pregnancy counselling for women with rheumatoid arthritis: a guide on risks, evaluations, and multidisciplinary approaches. J Clin Med. 2024;14(1):114. doi:10.3390/jcm14010114. https://pmc.ncbi.nlm.nih.gov/articles/PMC11722274/
  5. van Drongelen V, Holoshitz J. Human leukocyte antigen-disease associations in rheumatoid arthritis. Rheum Dis Clin North Am. Aug 2017;43(3):363-376. doi:10.1016/j.rdc.2017.04.003. https://pmc.ncbi.nlm.nih.gov/articles/PMC5643023/
  6. Gerosa M, De Angelis V, Riboldi P, Meroni PL. Rheumatoid arthritis: a female challenge. Womens Health (Lond). Mar 2008;4(2):195-201. doi:10.2217/17455057.4.2.195. https://pubmed.ncbi.nlm.nih.gov/19072521/
  7. Jahid M, Khan KU, Rehan Ul H, Ahmed RS. Overview of rheumatoid arthritis and scientific understanding of the disease. Mediterr J Rheumatol. Sep 2023;34(3):284-291. doi:10.31138/mjr.20230801.oo. https://pmc.ncbi.nlm.nih.gov/articles/PMC10628871/
  8. Rheumatoid arthritis: diagnosis, treatment, and steps to take. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Updated November 2022. Accessed October 21, 2025. https://www.niams.nih.gov/health-topics/rheumatoid-arthritis/diagnosis-treatment-and-steps-to-take
  9. Steiner G, Toes REM. Autoantibodies in rheumatoid arthritis - rheumatoid factor, anticitrullinated protein antibodies and beyond. Curr Opin Rheumatol. 2024;36(3):217-224. doi:10.1097/BOR.0000000000001006. https://pmc.ncbi.nlm.nih.gov/articles/PMC11139241/
  10. Rheumatoid arthritis: research and resources. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Updated November 2022. Accessed October 21, 2025. https://www.niams.nih.gov/health-topics/rheumatoid-arthritis/more-info

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Health Topic Summary

Last updated: 12/08/2025