One of the first large-scale studies to compare gout cases in men and women has found that many of the same things increase the risk of gout in both sexes – including older age, obesity, high blood pressure, and the use of a diuretic medication – though not always to the same degree.

Drinking alcohol, for example, particularly beer or spirits, seems to raise gout risk more for a woman than it does for a man 

High blood pressure and the use of a diuretic, a drug that rids to body of water, seem to be riskier, at least when it comes to gout, for women than they are for men.

The study was published in the journal Arthritis & Rheumatism.

In both sexes, gout is caused by elevated blood levels of a metabolic by-product called uric acid. When uric acid builds up, it may crystallize in joints, tendons and surrounding tissues. This leads to excruciatingly painful, debilitating attacks of acute inflammatory arthritis, often affecting the joint at the base of the big toe.

Thanks to the hormone estrogen, which helps the body get rid of uric acid, women are relatively protected from gout, accounting for only 1 out of every 3 cases in people older than age 65.

But surveys suggest that the number of women with gout is growing, and researchers have begun to better characterize gout in women in an effort to better understand and treat the disease.

Researchers from the Boston University School of Medicine reviewed data on more 2,476 women and 1,951 men who were followed for 52 years as part of the Framingham Heart Study. They identified 304 cases of gout, 104 of which were in women, and they compared their health histories and lifestyles to the male gout cases. 

Among heavy drinkers, those consuming more than five drinks a week, men saw their gout risk roughly double while women saw their risk triple.

The differences were even more pronounced when researchers looked at beer alone. In heavy beer drinkers, the risk of gout doubled for men but increased more than 7-fold for women.

Beer appears to be a kind of triple whammy for gout. It contains alcohol, which increases the body’s production of uric acid while simultaneously making it tougher for the kidneys to flush that compound. Beer is also a rich source of purines, compounds that break down into uric acid.

It is not known why beer may have a larger impact on gout risk for women than it does for men, however.