Rheumatoid Arthritis in Men: What’s Different?

Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation throughout the body and most often affects the joints, leading to pain, stiffness, swelling, and reduced mobility. While RA is commonly thought of as a disease that primarily affects women, it also occurs in men — just less often.

Although the underlying disease is the same, research suggests that RA can look and feel different in men compared with women, not only in terms of symptoms and complications but also in emotional impact and support needs.

At its core, rheumatoid arthritis behaves similarly in men and women. The immune system mistakenly attacks healthy tissue, triggering inflammation that can damage joints and affect other organs over time.

“From a medical standpoint, the disease itself doesn’t fundamentally change based on sex,” says Jonathan Greer, MD, a rheumatologist in Palm Beach, Florida.

“We’re still diagnosing the same condition and using the same core treatments to control inflammation and prevent joint damage,” he says.

While RA affects men and women in similar ways biologically, research shows some differences in how the disease presents, progresses, and affects overall health.

Age at Diagnosis

Men tend to be diagnosed with rheumatoid arthritis later in life than women.

“In general, men tend to get rheumatoid arthritis in their fifties and sixties, which is later than women, who typically present with RA between their thirties and fifties. It’s unclear why that is; it may be hormonally related, but that’s still being studied,” says Dr. Greer.

Greer notes that this delay can make treatment more challenging as well. “When men come in later, they may already have more stiffness, more functional limitations, or other health issues that make management more complicated,” he says.

Disease Activity and Symptoms

In general, men with RA tend to have more swelling, joint damage, and objective signs of inflammation, says Greer, while women tend to have more pain, stiffness, and fatigue.

Treatment Response

Research suggests that men with rheumatoid arthritis may respond more quickly to certain treatments, especially when therapy is started early in the disease.

Heart and Lung Complications

Men with RA may face higher risks of certain comorbidities (coexisting conditions), particularly involving the heart and lungs, says Greer.

“It’s also more common for men with rheumatoid arthritis to get inflammatory lung disease called interstitial lung disease, especially men with RA who smoke,” says Greer.

“RA is not just a joint disease. For everyone, but men especially, we’re paying very close attention to heart health and lung symptoms, because those complications can have a big impact on long-term outcomes,” says Greer.

Emotional Impact of RA on Men

The emotional and psychological effects of RA can differ sharply between men and women, shaped in part by social expectations around masculinity, work, and stereotypes about how men have to be tough or stoic.

Research suggests that men with RA often feel pressure to appear strong and self-reliant, leading some to minimize their symptoms or delay seeking help. In interviews, men described hiding their condition at work, pushing through pain, and struggling with the loss of physically demanding roles that were central to their identity.

“Many men may feel like they’re supposed to just deal with it — they may not talk openly about pain, fatigue, or emotional stress, even when it’s affecting their quality of life,” says Greer.

RA can also affect sexual health and intimacy, due to pain, fatigue, and reduced mobility, which some men may be reluctant to talk about with their provider.

“I always encourage my male patients to bring these issues up. They’re common, they’re treatable, and they’re an important part of overall well-being,” says Greer.

Support can be a critical part of managing RA, but research suggests that men may engage with support differently than women.

Studies indicate that men often prefer practical, action-oriented support focused on problem-solving, education, and self-management skills, rather than emotionally driven group discussions. Men may also be more likely to participate in self-management programs when those programs are clearly legitimized by their healthcare team rather than framed as optional or informal.

• Even though rheumatoid arthritis is less common in men, it is still a chronic inflammatory disease that can damage joints and other organs if it isn’t treated early.
• Men are often diagnosed later in life, which can make diagnosis and treatment more complex.
• RA can raise the risk of serious complications in men, including heart disease and lung problems, so paying attention to cardiovascular health and breathing symptoms is an important part of care.
• Getting the right kind of support can make living with RA easier for men, especially when it focuses on problem-solving, education, and maintaining independence.