Gout

Gout is rare in premenopausal women because estrogen promotes uric acid excretion through the kidneys. However, after menopause, when estrogen levels drop sharply, the ability to excrete uric acid falls to the level of men, and thiazide diuretics, frequently used to treat high blood pressure, further inhibit uric acid excretion, increasing the risk of gout. Gout in women more frequently affects the ankle, knee, and finger joints than the toes, and because pain can manifest somewhat atypically, diagnosis is sometimes delayed. In Korean medicine, gout in postmenopausal women is viewed as a condition where fluid metabolism is impaired due to weakened kidney energy. A deficiency in kidney yin energy generates "false heat" within the body; this heat combines with latent dampness to transform into heat toxins, triggering joint inflammation. For menopausal women, the principle is to combine herbal medicines that replenish kidney yin energy with treatments that cool heat and expel dampness. Additionally, since decreased bone density and joint aging may occur, treatments to strengthen bones and joints are also administered concurrently to manage overall joint health.