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Sex differences in myalgic encephalomyelitis and chronic fatigue syndrome
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[[Myalgic encephalomyelitis]] affects three to four times as many adult females as males.<ref>http://www.meresearch.org.uk/news/sex-differences-in-mecfs/</ref> Sex differences have been found in the pathophysiology of ME/CFS. == Epidemiology == [[File:Age and Gender distribution.png|thumb|Age and gender distribution of ME/CFS.<ref name="twopeaks" />]] Numerous studies have found the rates of [[ME/CFS]] to be substantially higher in adult women than in men, with estimates ranging from 75-85%.<ref name="Jason, 19992">{{Citation | last1 = Jason | first1 = LA | authorlink1 = Leonard Jason | last2 = Richman | first2 = JA | authorlink2 = | last3 = Rademaker | first3 = AW | authorlink3 = | last4 = Jordan | first4 = KM | authorlink4 = Karen Jordan | last5 = Plioplys | first5 = AV | authorlink5 = | last6 = Taylor | first6 = RR | authorlink6 = Renee Taylor | last7 = McCready | first7 = W | authorlink7 = | last8 = Huang | first8 = C | authorlink8 = | last9 = Plioplys | first9 = S | authorlink9 = | title = A Community-Based Study of Chronic Fatigue Syndrome | journal = Arch Intern Med | volume = 159 | issue = 18 | page = 2129-2137 | date = 1999 | pmid = | doi = 10.1001/archinte.159.18.2129 }}</ref><ref name="twopeaks">{{Cite journal | last = Bakken | first = Inger Johanne | authorlink = Inger Johanne Bakken | last2 = Tveito | first2 = Kari | author-link2 = Kari Tveito | last3 = Gunnes | first3 = Nina | authorlink3 = Nina Gunnes | last4 = Ghaderi | first4 = Sara | authorlink4 = Sara Ghaderi| last5 = Stoltenberg | first5 = Camilla | authorlink5 = Camilla Stoltenberg | last6 = Trogstad | first6 = Lill | last7 = Håberg | first7 = Siri Eldevik | last8 = Magnus | first8 = Per | date = 2014-10-01 | title = Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012|url=https://www.ncbi.nlm.nih.gov/pubmed/25274261|journal=BMC medicine|volume=12|issue=|pages=167|doi=10.1186/s12916-014-0167-5|issn=1741-7015|pmc=4189623|pmid=25274261|quote=|via=}}</ref><ref>{{Cite book | title=Ciba Foundation Symposium 173 ‐ Chronic Fatigue Syndrome | last = Gunn | first = Walter|publisher=| year = 1993|isbn=|location=|pages=|chapter=Epidemiology of Chronic Fatigue Syndrome: The Centers for Disease Control Study}}</ref> A higher preponderance of women has also been noted in numerous [[List of myalgic encephalomyelitis and chronic fatigue syndrome outbreaks|outbreaks]] including [[1934 Los Angeles atypical polio outbreak|Los Angeles]], [[Akureyri]], [[1953 Maryland outbreak|Rockville, MD]], [[1955 Royal Free Hospital outbreak|Royal Free Hospital]], and [[1956 Punta Gorda outbreak|Punta Gorda, Florida]].<ref name=":022">{{Cite journal | last = Parish | first = JG | date = 1978 | title = Early outbreaks of 'epidemic neuromyasthenia'|url=https://www.ncbi.nlm.nih.gov/pubmed/370810|journal=Postgraduate Medical Journal|volume=54 | pages = 711-7|via=}}</ref><ref name="Shelokov, 19572">{{Citation | last1 = Shelokov | first1 = Alexis | authorlink1 = | last2 = Habel | first2 = Karl | authorlink2 = | last3 = Verder | first3 = Elizabeth | authorlink3 = | last4 = Welsh | first4 = William | author-link4 = | title = Epidemic Neuromyasthenia — An Outbreak of Poliomyelitis-like Illness in Student Nurses | journal = New England Journal of Medicine | volume = | issue = 257 | page = 345-355 | date = August 1957 | doi = 10.1056/NEJM195708222570801 }}</ref><ref name="Gilliam, 1936-382">{{Citation | last1 = Gilliam | first1 = A.G. | authorlink1 = | title = Epidemiological Study Of An Epidemic, Diagnosed As Poliomyelitis, Occurring Among The Personnel Of The Los Angeles County General Hospital During The Summer Of 1934 | journal = Public health bulletin, 1936-1938 | issue = 231-240 | page = | date = 1938 | pmid = | url = http://babel.hathitrust.org/cgi/pt?id=mdp.39015022082260;view=1up;seq=617 }}</ref><ref name="Acheson, 19592">{{Citation | last1 = Acheson | first1 = E.D. | authorlink1 = | title = The Clinical Syndrome Variously Called Benign Myalgic Encephalomyelitis, Iceland Disease and Epidemic Neuromyasthenia | journal = American Journal of Medicine | volume = 26 | issue = 4 | page = 569–595 | date = 1959 | pmid = | url = http://www.name-us.org/defintionspages/DefinitionsArticles/Acheson1959.pdf }}</ref><ref name="Poskanzer, 19572">{{Citation | last1 = Poskanzer | first1 = David C. | authorlink1 = | last2 = Henderson | first2 = Donald A. | authorlink2 = | last3 = Kunkle | first3 = E. Charles | authorlink3 = | last4 = Kalter | first4 = Seymour S. | authorlink4 = | last5 = Clement | first5 = Walter B. | authorlink5 = | last6 = Bond | first6 = James O. | authorlink6 = | title = Epidemic Neuromyasthenia — An Outbreak in Punta Gorda, Florida | journal = New England Journal of Medicine | volume = | issue = 257 | page = 356-364 | date = 1957 | pmid = 13464939 | doi = 10.1056/NEJM195708222570802 | url = http://www.nejm.org/doi/full/10.1056/NEJM195708222570802 }}</ref><ref name=":32">[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962472/ An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955 - The Medical Staff Of The Royal Free Hospital]</ref><ref name=":42">{{Cite journal|url=https://www.ncbi.nlm.nih.gov/pubmed/14771044 | title = A disease epidemic in Iceland simulating poliomyelitis | last = Sigurdsson | first = B | author-link = Björn Sigurdsson | date = September 1950|journal=American Journal of Hygiene|volume=52|pages=222-38|via=}}</ref> In some cases, this was thought to do with the occupational hazard of nursing, but this female-skewed sex ratio was also found in several outbreaks among the general population. However, in other outbreaks, including the 1949-1953 [[1949-53 Adelaide outbreak|Adelaide]] outbreak and an outbreak in [[1955 North of England outbreak|northern England in 1955]], a 1:1 gender ratio was reported.<ref name=":022" /> In Akureyri, a significantly higher incidence rate was found among adult women but not in patients under twenty.<ref name=":42" /> A 2015 epidemiology study of [[ME/CFS]] in [[Spain]] found that although the most common trigger for both males and females was infection, the mean age of symptoms onset was lower in males than females. Males reported less pain and fewer comorbidities. In this cohort, [[fibromyalgia]] was present in 29% of the males vs 58% in the females.<ref name="Faro, 20152">{{Citation | last1 = Faro | first1 = Mónica | authorlink1 = | last2 = Sáez-Francàs | first2 = Naia | authorlink2 = | last3 = Castro-Marrero | first3 = Jesús | authorlink3 = Jesús Castro-Marrero | last4 = Aliste | first4 = Luisa | authorlink4 = | last5 = Fernández de Sevilla | first5 = Tomás | authorlink5 = | last6 = Alegre | first6 = Jose | authorlink6 = | title = Gender Differences in Chronic Fatigue Syndrome | journal = Reumatologia clinica | volume = 12 | issue = 2 | page = | date = 2015 | pmid = | doi = 10.1016/j.reuma.2015.05.007 }}</ref> == Physiology == Naviaux found women with ME/CFS, but not men, generally had disturbed [[:Category:Fatty acids|fatty acid]] and [[endocannabinoid]] metabolism. Men, but not women, generally showed increased [[serine]] and [[threonine]] concentrations.<ref name="Naviaux, 2016">{{Citation | last1 = Naviaux | first1 = Robert K | authorlink1 = Robert Naviaux | last2 = Naviaux | first2 = Jane C. | authorlink2 = | last3 = Li | first3 = Kefeng | author-link3 = | last4 = Bright | first4 = A. Taylor | authorlink4 = | last5 = Alaynick | first5 = William A. | authorlink5 = | last6 = Wang | first6 = Lin | authorlink6 = | last7 = Baxter | first7 = Asha | authorlink7 = | last8 = Nathan | first8 = Neil | authorlink8 = | last9 = Anderson | first9 = Wayne | authorlink9 = | last10 = Gordon | first10 = Eric | authorlink10 = Eric Gordon | url = https://www.pnas.org/content/113/37/E5472 | title = Metabolic features of chronic fatigue syndrome | journal = PNAS | volume = 113 | issue = 37 | page = | date = Sep 13, 2016 | pmid = 27573827 | pmc = PMC5027464 | doi = 10.1073/pnas.1607571113}}</ref> ==Notable studies== *2015, Gender Differences in [[Chronic Fatigue Syndrome]]<ref>{{Cite journal | last = Faro | first = Mònica | author-link = | last2 = Sàez-Francás | first2 = Naia | authorlink2 = | last3 = Castro-Marrero | first3 = Jesús | authorlink3 = Jesús Castro-Marrero | last4 = Aliste | first4 = Luisa | authorlink4 = | last5 = Fernández de Sevilla | first5 = Tomás | authorlink5 = | last6 = Alegre | first6 = José | authorlink6 = José Alegre | date = Mar 2016 | title = Diferencias de género en pacientes con síndrome de fatiga crónica|url=https://linkinghub.elsevier.com/retrieve/pii/S1699258X15000819|journal=Reumatología Clínica|volume=12|issue=2 | pages = 72–77|doi=10.1016/j.reuma.2015.05.007|issn=1699-258X|quote=|via=}}</ref> [http://www.reumatologiaclinica.org/en/gender-differences-in-chronic-fatigue/articulo/S2173574316000289/ (Full Text)] *2011, Gynecological History in Chronic Fatigue Syndrome: A Population-Based Case-Control Study<ref>{{Cite journal | last = Boneva | first = Roumiana S. | last2 = Maloney | first2 = Elizabeth M. | last3 = Lin | first3 = Jin-Mann | last4 = Jones | first4 = James F. | last5 = Wieser | first5 = Friedrich | last6 = Nater | first6 = Urs M. | last7 = Heim | first7 = Christine M. | last8 = Reeves | first8 = William C. | date = Jan 2011 | title = Gynecological history in chronic fatigue syndrome: a population-based case-control study|url=https://www.ncbi.nlm.nih.gov/pubmed/21091051|journal=Journal of Women's Health (2002)|volume=20|issue=1|pages=21–28|doi=10.1089/jwh.2009.1900|issn=1931-843X|pmc=3017420|pmid=21091051|quote= | authorlink3 = Jin-Mann Sally Lin | authorlink4 = | authorlink5 = |via= | authorlink8 = William Reeves}}</ref> *2002, [https://www.ncbi.nlm.nih.gov/pubmed/11837367 Women's experiences of stigma in relation to chronic fatigue syndrome and fibromyalgia.]<ref name="asbring2002">{{Citation| issn = 1049-7323| volume = 12 | issue = 2| pages = 148–160| last1 = Asbring | first1 = Pia | last2 = Närvänen | first2 = Anna-Liisa | title = Women's experiences of stigma in relation to chronic fatigue syndrome and fibromyalgia| journal = Qualitative Health Research| date = February 2002 | pmid = 11837367}}</ref> == See also == *[[Pregnancy]] *[[Epidemiology of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome|Epidemiology of ME and CFS]] == References == {{Reflist}} [[Category:Core topics]]
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