Female predominant diseases
Many immunological and neurological diseases disproportionately affect women.
Epidemiology[edit | edit source]
Roughly 80% of patients with autoimmune disease are women. Over the last decades, the ratio of women to men with MS has increased markedly, representing a true increase in MS among women but not men.
Mechanisms[edit | edit source]
Immune system[edit | edit source]
Summary of sex differences in innate and adaptive immune responses
|Immune component||Characteristic||In Females (relative to males)|
|Innate immune system|
|Toll-like receptor (TLR) pathways||TLR pathway gene expression||Higher|
|Interleukin 10 (IL-10) production by TLR9-stimulated peripheral blood mononuclear cells||Lower|
|antigen-presenting cell (APCs)||APC efficiency||Higher|
|Dendritic cells||TLR7 activity||Higher|
|Pro-inflammatory cytokine production||Lower|
|Natural killer cells||NK cell numbers||Lower|
|Adaptive immune system|
|Thymus||Size of thymus||Smaller|
|T cells||CD4 T cell counts||Higher|
|CD4/CD8 T cell ratio||Higher|
|CD8 T cell counts||Lower|
|Number of activated T cells||Higher|
|T cell proliferation||Higher|
|Cytotoxic T cells||Increased activity|
|Th1 v Th2 cell bias||Th2 cell bias in females, Th1 cell bias in males|
|Regulatory T cell numbers||Lower|
|B cell||B cell numbers||Increased|
Hormones[edit | edit source]
Women with these diseases may experiencing a worsening of symptoms at specific points in their menstrual cycle, particularly just before or around their periods. Estradiol and progesterone induce mast cell maturation and degranulation, which may contribute to the symptoms of a wide range of allergic and mast cell-mediated diseases.
Genetics[edit | edit source]
Diseases[edit | edit source]
Asthma[edit | edit source]
In humans, a much higher asthma prevalence was found in women at reproductive age as compared to men. Serum levels of estradiol and progesterone have been directly correlated with the clinical and functional features of asthma. Around 30–40% of women with asthma experience a worsening of symptoms near their period. Postmenopausal women receiving hormone replacement therapy have an increased risk of new onset of asthma.
Social impact[edit | edit source]
Treatment options[edit | edit source]
Research funding[edit | edit source]
Stigma[edit | edit source]
Men and women with these diseases are at risk of stigmatization, dismissal, minimization and psychologization of their symptoms.
List of diseases[edit | edit source]
Below, a list of diseases that disproportionately affect women.
|Conditions||% female||Ratio (F:M)||US prevalence||NIH funding||NIH funding per patient|
|Empty sella syndrome||5:1|
|Idiopathic intracranial hypertension|
|Postural orthostatic tachychardia||80-85%|
|Chronic fatigue syndrome||75-85%|
|Multiple sclerosis||3:1 to 4:1|
|Primary Billary Cirrhosis|
|Irritable Bowel Syndrome (IBS)||65%|
|Systemic lupus erythematosus|
|Connective tissue disorders|
|Ehler's Danlos Syndrome Type 3|
|Chronic lyme disease|
See also[edit | edit source]
Learn more[edit | edit source]
- Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick by Maya Dusenbery
References[edit | edit source]
- Fairweather, DeLisa (November 2004). "Women and Autoimmune Diseases". Emerging Infectious Disease.
- Harbo, Hanne (July 2013). "Sex and gender issues in multiple sclerosis". Ther Adv Neurol Disord.
- Klein, SL (October 2016). "Sex differences in immune responses". Nat Rev Immunol.
- Zierau, Oliver (2012). "Role of female sex hormones, estradiol and progesterone, in mast cell behavior". Front Immunol.
- Aruna, P (April 2014). "Partial Empty Sella Syndrome: A Case Report and Review". Indian Journal of Biochemistry.
- "10 Facts Doctors Should Know About POTS". Dysautonomia International. April 19, 2018.
- "Who Gets MS? (Epidemiology)". National Multiple Sclerosis Society.