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.[1] Sex differences have been found in the pathophysiology of ME/CFS.

Epidemiology[edit | edit source]

Age and gender distribution of ME/CFS.[2]

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%.[3][2][4]

A higher preponderance of women has also been noted in numerous outbreaks including Los Angeles, Akureyri, Rockville, MD, Royal Free Hospital, and Punta Gorda, Florida.[5][6][7][8][9][10][11] 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 Adelaide outbreak and an outbreak in northern England in 1955, a 1:1 gender ratio was reported.[5] In Akureyri, a significantly higher incidence rate was found among adult women but not in patients under twenty.[11]

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.[12]

Physiology[edit | edit source]

Naviaux found women with ME/CFS, but not men, generally had disturbed fatty acid and endocannabinoid metabolism. Men, but not women, generally showed increased serine and threonine concentrations.[13]

Notable studies[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  2. 2.0 2.1 Bakken, Inger Johanne; Tveito, Kari; Gunnes, Nina; Ghaderi, Sara; Stoltenberg, Camilla; Trogstad, Lill; Håberg, Siri Eldevik; Magnus, Per (October 1, 2014). "Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012". BMC medicine. 12: 167. doi:10.1186/s12916-014-0167-5. ISSN 1741-7015. PMC 4189623. PMID 25274261.
  3. Jason, LA; Richman, JA; Rademaker, AW; Jordan, KM; Plioplys, AV; Taylor, RR; McCready, W; Huang, C; Plioplys, S (1999), "A Community-Based Study of Chronic Fatigue Syndrome", Arch Intern Med, 159 (18): 2129-2137, doi:10.1001/archinte.159.18.2129
  4. Gunn, Walter (1993). "Epidemiology of Chronic Fatigue Syndrome: The Centers for Disease Control Study". Ciba Foundation Symposium 173 ‐ Chronic Fatigue Syndrome.
  5. 5.0 5.1 Parish, JG (1978). "Early outbreaks of 'epidemic neuromyasthenia'". Postgraduate Medical Journal. 54: 711–7.
  6. Shelokov, Alexis; Habel, Karl; Verder, Elizabeth; Welsh, William (August 1957), "Epidemic Neuromyasthenia — An Outbreak of Poliomyelitis-like Illness in Student Nurses", New England Journal of Medicine (257): 345-355, doi:10.1056/NEJM195708222570801
  7. Gilliam, A.G. (1938), "Epidemiological Study Of An Epidemic, Diagnosed As Poliomyelitis, Occurring Among The Personnel Of The Los Angeles County General Hospital During The Summer Of 1934", Public health bulletin, 1936-1938 (231–240)
  8. Acheson, E.D. (1959), "The Clinical Syndrome Variously Called Benign Myalgic Encephalomyelitis, Iceland Disease and Epidemic Neuromyasthenia" (PDF), American Journal of Medicine, 26 (4): 569–595
  9. Poskanzer, David C.; Henderson, Donald A.; Kunkle, E. Charles; Kalter, Seymour S.; Clement, Walter B.; Bond, James O. (1957), "Epidemic Neuromyasthenia — An Outbreak in Punta Gorda, Florida", New England Journal of Medicine (257): 356-364, doi:10.1056/NEJM195708222570802, PMID 13464939
  10. An Outbreak of Encephalomyelitis in the Royal Free Hospital Group, London, in 1955 - The Medical Staff Of The Royal Free Hospital
  11. 11.0 11.1 Sigurdsson, B (September 1950). "A disease epidemic in Iceland simulating poliomyelitis". American Journal of Hygiene. 52: 222–38.
  12. Faro, Mónica; Sáez-Francàs, Naia; Castro-Marrero, Jesús; Aliste, Luisa; Fernández de Sevilla, Tomás; Alegre, Jose (2015), "Gender Differences in Chronic Fatigue Syndrome", Reumatologia clinica, 12 (2), doi:10.1016/j.reuma.2015.05.007
  13. Naviaux, Robert K; Naviaux, Jane C.; Li, Kefeng; Bright, A. Taylor; Alaynick, William A.; Wang, Lin; Baxter, Asha; Nathan, Neil; Anderson, Wayne; Gordon, Eric (September 13, 2016), "Metabolic features of chronic fatigue syndrome", PNAS, 113 (37), doi:10.1073/pnas.1607571113, PMC 5027464, PMID 27573827
  14. Faro, Mònica; Sàez-Francás, Naia; Castro-Marrero, Jesús; Aliste, Luisa; Fernández de Sevilla, Tomás; Alegre, José (March 2016). "Diferencias de género en pacientes con síndrome de fatiga crónica". Reumatología Clínica. 12 (2): 72–77. doi:10.1016/j.reuma.2015.05.007. ISSN 1699-258X.
  15. Boneva, Roumiana S.; Maloney, Elizabeth M.; Lin, Jin-Mann; Jones, James F.; Wieser, Friedrich; Nater, Urs M.; Heim, Christine M.; Reeves, William C. (January 2011). "Gynecological history in chronic fatigue syndrome: a population-based case-control study". Journal of Women's Health (2002). 20 (1): 21–28. doi:10.1089/jwh.2009.1900. ISSN 1931-843X. PMC 3017420. PMID 21091051.
  16. Asbring, Pia; Närvänen, Anna-Liisa (February 2002), "Women's experiences of stigma in relation to chronic fatigue syndrome and fibromyalgia", Qualitative Health Research, 12 (2): 148–160, ISSN 1049-7323, PMID 11837367