Why Is Autoimmune Disease More Common in Women?
Why do more women than men have autoimmune conditions?
While the reasons are not fully understood (like much of medicine), there is most certainly a bias towards women and autoimmune conditions, when considering the number of new cases per year and the overall number of cases in the population. An NIH (National Institutes of Health) study on these figures found women to be nearly three times more likely than men to develop disease. Part of the reason lies in the genetic differences between the sexes, and the effects these differences have on physical expression and features within the body.
Specifically, researchers believe part of the mechanism involves the fact that women typically display greater levels of some important antigens involved in triggering hyperimmune responses. Thus, having higher levels of these substances would lead to specific diseases, depending on the protein and antibodies in question. Also, it is believed that the causal pathways or mechanisms (ways in which the diseases come about) may, to some extent, be quite different in men versus women, suggesting that different sex-based triggers and mechanisms may be at work.
A decent percentage of the autoimmune conditions in women are endocrine in nature (relating to disturbances in hormones, such as thyroid hormones, insulin, estrogen and others), so there is an implication for the role of differences in circulating hormones between males and females, and the ways such levels affect the sexes differently.
The occurrence of overt autoimmune disease, as opposed to the presence of autoimmune antibodies in the blood, depends on a balance between the incorrectly functioning systems, and the body’s ability to regulate them. It is possible that pregnancy and childbirth may leave women more susceptible to these conditions than men. And as indicated above, it seems that genetics play another important role in formation of autoimmune disease.
Finally, one should keep in mind that while the predilection for women certainly exists as the rule, there are exceptions. Certain autoimmune disorders, such as ankylosing spondilitis, are found more commonly in men than women, meaning the bias towards women is not absolute.
What are the most common autoimmune diseases in women?
Some of the most common autoimmune diseases prevalent in women include:
- Systemic lupus erythrematosus (“lupus” or SLE)
- Hashimoto’s or Graves’ thyroiditis (immune system attacks the thyroid)
- Postpartum thyroiditis (thyroid attack following childbirth)
- Rheumatoid arthritis (RA; attacks the joints)
- Anti-phospholipid syndrome (attacks certain fat cells)
- Type-1 diabetes mellitus (T1DM; attacks pancreatic cells)
There are of course other common conditions in women, but these are among the most common.
Are women more likely to have multiple autoimmune diseases, and why?
Yes and no. Autoimmune conditions have a tendency to appear in clusters, which would explain high numbers of female patients with multiple conditions, correlated to the male/female imbalance in prevalence rates. That is, since women definitely experience more overall autoimmune disease, they are more likely to be part of a subset that experiences multiple disorders simultaneously. Again, there is little if any hard evidence in this regard beyond speculative efforts, so whether there is a real statistical difference once this is corrected for is unclear.
However, researchers have found what they believe to be certain genetic predispositions for susceptibility to autoimmune diseases, with the thinking that these genetic variants and common triggers often lead to the advent of one or more autoimmune conditions in the patient. In consideration of basic differences in certain gene expression in men and women, as well as the likelihood of having certain triggers present (hormones or otherwise) depending on sex, we can postulate a scenario where these differences result in contrasting incidences of disease.
Still, it is important to understand that said variations among men and women are but one factor affecting these complicated disease states. Other innate and acquired elements are also often at work, such as familial heredity and common exposure to potential triggers. For example, there is much evidence demonstrating tendencies for some autoimmune disorders to travel within families and because of common traits therein, meaning gender differences cannot completely explain susceptibility and prevalence estimates.
Having said that, and based on the factors listed above, there does appear to be a substantial difference between men and women with regard to the risk of single and multiple autoimmune conditions, which should to some extent guide one’s health care habits and discussions with your providers.
Questions for your doctor:
- Which diagnoses, if any, should I be particularly concerned about, given my medical history and current state?
- Can you explain briefly autoimmune diseases and the similarities/differences to/from endocrine or hormonal diseases?
- If I already suffer from a disorder that is more prominent in females, does that indicate a likely autoimmune cause?
- What are my chances of developing multiple conditions after being diagnosed with a single autoimmune disease?
- Are there any non-prescription therapies or measures to follow that might aid in my treatment and recovery?
About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians. After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time. He may be reached at firstname.lastname@example.org.
This blog post was originally published by AutoimmuneMom.com, written by Dr. Rothbard, and first published on Apr 4, 2013.
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