Why Autoimmune Diseases Affect Women More Than Men
By: Holly L. Thacker, MD • Feyrouz Al-Ashkar, MD, FACR • Posted on August 01, 2019
There are several autoimmune conditions and many affect women more than men. At least 90% of people with Multiple Sclerosis (MS) are women. Systemic Lupus Erythematosis (SLE) and Rheumatoid Arthritis (RA) disproportionately affect females. This is because women have a stronger immune system than men, which is a double edged sword. Conversely, males are twice as likely to get infections and cancers than females, while women are several fold more likely to get autoimmune conditions.
Auto Immune Risks
Hashimoto’s thyroiditis, which often leads to low thyroid, affects 1 in 8 women and runs in families. If you have one auto-immune condition, you may be at risk for others, including:
- Pernicious anemia (low B12 requiring B12 shots)
- Addison’s disease (adrenal failure)
- Premature Ovarian Insufficiency
- Type 1 Diabetes Mellitus
Women with Hashimoto’s low thyroid and other autoimmune conditions may have reduced ovarian function and thus may be more likely to have earlier menopause and need menopausal hormone therapy. There are some 80 conditions linked to autoimmune conditions.
Estrogen May Help With Autoimmune Conditions
Women with autoimmune conditions may think that since many of these conditions are more common in women that they should avoid estrogen and that is not always the case. In fact, women with Rheumatoid Arthritis who also have high estrogen state like in pregnancy, may do better with estrogen than without estrogen. Women with Systemic Lupus Erythematosis (SLE) may use hormonal contraceptives and postmenopausal hormone therapy if their SLE is stable and doesn’t involve kidney impairment and active blood clotting.
Things to Know
- Know your family history as there is a genetic component in many conditions.
- Your immune system is a hard worker and sometimes goes into overdrive and attacks normal tissues like skin, joints, thyroid and glands.
- Some autoimmune conditions have similar symptoms.
- Fatigue. Nonspecific but very common in several conditions
- GI upset and sensitive bowels:
- from celiac disease/gluten sensitivity
- Crohn’s disease
- Ulcerative colitis
- Hair loss (seen in SLE, alopecia totalis, thyroid disease)
- Joint pain (RA, SLE)
- Rashes (SLE, psoriasis)
Research and Treatments
Exciting new research is looking into the gut micro-biome and the immune system.
There are several treatments available for autoimmune conditions. If you have unexplained symptoms, looking into your immune system may be the key. It is important to understand that a diagnosis of autoimmune conditions is not an exact science. There are not perfect tests. Some women visit several physicians before a diagnosis is made. Many physicians recommend a whole food plant-based, anti-inflammatory diet for patients with inflammatory arthritis.
Healthy Living Tips for Autoimmune Diseases
- Good nutrition, including a plant based anti-inflammatory diet
- Healthy lifestyle with stress reduction
- Selected therapies that may include disease modifying anti-rheumatic drugs (DMARDS) and selected hormonal therapies as indicated for low hormone state
Be Strong. Be Healthy. Be in Charge!
-Holly L Thacker, MD and Feyrouz Al-Ashkar, MD
- Undo It by Dean Ornish, MD and Ann Ornish
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Feyrouz Al-Ashkar, MD, FACR, is a Staff Physician who specializes in evaluating and treating rheumatic and immunologic disease at Cleveland Clinic Lorain and Avon REJ, Family Health and Surgery Centers. She also specializes in evaluating and treating metabolic bone disorders, such as osteoporosis, osteopenia and paget's disease of the bone.
She is also board-certified by the American Board of Rheumatology and the American Board of Internal Medicine.
women's health, autoimmune disease, hashimoto's, MS, lupus, dr. feyrouz al-ashkar, dr. holly l. thacker
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