What are autoimmune diseases and why are they considered a women’s issue?

How many people are impacted by autoimmune diseases in the US?

Perhaps around 50 million people, of those, 25% have been diagnosed with more than one. But we don’t have an exact number because there is a lack of agreement on what constitutes an autoimmune disease, too many autoimmune diseases go undiagnosed, and there is no centralized database or coordinated research to help get an accurate count.

Research suggests that autoimmune diseases will soon become one of the most predominant medical disorders in the U.S.

By some estimates, autoimmune disease directly costs the U.S. economy about $100 billion a year, and it is acknowledged that this number is an underestimation.

What is an autoimmune disease?

Under the umbrella “autoimmune disease” is over 100 diseases and chronic conditions. In general, an autoimmune disease is when the body’s own immune system begins to attack other systems, cells, and/or tissues. The reason why is unknown. It is theorized that a person may have a predisposition to develop a disorder that is triggered by the inflammation caused by bacteria, viruses, toxins, some prescription drugs, environmental impacts such as smoking, stress, lack of exercise, and possibility due to normal hormone fluctuations.

Autoimmune diseases are categorized into organ-specific disorders and non-organ-specific disorders. Type 1 diabetes is considered organ-specific since it impacts the pancreas, whereas rheumatoid arthritis (RA) is non-organ-specific since the autoimmune activity is spread throughout the body.

The most common autoimmune diseases are:

Crohn’s Disease: an inflammatory bowel disease that can impact the entire GI tract

Diabetes Type 1: a disease impacting the pancreas, causing a buildup of glucose in the blood

Multiple Sclerosis (MS): a nervous system disease that affects the brain and spinal cord

Rheumatoid Arthritis (RA): an inflammatory disease impacting the joints

Lupus: an inflammatory disease that can impact almost every system in the body

Scleroderma: a disease that cause abnormal growth of connective tissue, impacting the skin, internal organs, and blood vessels

Psoriasis: a skin disease that causes a rash with itchy patches. 30% of people go on to develop psoriatic arthritis

How are autoimmune diseases treated?

Autoimmune diseases are treated by a specialist determined by the body system it impacts, for example:

neurologists treat MS,

rheumatologist treat RA, lupus, and scleroderma,

gastroenterologist treat Crohn’s,

endocrinologist treat diabetes

dermatologist treat psoriasis

and hematologist treat autoimmune diseases that impact blood.

There is no cure for autoimmune diseases. There are a variety of medications that treat the symptoms. Most fall into 3 broad categories, reducing inflammation, reducing pain, and suppressing the immune system.

What are the causes?

Presently, we do not know what causes autoimmune diseases.

Research has found links to diet, exposure to pesticides, pollutants, drugs, chemicals, hormone fluctuation, increase in obesity, sleep deprivation, stress, air pollution and the impact of climate change.

Autoimmune diseases, in general, tend to run in families, but not specific disorders. For example, one family member may have lupus and another RA.

Why are autoimmune diseases a women’s issue?

80% of patients diagnosed with autoimmune diseases are women.

Lupus impacts Black women 3x more than white women.

The U.S. Department of Health and Human Services (HHS), acknowledge autoimmune diseases are the 4th cause of disability among American women, and the 8th leading cause of death among women between the ages of 15 and 64.

A study published in 2020, identified that autoimmune diseases tend to impact women during periods of extreme stress on the body, for example, during pregnancy and hormonal changes.

Some researchers have explained the sex difference by pointing to the X chromosome, of which females have two. The X chromosome carries immune system related genes, and since women have two, it is thought that there is twice the risk of mutations.

Other research suggests that estrogen and progesterone serve a function to help reduce inflammation. This could possibly explain why women between the ages of 40 and 60 have the highest rates of RA and Sjögren’s syndrome diagnoses since this same group would be experiencing a drop in estrogen and progesterone due to peri- and post-menopause.

Hormonal changes and fluctuations during puberty and pregnancy are also considered a possible causation factors. An increase in estrogen during pregnancy is being attributed to systemic sclerosis. A study in Taiwan noted a greater risk of developing MS in postpubescent girls compared to prepubescent girls and boys in either group.

If you have been diagnosed with or suspect you have an autoimmune disease/disorder and would like to help add to the collection of data about sex and race, I encourage you to visit the Autoimmune Association’s page “Define the Gap” and join their patient registry.

https://autoimmune.org/research/define-the-gap/

References:

Facts and figures for this post came from:

Autoimmune Association website: https://autoimmune.org

National Stem Cell Foundation website: https://nationalstemcellfoundation.org

2020 study, The Prevalence of Autoimmune Disorders in Women: A Narrative Review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292717/

This blog post is for informational purposes only and does not create any type of therapeutic relationship. For specific assistance, please consult your own medical and/or mental health provider.