Why are autoimmune diseases more prevalent in women?

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Age, genetic and hormonal factors may explain why women are disproportionately affected by autoimmune diseases than men, said experts on Wednesday.

Autoimmune disease occurs when the immune system attacks the body's tissues. Studies show that the condition affects approximately 8 per cent of people worldwide, of which 78 per cent are women.

Dr Rajeev Gupta, Director - Internal Medicine at the CK Birla Hospital (R), Delhi said that hormonal influence and chromosomal differences are the two main reasons why autoimmune diseases are more common in women.

"Women experience significant hormonal fluctuations throughout their lives, particularly during puberty, pregnancy, and menopause. These changes, especially in oestrogen levels, may influence the immune system and make women more susceptible to mistakenly attacking healthy tissues (autoimmunity)," the doctor said.

Regarding chromosomes, women have two X, while men have one X and one Y.

"One theory suggests that the process of inactivating one X chromosome in each female cell might be incomplete sometimes. This could lead to an overabundance of certain genes on the active X chromosome, potentially triggering an overactive immune response and autoimmunity," Dr Rajeev said.

"Autoimmune disorders in women may be due to the silencing of their second X chromosome by molecules leading to a confusing immune system. This can explain why conditions like multiple sclerosis and lupus are more common in women than men," added Dr Yathish G C, Lead Consultant - Rheumatology, Aster Whitefield Hospital, Bengaluru.

Commonly, autoimmune diseases become more prevalent after a woman's thirties, coinciding with hormonal changes associated with ageing.

However, some autoimmune diseases can occur at any age.

"Some like multiple sclerosis usually begin between the ages of 20 and 40 years whereas others such as rheumatoid arthritis start manifesting later in the 40s or early in 50s," Dr Yathish said.

Dr Harman Singh, Consultant Rheumatologist, Fortis Hospital, Kalyan noted a dramatic rise in autoimmune illnesses, notably among women aged 50 and above.

The experts called for adopting healthy lifestyle practices such as a balanced diet, stopping smoking, avoiding alcohol, stress reduction techniques, being physically fit, and avoiding environmental pollutants.

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