The War Waged Within: Autoimmunity in Women

Many autoimmune diseases affect women more frequently than men. The ratio of affected women to affected men are given above for several autoimmune diseases on which 23andMe reports. (Source: American Autoimmune Related Disease Association, Inc.)

Editor’s note: Pending an FDA decision, 23andMe no longer offers new customers access to health reports referred to in this post. Customers who purchased prior to November 22, 2013 will still be able to see their health reports, but those who purchased after that time will not. Those customers will have access to ancestry information as well as access to their uninterpreted raw data.There are many wonderful things about being a woman, but our increased risk of autoimmune disease is not one of them. Autoimmune diseases are essentially civil wars within the body — the body’s immune system attacks its own organs and tissues. The term “autoimmune” covers a wide variety of conditions, from rheumatoid arthritis and multiple sclerosis to the lesser-known conditions of Hashimoto’s thyroiditis and Sjögren’s syndrome.One commonality of these conditions is that they affect women much more frequently than men. In some cases, this gender bias is quite striking; Hashimoto’s thyroiditis, a condition in which the immune system attacks the thyroid gland, affects women ten times more often than men. Some autoimmune diseases, however, are less biased; type I diabetes, for instance, affects women and men at approximately the same rate.
To learn more about these conditions and your genetic risk for them, you can check out the following 23andMe reports: Not yet a customer? Visit our store or learn more.
Why women are disproportionately affected by autoimmune disease is not fully known or understood, although the hypotheses are numerous. Some research suggests that estrogen may help antibody production and immune system response, but can also lead to an overly active immune system. Other research indicates that genes on the X chromosomes may play a role in these immune system mutinies, and women — who have two X chromosomes — may thus be at an increased risk over men who have only one X chromosome.Still other research suggests that “fetal-maternal microchimerism” may be the root cause. In this strange-sounding phenomenon, a small number of the baby’s cells pass through the placenta into the mother and continue to live within the mother. The presence of these foreign fetal cells within the mother may result in an incorrect immune system response and autoimmune disease. More research, however, is needed to establish which of these hypotheses (if any) are correct.Autoimmune diseases are serious medical concerns for women; indeed, when taken together, autoimmune diseases constitute one of the top ten causes of death among young and middle-aged women. The irony of these conditions is that the immune system, which should be a woman’s greatest ally in fighting disease, becomes her worst enemy. Why and how a body’s betrayal occurs needs to be better understood through further research.

  • Melissa

    Hi 23&Me folks!

    I’m a nutritionist/exercise physiologist/yoga person (and total science nerd). I am also a user of 23&Me. I do presentations on gluten/celiac disease, health, nutrition, etc. Would you let me use this autoimmune diseases slide of yours in a presentation? I will give you full credit.

    Thank you! I appreciate your time!

    Melissa McLean Jory
    Nutrition Therapy & Exercise Science
    303 868-7790

    • Hi Melissa,

      You are welcome to incorporate this image into your presentation. Thanks for being a customer (and fellow science nerd!) 🙂

  • Could there be an environmental connection as well? Like say, for example, women tend to be exposed to certain household chemicals more than men do during the course of their day (at least… in my household!) and these chemicals are playing havoc on our immune systems/bodies.

  • Teddy Devereux

    About the time of menopause I became afflicted with two dermal autoimmune diseases. Luckily for me, the symptoms have been minor and managable over the past 15 or so years. But now several of my friends who have recently gone through menopause seem to be acquiring odd medical problems (like new allergies) also. Is there any indication of increased autoimmune disease with menopause?

    Also, I wonder about your possible explanation about fetal cells moving into a mother’s blood causing some autoimmune diseases. Is there any evidence that mother’s have more autoimmune diseases than non-mothers, or that increased number of births causes increased propensity for auto-immune disease.

  • EChang

    Hi Teddy,
    Thank you for your comments. Unfortunately, much is still unknown about autoimmune diseases. A few studies have looked for a correlation between autoimmune risk and parity (number of children) but they were too small to say anything definitive. The average age of onset (and whether onset is before or after menopause) is highly dependent upon the type of autoimmune disease, but many conditions (such as lupus) often affect women of childbearing age.
    Thanks again for posting!

  • Heather D

    The theory about the baby’s cells passing into the mother doesn’t necessarily seem related to autoimmune disease…in my personal experience, it seems like many more women have these issues than men, and all of the women I know with these problems are younger women (20s) who have not had children. Can you provide some statistics on the occurrence of autoimmune disease in women who haven’t had children vs. men?

  • Sherry T

    Have you looked into Glomerulonephritis through 23andMe? Since it begins with a strep infection, then becomes an autoimmune disease, it may hold cues for these hypotheses. For instance, it occurs in early childhood, thus ruling out the microchimerism hypothesis, for at least these instances.
    Thanks for a good article!
    All the best

  • Deborah L

    Hi Teddy,

    I am curious about the dermal autoimmune diseases you mentioned. I am 53 and things are getting strange in the menopause department, but have recently developed vitiligo. Anyway, the article is welcome.

  • Carol D

    Sounds like my case. Menopause around age 50. Pemphigus vulgaris at age 53. That went into remission. Second autoimmune condition (myasthenia gravis) diagnosed at age 59. I had surgery (thymectomy) and am slowly recovering.

  • Donita O

    My 28 year old daughter was just diagnosed with Sjogrens Syndrome. I am 62 and my 3 sisters are younger; None of us have experienced symptoms suggesting testing for any autoimmune disorders, but our mother died at age 75 as a result of complications from Diffuse Systemic Scleraderma. We know of no other person in our reasonably large family (Mother’s side) with an autoimmune disorder, except a cousin on my Father’s side who turns out to also be our 4th cousin on Mother’s side. Would my DNA show me as more likely to have an autoimmune disorder? Can DNA identify a “carrier” of disease? How does the genetic code work in passing on a disease that seems to show up so seldom within a large family? Would my daughter’s DNA add anything to current studies on autoimmune disorders?

    • Hi Donita,

      Autoimmune disorders are very complex. While many genetic factors have been identified for most of them and some of the diseases appear to be similar genetically, there is still much unknown about the development of these disorders. The environment also plays a large role. For these reasons, the genetic factors that are currently known are usually not the whole picture. In rare cases, a specific genetic factor may be at cause, but more often these diseases are the result of many different factors, both genetic and non-genetic.

      Your daughter could certainly contribute to research on Sjogren’s syndrome. It does often take thousands of people and some time to make discoveries but every little bit helps!

  • Robert Specker

    I am a male with Ankylosing Spondylitis (AS), an example where male cases are higher then female cases. AS is a horrible autoimmune disease. I’m pretty sure I received it from my mother. However, she grew up in an orphanage, so I can’t determine that for sure. Males express the disease to a greater extent than females, as well. Very little research has been done on this disease.

  • dancinbarefoot

    Does this 23 and me test tell me anything about autoimmune disorders that I have? I really don’t care to know if maple syrup urine disease or unibrow runs in my family. Most of this in here seems useless info to me. No disrespect meant, just saying. How would this report help with my Hashimoto’s and adrenal fatigue?

    • 23blog

      We do not have reports on autoimmune disorders and it’s unlikely that the reports we offer will help you with the conditions you mention in your comment.