Women's Health Issues--Beyond Menopause

In addition to what are usually thought of as "women's health" issues, there are many other conditions that are much more common in women, and may be due in part to biological differences between the sexes. For example, autoimmune diseases are the third most common major illness in the United States, impacting more than 8.5 million Americans. And three out of four people suffering from autoimmune diseases, such as multiple sclerosis (MS), rheumatoid arthritis (RA) and lupus, are women.¹ Interestingly, women have enhanced immune systems compared to men, which increases their resistance to many types of infection, but also makes them more susceptible to autoimmune diseases.²

One of the most common autoimmune conditions is rheumatoid arthritis (RA), a debilitating form of arthritis that affects 2.1 million Americans, mostly women. This chronic, systemic disease manifests in the synovial lining of joints and can only be controlled, not cured. As in other prominent autoimmune diseases, inflammation is central to the pathology of RA, as swelling in the synovium leads to thickening of the lining, followed by the release of enzymes that eat away the adjacent bone and cartilage. Pain is the chief symptom of RA, along with swelling, stiffness, joint damage and lack of mobility. The immune malfunction might reach beyond joints in RA patients, so symptoms of other autoimmune diseases, such as Sjogren's and psoriasis, are not uncommon.

Lupus, meanwhile, is a lifelong disease characterized by an immune system attack on various tissues and organs, including the skin, joints, lungs, heart and kidneys. People who develop lupus suffer a range of symptoms—from joint aches, high fevers, arthritis, chronic fatigue and anemia to skin rashes, kidney dysfunction and chest pain during deep breathing. The Lupus Foundation of America reports more than 1.5 million Americans suffer some form of the disease. However, lupus has a knack for mimicking other illnesses, making accurate epidemiology on the disease elusive. Lupus affects women 10 to 15 times more frequently than men.

And Multiple Sclerosis (MS) affects about 400,000 Americans, affecting two to three times as many women as men, according to the National Multiple Sclerosis Society. While scientists struggle to find the causes of MS, save strong genetic factors and possible environmental triggers, the mechanism of MS autoimmune action has become more apparent. Nerve fibers of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves, are enveloped in myelin, a fatty tissue that helps nerves conduct electrical impulse communications. Scientists suggest the immune system attacks the myelin, leaving damaged areas of scar tissue, called sclerosis. Also called plaques or lesions, these damaged areas are no longer able to support proper functioning of the electrical impulses crucial to nerve communication. Neurological dysfunction ensues, and people suffering MS can experience endless cycles of flare-ups--episodes of acute malfunctioning.

Scientists are still unsure exactly what causes immune system malfunctions, but they suspect a mixture of possible contributors, including environmental toxins, chronic stress, viral infections, lack of sunlight, hormones, pregnancy and heredity. Genes can determine the status of various immune components; yet, the presence of genetic markers for certain autoimmune outcomes does not necessarily manifest in disease. The exact manifestations of the autoimmune condition may be variable but they are generally linked by chronic inflammation, which suggests some commonality in nutritional treatments.

Inflammation has been particularly a particular research focus for essential fatty acids (EFAs). A review out of the University of Greenwich at Medway, Kent, England, stated both omega-3 and omega-6 EFAs are important for immune system development and response; the author noted the effect of fatty acids in autoimmune disease is variable and while omega-3s may enhance certain immune functions, omega-6s are critical for the balance of others.³

As far as omega-3 fatty acids, a review from The Center for Genetics, Nutrition and Health, Washington, noted omega-3s have potent immunomodulatory effects, impacting the types of eicosanoids made and reducing chronic inflammation.⁴ Researchers from the University of Texas Health Science Center at San Antonio conducted an animal study to assess the impact of fish oil, a rich source of long-chain omega-3s, on production of inflammatory cytokines.⁵ Administration of fish oil with different contents of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) produced variable effects, with a 23-to-14 ratio, respectively, producing significant decrease in tumor necrosis factor-alpha (TNF-a), interleukin-6 (IL-6) and IL-1beta. And Thai researchers examining the impact of a low omega-6 fatty acid diet supplemented with fish oil on 60 RA patients found higher fish oil intakes reduced TNF-p55 and C-reactive protein levels.⁶