It’s no coincidence that March is designated as both National Autoimmune Diseases Awareness and Women’s History Months. I thought I would share a bit about what I've learned about Autoimmune disease as it relates to women since I've been diagnosed with Primary Ovarian Insufficiency (POI).
Prior to my diagnosis I haven't really had much experience or knowledge in autoimmune diseases. I don't have any family history (that I'm aware of) and I didn't have any autoimmune conditions prior to my diagnosis. But after I was diagnosed with POI I began my research trying to find the underlying cause of my POI. I've spend the past year reading research articles, listening to podcasts, and joining support groups looking for answers.
80-90% of women with POI are thought to be idiopathic POI (no underlying cause). While some causes are genetic or iatrogenic (surgery or cancer treatments) autoimmune conditions are linked to around 5% of women with POI. Autoimmune disorders are conditions in which the body’s immune system can attack its own tissues. If damage occurs to the ovaries it can result in POI. POI is connected with autoimmune disorders including underactive thyroid (hypothyroidism and/or Hashimoto's), type 1 diabetes, and Addison's disease.
It's estimated that 50 million Americans or 8% of the population or nearly 4% of the world's population have an autoimmune disease. With 5-10% having more than one autoimmune disease. There are 80-100 autoimmune diseases known to exist, ranging from mild to severe and intermittent to chronic. Women are much more likely to be affected by autoimmune diseases than men with an estimate of 80% being women! Autoimmune diseases tend to run in families, but there may be other culprits involved, scientists say, such as diet, environmental factors, viruses, bacteria and even stress. Then, there's the gender bias, research shows autoimmune diseases are more common in women, occurring at a rate of 2 to 1. One reason for higher rates of autoimmune diseases in females could be women's higher fluctuating hormone levels. Many autoimmune disorders tend to affect women during periods of extensive stress, or during a great hormonal change such as pregnancy or menopause.
Here are five of the most common autoimmune diseases that affect women:
Systemic lupus erythematosus (lupus).
Multiple sclerosis (MS)
Thyroid diseases (Hashimoto's & Graves')
Rheumatoid arthritis (RA)
Psoriasis
Autoimmune diseases most commonly connected to Premature Ovarian Insufficiency are:
Hashimoto's Thyroiditis - The thyroid gland becomes inflamed, impairing its ability to produce thyroid hormones. This leads to a gradual decline in function and eventually an underactive thyroid, which causes many functions of the body to slow down.
Autoimmune Addison's Disease - AAD affects the function of the adrenal glands, which disrupts the production of several hormones including cortisol and aldosterone, which regulate stress response (fight or flight) and blood pressure.
Type 1 Diabetes - T1D occurs when the body’s immune system attacks insulin-producing pancreatic beta cells (islets), causing the body to have insufficient insulin stores. These insufficient insulin levels hinder glucose from entering cells, negatively impairing the energy production process in the body.
After doing more research and digging into what my root cause of POI might be I was going over all of my symptoms with a new doctor and we decided to go for an MRI to rule out a Pituitary Adenoma. Pituitary Adenomas are non cancerous tumors that can affect hormones and interfere with menstrual cycles. After completing the MRI (which was pretty scary and overwhelming but not as bad as my husband made it out to be LOL) my results came back stating Lymphocytic Hypophysitis or Autoimmune Hypophysitis - this disease is characterized by chronic inflammation of the pituitary gland resulting in a reduction of several pituitary hormones related to various metabolic functions. Common symptoms include headache, absence of menstruation in females, sexual dysfunction in males, visual disturbances, and diplopia. Coexisting diseases and conditions are Diabetes insipidus, Hashimoto’s thyroiditis, and Addison’s disease. (also common in POI) Research states that females are 3 times more likely to get autoimmune hypophysitis than males. The condition also is more likely to occur during the third trimester of pregnancy or early postpartum period. I'm seeing an Endocrinologist to frequently check hormone levels to monitor my thyroid and adrenals to see if the Hypophysitis results in Hashimoto's or Addison's.
Trying to find the right doctor and knowing who can help diagnose and treat you is in my opinion one of the toughest things. It can take on average 4.5 years to get an autoimmune disease diagnosed and during that time patients typically will have seen 4 doctors. Rheumatologists are trained to diagnose and treat autoimmune and inflammatory diseases that affect the musculoskeletal system, as well as systemic conditions. Other doctors who diagnose and treat autoimmune disease and related conditions:
Dermatologists
Endocrinologists
Gastroenterologists
Immunologists
Internists
Neurologists
Functional medicine doctors
Integrative medicine doctors
Naturopathic doctors
Osteopaths
Naturopathic doctors work with a combination of modern Western physicians and holistic practitioners to build your network of healthcare providers. It can be helpful to work with more than one expert in order to benefit from their additional knowledge, experience, and methods. They may offer fresh perspectives and be willing to communicate with each other, as the need arises, and coordinate your care. It's important to be your own advocate for your health and take charge by identifying your symptoms, collect family history, seek referrals and specialists who have experience with your most major symptoms, and get a second, third or even fourth opinion!
sources: American Autoimmune Related Disease Association (AARD) and Global Autoimmune Institute.
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