I think it was in interview with Gabor Mate I heard, in which he hypothesized that women have more autoimmune disease than men because of a multitude of factors that lead to increased cortisol levels. These included putting others needs above your own, caretaking in general, increased daily responsibility, etc. Regardless of the specific cultural/lifestyle contributions, I am intrigued about the role of cortisol in the development of these autoimmune diseases.
His book When the Body says No. the cost of hidden stress is worth a read. I believe our early traumatic experiences, when our developing brain is flooded with cortisol, has an impact on future health. On the other hand siblings can suffer the same level of trauma and not all develop disease. There must be several factors at play.
Gabor Mate (love him btw) also says that each child was raised by a different parent. Meaning that the parents responded to each child differently. So even through the two people are siblings and birth parents are the same, they were each raised by different people.
I agree with that. All relationships are different. Even with our children. I have 3 and I interact differently with them. My first one was born after baby losses etc in late 80s. I was so mentally unprepared for him. I was in constant anxiety throughout the pregnancy. I didn’t think I’d have a live baby. I couldn’t be the mother I wanted to be. He is a highly anxious person. My daughter was born in 2000, situation was stable, and i had a different relationship all together. I can see the reflection of what was going on in my life on all 3 of them.
Is it anecdotal that more women are diagnosed soon after pregnancy? Pregnancy suppresses symptoms which return ( often significantly) afterwards which would suggest hormonal involvement? Women are more susceptible to auto immune conditions which are being more frequently recognised?
I was going to write a similar thing. I read an article in Scientific American about auto immune diseases and women. which linked hormone involvement. It mentions MS a couple of times. Here is a link to the article.
It let me click it on it, so I'm assuming it's not behind a paywall. That being said, I don't understand how paywalls work, and if they're country specific lol
What I find interesting and extremely frustrating is that women's MS disability statistically get's worse around the time of perimenopause and menopause. Check out the clinical research on women with MS by Dr. Voskuhl out of UCLA. I just turned 50 and you would think that women with MS would be supported hormonally (or even biologically during this time). It was extremely difficult to get estrogen (estriol B) patches in Canada. I started reading the research and clinical findings of women with MS during perimenopause and Menopause and what happens to their brains and got scared for my life and brain and when there I went looking to actual help from the medical system - I'll just say it was (and ppl with MS know the struggle) but getting proper help for our brains during this time was so exceptionally difficult (I speak for my self in Canada) that women could legit make a case to the Human Rights Commission or Amnesty International for hate crimes against middle aged women with MS.
Could it be anything to do with how women handle life in general? Women tend to stress a lot more which can then put a lot of strain on the body and cause inflammation. A lot of people report relapses after a stressful life changing event like a death in the family.
Women's immune system are different to that of men. Look to incidents of COVID hospitalisation from male to female. More men were hospitalised, but also women in peri and post menopause. Women's immune system is more reactive compared to men's and changes throughout the cycle and life.
I'd say that it's likely that this is multifactorial, not as simple as 1 virus + genes = MS.
It's probably more likely the case, given the changes of F:M ratio and diagnosis across regions, that as you say, there are environmental impacts at play, too. Plastics play a big role in both male and female hormone panels as one example - and not unilaterally the same for both F & M. Iran is a big producer of some consumables in the west/globally, Canada is also one the US's biggest exporters (oil/gas, foods, paper goods, printed goods etc). Historical times (and current) could include exposure to lead, fungal spores, specific bacterium. But men typically work in labour fields.
A single 'contaminant' may not have the same impact on Joe as Jane, nor Joe's brother. Genes, exposures to viruses all stack the deck.
My personal opinion is that we may never know a single cause or even multifactorial causes because it's so complex and truthfully, we know what's killing us and the planet now - and, we're still acting as though everything is fine. Even if a discovery were to occur, the goal would be to treat not cease destructive behaviours. Besides which, it may be entirely 'benign' what's causing MS (full stop) let alone the F:M ratio difference, regional difference.
It's a really interesting question, especially given the changes over history.
I agree, microplastics and other hormone interruptors, other toxins that women are possibly exposed to more than men such as cleaning products, hair dyes and other cosmetics - maybe all of these things can impact hormones which then impact endocrine and other systems in the body?
There is evidence to suggest that it’s the burden of caregiving women take on that could be contributing factor to the ratio as it has changed too fast from a time it was 50:50 to be explained by genetics or epigentics. It is evident in other autoimmune conditions also. Also decreasing hormones lead to more insulin resistance and thus inflammation, again thought to be a factor. I get all this information from the Feel Better Live More podcast with guests of significant scientific background.
Gabor Mate is really good on this. Maybe telling women they can 'have it all' which really means 'do it all' where 'it' is working, parenting (children and partner!), housework, elder care, and generally making sure everyone else is ok, is the cause of the increase during the 20th century which continues today. We need to teach our girls to be selfish! Mate says if something goes wrong with the body, we should be asking what it is trying to tell us. I always think this now when I start to feel fatigued, pain etc. It's normally telling me to rest, and stop worrying about everyone else!
women are more likely to have to deal with coercion and abuse from their partners. when someone has to be quiet in this environment, the nervous system
Regarding stress as a trigger, has work been done to look at sex and job / profession? I recognise that stress is personal and people handle it very differently! I thought I handled stress well but my first symptom of optic neuritis did coincide with a crazy stressful period in my life 🤷♂️
A very interesting mystery! I know the mind jumps immediately to things like hormonal changes and stress and such. But women have always had hormonal changes (including pregnancies and menopause) and I'm sure they've also had stress, even though the specific reasons for that stress changed. So these things could explain a higher incidence in women than in men, but not an actually RISING incidence - unless we think more in the direction of xeno-estrogens and potential other environmental toxins that might influence female hormones (e.g. dioxins). Since personally I think EBV could very well be not only the trigger, but also a continued driving factor of MS, I wonder how the virus would interact differently with female hormones (or possible disturbances there through environmental factors) compared to male hormones. At the same time I wonder about other possible causes for this mystery, that might not be related to female hormones at all.
The inbuilt gender bias in everything. As others have mentioned - women trying to do it all - usually lands up with them doing it all with little to no support.
Women’s health conditions are not managed to an optimal level because most research was done in men. The gap is even wider for women of colour.
Also, domestic abuse is rife. Women living in abusive and coercive relationships - often not even realising it. As much as men would like to say that men are the victims in domestic support - the true numbers are much more weighted to women being the victim.
I work in a NHS Community Mental Health Team. I also have RR MS. I have a theory (not based on any clinical trials yet) that the incidence of MS in females is linked to childhood trauma. I believe epigenetics, smoking, lack of vitamin D and hormonal factors also play a part. Every female with MS I know in my personal life and every female patient with MS, has experienced Adverse Childhood Experiences (ACE's) - that is childhood trauma.
While it is multifactorial, I believe the key is HORMONES. There is some interesting research happening in this area.
Side note: I recently believed my MS was progressing - symptoms were escalating - my GP suggested that my symptoms were related to the MS handed me an antidepressant, and a OBGYN concurred.
Luckily, my neurologist (an MS specialist) pointed out, after MRIs of brain, C-spine, T-spine, that menopause was the the likely driver.
I now have a new GP/GYN and am on hormone replacement therapy. Quality of live is better by a factor of a TON.
I asked Claude-AI what it thought about it, considering this post, the comment-section, and its general knowledge. Here's what it told me:
"**Stress and Biological Response:**
- Chronic stress and cortisol levels (as Gabor Maté suggests) from increasing societal pressures
- The "do it all" expectation of modern women (work, family care, household management)
- Different stress-handling patterns between genders
- Early life stress and trauma impacts on immune system development
**Hormonal/Reproductive Patterns:**
- Complex interactions between pregnancy, postpartum, and MS
- Changes in pregnancy patterns (later, fewer, or no pregnancies)
- Hormonal fluctuations during perimenopause
- Interactions between estrogen and the immune system
- Changes in breastfeeding patterns
**Environmental/Chemical Exposure:**
- Increased exposure to endocrine-disrupting chemicals
- Higher exposure to personal care products and cosmetics
- Household cleaning products exposure
- Microplastics and their hormone-disrupting effects
- Different workplace exposures as women's roles evolved
**Biological/Medical Factors:**
- Sex differences in immune system reactivity
- Gut microbiome changes and their immune effects
- Potential diagnostic patterns (women seeking medical care earlier)
- Interaction between EBV and sex-specific biology
- Weight changes and metabolic factors
What makes this particularly intriguing is that these factors:
1. Changed gradually over the 20th century
2. Affect immune system regulation
3. Impact women differently than men
4. Vary by geography/culture
5. Might specifically affect RRMS but not PPMS
The Iranian data showing a reversing trend suggests whatever drives this shift is environmental rather than genetic and potentially modifiable. Given the complexity of factors raised in the discussion, we're likely looking at multiple interacting causes rather than a single factor.
This also raises important questions about prevention and whether addressing some of these modifiable factors could help reduce risk."
What is the cultural differences between men and women in Iran. Do men have more access to medical care than women? Also, cultural biases, power imbalances, disclosure, access to money, MS is a very costly disease.
Prof. Colleen Hayes has done some interesting research on vit. D and how it interacts with estrogen, linking to the sex differences. She's actually quite a great researcher to connect with!
I thought I read an article a couple of years ago which suggested that pregnancy can reduce the risk of a woman subsequently developing MS. More women now (compared to earlier decades) do not have children / are having one child / are having children later. Perhaps these changes might explain some of the rising incidence.
Could it be a diagnosis bias? Ie more women tend to address more bodily issues with doctors early on before men do. So women get diagnosed earlier than men when MS is at its early stages- during RRMS . Men tend to wait until their MS is at its 11th hour, when MS has likely gone past RRMS stage and moved into progressive MS. Also i wonder if rising incidence of MS could be due to more clinicians being clued up on MS now, so diagnosis is on the up.
I think it was in interview with Gabor Mate I heard, in which he hypothesized that women have more autoimmune disease than men because of a multitude of factors that lead to increased cortisol levels. These included putting others needs above your own, caretaking in general, increased daily responsibility, etc. Regardless of the specific cultural/lifestyle contributions, I am intrigued about the role of cortisol in the development of these autoimmune diseases.
His book When the Body says No. the cost of hidden stress is worth a read. I believe our early traumatic experiences, when our developing brain is flooded with cortisol, has an impact on future health. On the other hand siblings can suffer the same level of trauma and not all develop disease. There must be several factors at play.
Gabor Mate (love him btw) also says that each child was raised by a different parent. Meaning that the parents responded to each child differently. So even through the two people are siblings and birth parents are the same, they were each raised by different people.
I believe domestic violence against women plays a strong part.
I agree with that. All relationships are different. Even with our children. I have 3 and I interact differently with them. My first one was born after baby losses etc in late 80s. I was so mentally unprepared for him. I was in constant anxiety throughout the pregnancy. I didn’t think I’d have a live baby. I couldn’t be the mother I wanted to be. He is a highly anxious person. My daughter was born in 2000, situation was stable, and i had a different relationship all together. I can see the reflection of what was going on in my life on all 3 of them.
Is it anecdotal that more women are diagnosed soon after pregnancy? Pregnancy suppresses symptoms which return ( often significantly) afterwards which would suggest hormonal involvement? Women are more susceptible to auto immune conditions which are being more frequently recognised?
I was going to write a similar thing. I read an article in Scientific American about auto immune diseases and women. which linked hormone involvement. It mentions MS a couple of times. Here is a link to the article.
https://www.scientificamerican.com/article/why-nearly-80-percent-of-autoimmune-sufferers-are-female/
It let me click it on it, so I'm assuming it's not behind a paywall. That being said, I don't understand how paywalls work, and if they're country specific lol
What I find interesting and extremely frustrating is that women's MS disability statistically get's worse around the time of perimenopause and menopause. Check out the clinical research on women with MS by Dr. Voskuhl out of UCLA. I just turned 50 and you would think that women with MS would be supported hormonally (or even biologically during this time). It was extremely difficult to get estrogen (estriol B) patches in Canada. I started reading the research and clinical findings of women with MS during perimenopause and Menopause and what happens to their brains and got scared for my life and brain and when there I went looking to actual help from the medical system - I'll just say it was (and ppl with MS know the struggle) but getting proper help for our brains during this time was so exceptionally difficult (I speak for my self in Canada) that women could legit make a case to the Human Rights Commission or Amnesty International for hate crimes against middle aged women with MS.
Implications of menopause not discussed with me at all. 7 years later I fell, broke my hip and was diagnosed with osteoporosis…
Could it be anything to do with how women handle life in general? Women tend to stress a lot more which can then put a lot of strain on the body and cause inflammation. A lot of people report relapses after a stressful life changing event like a death in the family.
Women's immune system are different to that of men. Look to incidents of COVID hospitalisation from male to female. More men were hospitalised, but also women in peri and post menopause. Women's immune system is more reactive compared to men's and changes throughout the cycle and life.
I'd say that it's likely that this is multifactorial, not as simple as 1 virus + genes = MS.
It's probably more likely the case, given the changes of F:M ratio and diagnosis across regions, that as you say, there are environmental impacts at play, too. Plastics play a big role in both male and female hormone panels as one example - and not unilaterally the same for both F & M. Iran is a big producer of some consumables in the west/globally, Canada is also one the US's biggest exporters (oil/gas, foods, paper goods, printed goods etc). Historical times (and current) could include exposure to lead, fungal spores, specific bacterium. But men typically work in labour fields.
A single 'contaminant' may not have the same impact on Joe as Jane, nor Joe's brother. Genes, exposures to viruses all stack the deck.
My personal opinion is that we may never know a single cause or even multifactorial causes because it's so complex and truthfully, we know what's killing us and the planet now - and, we're still acting as though everything is fine. Even if a discovery were to occur, the goal would be to treat not cease destructive behaviours. Besides which, it may be entirely 'benign' what's causing MS (full stop) let alone the F:M ratio difference, regional difference.
It's a really interesting question, especially given the changes over history.
I agree, microplastics and other hormone interruptors, other toxins that women are possibly exposed to more than men such as cleaning products, hair dyes and other cosmetics - maybe all of these things can impact hormones which then impact endocrine and other systems in the body?
There is evidence to suggest that it’s the burden of caregiving women take on that could be contributing factor to the ratio as it has changed too fast from a time it was 50:50 to be explained by genetics or epigentics. It is evident in other autoimmune conditions also. Also decreasing hormones lead to more insulin resistance and thus inflammation, again thought to be a factor. I get all this information from the Feel Better Live More podcast with guests of significant scientific background.
Gabor Mate is really good on this. Maybe telling women they can 'have it all' which really means 'do it all' where 'it' is working, parenting (children and partner!), housework, elder care, and generally making sure everyone else is ok, is the cause of the increase during the 20th century which continues today. We need to teach our girls to be selfish! Mate says if something goes wrong with the body, we should be asking what it is trying to tell us. I always think this now when I start to feel fatigued, pain etc. It's normally telling me to rest, and stop worrying about everyone else!
women are more likely to have to deal with coercion and abuse from their partners. when someone has to be quiet in this environment, the nervous system
fails. autoimmunity can result. 100%.
yes!
Regarding stress as a trigger, has work been done to look at sex and job / profession? I recognise that stress is personal and people handle it very differently! I thought I handled stress well but my first symptom of optic neuritis did coincide with a crazy stressful period in my life 🤷♂️
It would be interesting to know if other immune system conditions follow a similar pattern of prevalence.
A very interesting mystery! I know the mind jumps immediately to things like hormonal changes and stress and such. But women have always had hormonal changes (including pregnancies and menopause) and I'm sure they've also had stress, even though the specific reasons for that stress changed. So these things could explain a higher incidence in women than in men, but not an actually RISING incidence - unless we think more in the direction of xeno-estrogens and potential other environmental toxins that might influence female hormones (e.g. dioxins). Since personally I think EBV could very well be not only the trigger, but also a continued driving factor of MS, I wonder how the virus would interact differently with female hormones (or possible disturbances there through environmental factors) compared to male hormones. At the same time I wonder about other possible causes for this mystery, that might not be related to female hormones at all.
The inbuilt gender bias in everything. As others have mentioned - women trying to do it all - usually lands up with them doing it all with little to no support.
Women’s health conditions are not managed to an optimal level because most research was done in men. The gap is even wider for women of colour.
Also, domestic abuse is rife. Women living in abusive and coercive relationships - often not even realising it. As much as men would like to say that men are the victims in domestic support - the true numbers are much more weighted to women being the victim.
I work in a NHS Community Mental Health Team. I also have RR MS. I have a theory (not based on any clinical trials yet) that the incidence of MS in females is linked to childhood trauma. I believe epigenetics, smoking, lack of vitamin D and hormonal factors also play a part. Every female with MS I know in my personal life and every female patient with MS, has experienced Adverse Childhood Experiences (ACE's) - that is childhood trauma.
While it is multifactorial, I believe the key is HORMONES. There is some interesting research happening in this area.
Side note: I recently believed my MS was progressing - symptoms were escalating - my GP suggested that my symptoms were related to the MS handed me an antidepressant, and a OBGYN concurred.
Luckily, my neurologist (an MS specialist) pointed out, after MRIs of brain, C-spine, T-spine, that menopause was the the likely driver.
I now have a new GP/GYN and am on hormone replacement therapy. Quality of live is better by a factor of a TON.
I asked Claude-AI what it thought about it, considering this post, the comment-section, and its general knowledge. Here's what it told me:
"**Stress and Biological Response:**
- Chronic stress and cortisol levels (as Gabor Maté suggests) from increasing societal pressures
- The "do it all" expectation of modern women (work, family care, household management)
- Different stress-handling patterns between genders
- Early life stress and trauma impacts on immune system development
**Hormonal/Reproductive Patterns:**
- Complex interactions between pregnancy, postpartum, and MS
- Changes in pregnancy patterns (later, fewer, or no pregnancies)
- Hormonal fluctuations during perimenopause
- Interactions between estrogen and the immune system
- Changes in breastfeeding patterns
**Environmental/Chemical Exposure:**
- Increased exposure to endocrine-disrupting chemicals
- Higher exposure to personal care products and cosmetics
- Household cleaning products exposure
- Microplastics and their hormone-disrupting effects
- Different workplace exposures as women's roles evolved
**Biological/Medical Factors:**
- Sex differences in immune system reactivity
- Gut microbiome changes and their immune effects
- Potential diagnostic patterns (women seeking medical care earlier)
- Interaction between EBV and sex-specific biology
- Weight changes and metabolic factors
What makes this particularly intriguing is that these factors:
1. Changed gradually over the 20th century
2. Affect immune system regulation
3. Impact women differently than men
4. Vary by geography/culture
5. Might specifically affect RRMS but not PPMS
The Iranian data showing a reversing trend suggests whatever drives this shift is environmental rather than genetic and potentially modifiable. Given the complexity of factors raised in the discussion, we're likely looking at multiple interacting causes rather than a single factor.
This also raises important questions about prevention and whether addressing some of these modifiable factors could help reduce risk."
What is the cultural differences between men and women in Iran. Do men have more access to medical care than women? Also, cultural biases, power imbalances, disclosure, access to money, MS is a very costly disease.
Prof. Colleen Hayes has done some interesting research on vit. D and how it interacts with estrogen, linking to the sex differences. She's actually quite a great researcher to connect with!
https://biochem.wisc.edu/people/hayes/
Thanks so this.
I thought I read an article a couple of years ago which suggested that pregnancy can reduce the risk of a woman subsequently developing MS. More women now (compared to earlier decades) do not have children / are having one child / are having children later. Perhaps these changes might explain some of the rising incidence.
Could it be a diagnosis bias? Ie more women tend to address more bodily issues with doctors early on before men do. So women get diagnosed earlier than men when MS is at its early stages- during RRMS . Men tend to wait until their MS is at its 11th hour, when MS has likely gone past RRMS stage and moved into progressive MS. Also i wonder if rising incidence of MS could be due to more clinicians being clued up on MS now, so diagnosis is on the up.