Myasthenia gravis (MG) is a heterogenous disease, meaning each patient will have a slightly different experience. Gender is one area where disease presentation fluctuates widely.
In general, women with MG experience a more severe disease course than men, possibly due to differences in hormones and responses to medication. Understanding these differences can help you advocate for gender-sensitive care that addresses these disparities.
Symptom onset
Women with MG tend to experience symptom onset much earlier in life, usually around 20 to 30 years old. Men, on the other hand, typically develop symptoms around age 60 to 70. Before age 40, around 75% of patients with MG are women.
Even though women with MG are normally diagnosed at younger ages, the time between symptom onset and diagnosis (referred to as diagnostic delay) is often longer for women than it is for men. This is partially because many women experience more general symptoms at disease onset, making it difficult for doctors to pinpoint MG as the cause.
Subtype of myasthenia gravis
There are several subtypes of MG, each with different causes and prognoses. One of these subtypes is anti-MuSK-positive MG. Patients with this type produce antibodies that attack muscle-specific tyrosine kinase (MuSK), a protein that supports the function of the neuromuscular junction.
Women account for up to 85% of anti-MuSK-positive MG cases. This subtype is associated with more rapid disease progression and more severe symptoms than other types of MG.
Read more about the types of myasthenia gravis
Disease severity
Overall, women with MG experience more severe symptoms than men. Women may also have more physical challenges related to daily activities than men and require more intensive rehabilitation.
Comorbidities are common among individuals with MG, regardless of gender. But women with MG are more likely to have autoimmune diseases such as thyroid conditions, rheumatoid arthritis and systemic lupus erythematosus. Cardiovascular conditions like high blood pressure, however, are typically more common among men.
Quality of life
Several studies have shown that women with MG have poorer quality of life than men. This can be attributed in part to greater levels of fatigue and higher rates of depression and anxiety.
Women with MG may also experience more severe fear of progression than men, meaning they worry more about the biological and psychological repercussions of the disease and the risk of recurrence or progression.
Although more research is still needed to better understand exactly why these sex-related differences exist, know that these disparities are very real and should be acknowledged as such by your healthcare providers.
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