Thomas et al. 2022: The underlying sex differences in neuroendocrine adaptations relevant to Myalgic Encephalomyelitis Chronic Fatigue Syndrome

[Rufous McKinney]

Review article
The underlying sex differences in neuroendocrine adaptations relevant to Myalgic Encephalomyelitis Chronic Fatigue Syndrome



Conclusions
There is clear evidence of a sex dimorphism with regards to prevalence (3:1 female preponderance), clinical phenotypes, and aetiological triggers prior to symptom onset of ME/CFS. Endocrinological events, particularly those throughout the female lifespan, are associated with ME/CFS and include reproductive menstrual cycle fluctuations, pregnancy, post-partum and perimenopause. Further, there is evidence for gonadal sex, adrenal stress and renal neuroendocrine systems as implicated in ME/CFS, including changes in estrogen, progesterone compounds, aldosterone, and cortisol levels, of which there are established sex differences. The broad effects of steroid hormones on the physiological systems may also speak to the diversity of ME/CFS symptomatology observed in patients. Further attention must be paid to sex, age, and steroid biology in ME/CFS.

 

[Rufous McKinney]

This will take time to wade through and ponder.

I experienced severe and devastating morning sickness. Consider the spinal defects, and your supposed to get a baby out of there? I had to get the Swedish vacuum. There is no energetic flow during the birthing experience.

Everything for me worsened at menopause dramatically, including the not sleeping. When that starts, your brain is not getting cleansed.

I think thats a key moment in "the worsening".

Not suggesting everyone worsens. In my case, I was under far too much stress. Like I spent five months with lawyers, flying around in airplanes, wearing suits and high heels, and attempting to actually secure an out come which failed. It was my job. I didn't fail, but the system did. I recall thinking they might have to call ambulances, to carry me away.

With an illness like this: I was in the wrong line of work.

 

[Marylib]

Thanks for posting. I am so tired of people writing studies about what has been so obvious for so long...then saying it should be studied further forever and ever. Maybe I should change my online handle to "Jaded." Looking forward to what the males have to say, too. Sorry to read about all your troubles @Rufous McKinney. I'm one of those whose reproductive system was so screwed up I could never conceive a child - much to my sorrow. (MCAS and endometriosis go together like .. um.. room-mates from hell.) Then came the early horribly painful menopause. On the plus side, I was healthy until my late 30's and many people with this disease don't get that long a ride.

 

[lenora]

Hello everyone. @Marylib.....I'm sorry that you wanted but couldn't have children. I do hope that you found a baby/child to fill that void for you (niece, nephew, friend's child).

Yes, we have many hormonal upheavals that affect our endocrine system. I had no trouble getting pregnant with my first child, but did with the second due to self-imposed stress (which I wasn't aware of at the time). You know, the old "do it all" feeling we feel capable of when young. I'm sure that men feel this also, not meaning to undermine them at all. Still we have different physical responses for the most part and it probably affects the body in a different manner.

How many of us entered menopause early, I wonder? It seems that I never came out of until about a year or two ago (now mid-70's). Is this common? Again, it was due to stress b/c of another neurologic disease apart from ME.

I would be interested in hearing other views. Always willing to learn. Be healthier. Yours, Lenora.

 

[Rufous McKinney]

How many of us entered menopause early, I wonder?

I think mine was a bit normal: around 48 to 50 things start to shift. I used some chinese herbs and progesterone so the actual menopause noticeable symptoms were not too bad.

I'm one of those whose reproductive system was so screwed up I could never conceive a child - much to my sorrow. (MCAS and endometriosis go together like .. um.. room-mates from hell.)

So hard, @Marylib ...especially if it was an important need that you had. Another thing about life to work through and seek to find the place where its Ok.

Endometriosis: oh how difficult.

 

[Rufous McKinney]

This paper definitely dredged up alot of personal history issues. Or asks one to consider a longer timeline for how this mystery unfolded.

 

[Marylib]

I think mine was a bit normal: around 48 to 50 things start to shift. I used some chinese herbs and progesterone so the actual menopause noticeable symptoms were not too bad.



So hard, @Marylib ...especially if it was an important need that you had. Another thing about life to work through and seek to find the place where its Ok.

Endometriosis: oh how difficult.

 

[Marylib]

Thanks @Rufous McKinney and @lenora for your kind words. Well, seeking to find the place where it's Ok is kind of...I guess I mean that some things will never be okay - and that's true for people who have lost children as well as those who were unable to have them in the first place. Losing a child is no doubt far more devastating. One of my grandmothers outlived both her children as well as her husband, so her example has always been a great comfort to me. Endometriosis showed up fairly early for me. At one point I saw a doctor who suggested I take a hormone therapy to better my chances - but the pills she gave me made me feel horrible, emotionally labile and depressed.

@lenora the early menopause is one of those 'more common in this group of women' than 'other groups of women.' At least that is what I have gathered over the years - but certainly those who lasted to age 50 defy those odds. My BFF (who doesn't have ME) didn't read menopause til her mid 50's. Maybe some men will eventually comment on this thread. I recall also that there has been some research examining short telomeres in those with ME. But apparently it's not so much indicative of a short life as it is of a kind of premature aging.

 

[Rufous McKinney]

Losing a child is no doubt far more devastating.

well I got one of those. Add it to the list of answers to some of the Why? questions.

Cord complications. Complications not seen, not predicted and extremely rare.

Life comes with every version, and every possible scenario that can unfold. I guess we must just keep seeking to find a place where we are OK with what has transpired.

I'll accept what I seem to have signed up for. I'll cope.

so this place does exist where its "sort of" Ok....

Fictional scenarios here lately sort of help me cope with all this.

My daughter and I likely would never have survived her birth, back in the cave. I'd not have made it in theory, past 15. (appendix, altho I doubt it needed removal)

 

[lenora]

Thanks @Rufous McKinney and @lenora for your kind words. Well, seeking to find the place where it's Ok is kind of...I guess I mean that some things will never be okay - and that's true for people who have lost children as well as those who were unable to have them in the first place. Losing a child is no doubt far more devastating. One of my grandmothers outlived both her children as well as her husband, so her example has always been a great comfort to me. Endometriosis showed up fairly early for me. At one point I saw a doctor who suggested I take a hormone therapy to better my chances - but the pills she gave me made me feel horrible, emotionally labile and depressed.

@lenora the early menopause is one of those 'more common in this group of women' than 'other groups of women.' At least that is what I have gathered over the years - but certainly those who lasted to age 50 defy those odds. My BFF (who doesn't have ME) didn't read menopause til her mid 50's. Maybe some men will eventually comment on this thread. I recall also that there has been some research examining short telomeres in those with ME. But apparently it's not so much indicative of a short life as it is of a kind of premature aging.

Hi @Marylib......I understand that endometriosis is extremely painful and I hope you are no long suffering from the problem. Of course then you're left with the HRT question, however in my little world women who want children will put up with the pain of endometriosis for years....until menopause, if necessary. My heart does go out to them.

Yes, the more people we have whom we love, the greater the chances of heartbreak can be. That's always in the forefront of my mind. It's good that you picked up on this connection, although I'm sure it doesn't alleviate your ongoing heartbreak. Sorry. Yours, Lenora.

 

[Marylib]

@Rufous McKinney I'm sorry you lost that baby. All too common. And true, we all are given what we are given in life, and we just keep on - life certainly came with no guarantees - and each life has its sorrows and its joys. I have my joys too, so I don't mean to be complaining about my lot in life.

Hi @lenora - the endometriosis gradually receded with the menopause. So I'm not in pain - thanks for asking. It can clog up the pipes, that's for sure. But that's all behind me now. The heartbreak factor over not having children is just one of those things that kind of comes and goes. Usually it's just a kind of wistfulness - it comes and goes, as does life itself. Raising children is no picnic either! One of my sisters went through years of troubles with her sons - thankfully that situation is better now too.

 

[Rufous McKinney]

. Usually it's just a kind of wistfulness - it comes and goes

thats an emotion we don't hear about as often...wistful.

all this is also what having a life means, as you clearly understand...- it means we will experience a whole array of things and if the only things that ever happened were good and perfect, we would not be these human beings.

Three young children were living downstairs , and this other neighbor spends time with them all the time. He has a grown son but it does not look like grandchildren are on the horizon for him.

So there are always children to find and possibly include in one's life. I would like to do that myself, but its sort of not happening at the moment. But that could change.

It takes a village, all that.

 

[Marylib]

Yes it does take a village. My niece used to talk about that - they have 4 kids. But now they are moving far out of state, so this has probably reawakened my wistful thing. I may never see them again. But that's okay. I'm just going through the same thing alot of lonely old ladies do. Especially with a pandemic going on...there's probably zillions of people feeling the same way I do at the moment. LOL - this is the wrong thread for my confessional! Sorry guys - do go on with your discussion of the topic at hand...