Systemic Lupus Erythematosus (SLE)
SLE (often referred to simply as “lupus”) is a chronic, autoimmune disease that affects various parts of the body, particularly the skin, blood, joints and kidneys, lungs, and heart. It is caused by an overactive immune system that produces antibodies that attack the body’s own organs, joints, and tendons. The result is the formation of immune cell complexes that build up in various tissues causing pain, inflammation, and eventual injury or destruction.
In her book Living Well with Autoimmune Disease, Mary Shomon writes: “For most, lupus is considered a mild condition, affecting only a few organs. For others, however, it may not take such a simple course and may trigger serious, even life-threatening, conditions.” Lupus can occur at any age, and while it is found in both men and women, the disease is 10-15 times more common in women.
Medical studies have investigated the use of DHEA (dehydroepiandrosterone), a hormone produced by the adrenal gland, and have found it to improve the health of people with lupus. DHEA is a major precursor, or building block, to the sex steroids (androgens and estrogens). Because studies have shown that some lupus patients have low levels of DHEA and that this may contribute to the onset of the disease, it is thought that increasing the level of androgens may help.
In a scientific review titled DHEA For Lupus, Dr. Kay Shaver concludes that the use of DHEA may provide lupus patients with several benefits including the potential to provide relief from symptoms, a decrease in the frequency of disease flare-ups, and possibly even sparing of the destructive effect on the bone.
Multiple Sclerosis (MS)
Multiple sclerosis is another chronic inflammatory autoimmune disease, but this one targets the central nervous system, affecting the brain and spinal cord. In MS, the body overproduces antibodies that specifically attack myelin (the protective sheath that covers our nerves) and can result in a variety of neurological problems. These problems include cognitive and psychological changes, weakness or paralysis of limbs, numbness, vision problems, speech difficulties, problems with walking and motor skills, and sexual dysfunction.
MS is the most common acquired neurological disease in young adults and, while it can affect anyone, it is most often diagnosed in individuals between the ages 20 and 40. Like all of the autoimmune diseases already discussed, MS is much more prevalent (twice) in women than in men.
Repeated observations that women with MS show a significant improvement in their symptoms and a decrease in their relapses or flare-ups upon becoming pregnant led to the design of some important studies. The effects of oral hormonal treatment for MS were tested by Dr. Nancy Sicotte and colleagues. They showed that estriol, a pregnancy hormone, when given to nonpregnant women with MS, helped to decrease MS symptoms. More extensive trials in animals with MS confirmed that various doses of estriol work to stabilize and even improve symptoms in this debilitating disease.
The role of another hormone— progesterone—has also been implicated in the possible treatment of MS. Dr. Herbert Koenig and colleagues showed in a laboratory study that progesterone may be involved in the process of myelination, or the formation of myelin to protect nerve cells. Their work suggests that the administration of progesterone may be a valuable therapeutic approach for initiating myelin repair in MS patients.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis is a widespread and disabling autoimmune disease that affects the joints and muscles. Most frequently the free-moving joints—such as the small joints of the hands, knees, ankles, hips, elbows, wrists, and shoulders—are targeted. In RA, our body launches an autoimmune attack on the synovial membranes (the tissue that lines and cushions the joints) leading to inflammation, thickening, and pain. As this process continues the pain and swelling increase, and ultimately can result in the destruction and deformity of the bones.
The condition usually starts between the ages 25 and 50, and perhaps because it is so common, the symptoms are often mistaken as a normal part of aging. RA afflicts females two to four more times frequently than males. For most patients, RA is progressive, despite treatment. The objective of treatment is primarily to control inflammation, prevent or slow joint damage, and ultimately ease the condition into remission.
The role of the hormone progesterone in RA patients has also been investigated. Dr. Rossella Valentino and colleagues describe decreased levels of progesterone in women with RA, and their studies support the positive outcomes reported by Dr. Miguel Cuchacovich when using progesterone treatment in RA patients. Dr. Valentino also describes decreased levels of testosterone in such patients and has shown the positive effects in laboratory and clinical studies when testosterone is used as therapy.
The Endocrine System and Autoimmune Diseases
The endocrine system is a target for autoimmune diseases. As the body’s hormonal regulator, the endocrine system releases and then slows and/or stops the production of different hormones in response to various internal and external triggers.
The tightly-controlled network of endocrine organs and glands (which includes the thyroid, pancreas, pituitary, adrenal, ovaries, and testes) may be affected in cases of autoimmune disease. In cases of insulin-dependent diabetes, the pancreas comes under attack, while in Graves’ disease, as discussed earlier, the thyroid gland goes into overdrive in response to the overproduction of antibodies.
Autoimmune disorders involving the endocrine system may also arise when a person produces antibodies to a particular hormone. Antibodies against naturally occurring hormones such as estradiol and progesterone can wreak havoc. When women make antibodies to such hormones, they may experience erratic ovulation or insufficient production of the uterine lining. These conditions can cause abnormal menstrual periods and even prevent successful implantation and pregnancy.
While autoimmune diseases afflict men, they are much more prevalent in the opposite sex. In his book Women and Autoimmune Disease, Dr. Robert Lahita writes, “Why is there such a seemingly unfair preponderance of women associated with practically every one of the autoimmune diseases? As it turns out, one of the greatest factors that influence the immune system is gender.”