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1/ THREAD: Sex Differences, the Brain, and #COVID19
I have been rheuminating over this topic for a while now, and this post from fellow #gynfluencer @jfitzgeraldMD particularly resonated with me.
We know that women disproportionately suffer pelvic floor disorders like OAB... https://twitter.com/jfitzgeraldMD/status/1360236164389736450
I have been rheuminating over this topic for a while now, and this post from fellow #gynfluencer @jfitzgeraldMD particularly resonated with me.
We know that women disproportionately suffer pelvic floor disorders like OAB... https://twitter.com/jfitzgeraldMD/status/1360236164389736450
2/ Which we believe stems from an over-activation of the nerves that stimulate the bladder, telling us we need to pee when our bladder isn't full yet, and can be associated w/ urinary incontinence.
One of the classes of drugs we prescribe for women is anticholinergics.
One of the classes of drugs we prescribe for women is anticholinergics.
3/ These drugs block the action of acetylcholine, a neurotransmitter in the brain. Blocking acetylcholine at synapses in the central & peripheral nervous system, inhibits the parasympathetic nervous system by selectively blocking the binding of ACh to its receptor in nerve cells.
4/ They have many side effects like dry eyes, dry mouth, overheating/inability to sweat, drowsiness/dizziness/confusion, increased heart rate, constipation, AND urinary retention (relaxation of the bladder to fill!).
Some of these side effects are obviously not ideal...
Some of these side effects are obviously not ideal...
5/ HOWEVER, more concerning is the association of these drugs with cognition and dementia in women. H/T @FPMRSJournal @otrowers_md and @jfitzgeraldMD https://twitter.com/FPMRSJournal/status/1360273385922658311
6/ Acetylcholine (ACh) is a neurotransmitter essential for processing memory and learning, and is decreased in both concentration and function in patients with Alzheimer's disease.
https://pubmed.ncbi.nlm.nih.gov/16273023/#:~:text=Evidence%20exists%20for%20both%20cholinergic,in%20patients%20with%20Alzheimer's%20disease.
https://pubmed.ncbi.nlm.nih.gov/16273023/#:~:text=Evidence%20exists%20for%20both%20cholinergic,in%20patients%20with%20Alzheimer's%20disease.
7/ Did you know that 2/3 of alzheimer’s patients worldwide are women?
Once Dx, female patients also experience poorer cognition & faster progression of symptoms compared to men. @womensbrainpro @heidari_s @VirusesImmunity @ShelFarFar @sabraklein1998
https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz.12068#:~:text=By%20mid%E2%80%90century%2C%20the%20number,who%20have%20Alzheimer's%20dementia%20today.
Once Dx, female patients also experience poorer cognition & faster progression of symptoms compared to men. @womensbrainpro @heidari_s @VirusesImmunity @ShelFarFar @sabraklein1998
https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz.12068#:~:text=By%20mid%E2%80%90century%2C%20the%20number,who%20have%20Alzheimer's%20dementia%20today.
8/ What about other neurological conditions?
- Women are nearly twice as likely to be diagnosed with depression and anxiety disorders compared to men, with these disorders presenting more persistently in women
@WHO report:
https://www.who.int/publications/i/item/depression-global-health-estimates
@heidari_s @sabraklein1998
- Women are nearly twice as likely to be diagnosed with depression and anxiety disorders compared to men, with these disorders presenting more persistently in women
@WHO report:
https://www.who.int/publications/i/item/depression-global-health-estimates
@heidari_s @sabraklein1998
9/ Women have a higher lifetime risk of stroke than men
*Female stroke patients w/ greater physical & cognitive impairment more limitations in day-to-day activities & a higher risk of depression following a stroke
*About 60% of stroke deaths occur in women https://www.ahajournals.org/doi/full/10.1161/01.cir.0000441139.02102.80
*Female stroke patients w/ greater physical & cognitive impairment more limitations in day-to-day activities & a higher risk of depression following a stroke
*About 60% of stroke deaths occur in women https://www.ahajournals.org/doi/full/10.1161/01.cir.0000441139.02102.80
10/ Women are also over-represented in neurologic autoimmune conditions like:
- Anti-NMDA Receptor Encephalitis: disease occurring when antibodies produced by the body’s own immune system attack NMDA receptors in the brain, 80% of the patients being women https://www.med.upenn.edu/autoimmuneneurology/nmdar-encephalitis.html
- Anti-NMDA Receptor Encephalitis: disease occurring when antibodies produced by the body’s own immune system attack NMDA receptors in the brain, 80% of the patients being women https://www.med.upenn.edu/autoimmuneneurology/nmdar-encephalitis.html
11/ This is consistent with MANY autoimmune conditions, which are currently not well understood (due primarily to a LACK of funding), which includes Multiple Sclerosis (MS): a chronic inflammatory disease of the CNS, per @mssociety, 4 times as many women have MS as men.
12/ Well Erin, that's all very interesting, but again, what does this have to do with COVID?
I'M SO GLAD YOU ASKED!
However...must hold due to day job responsibilities!
TO BE CONTINUED!!
I'M SO GLAD YOU ASKED!
However...must hold due to day job responsibilities!
TO BE CONTINUED!!
