Women have a greater chance of having chronic illness like anxiety and depression, chronic fatigue, etc., than men. This “gender gap” results from both “biological and social factors.” It was also found that illnesses predominantly found in female patients are often misdiagnosed as chronic Lyme disease. This article aims to explore how women with these chronic illnesses, especially those diagnosed with Lyme disease, can be treated in accordance to the patient’s menstrual cycle and/or phase of life.
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A woman’s physical health is intertwined with hormone fluctuation throughout the menstrual cycle, and if she is in perimenopause or menopause. Many women with Lyme disease, in addition to those symptoms, also experience symptoms of estrogen dominance such as painful periods and cysts. These women additionally experience luteal phase flare (LPF), in which these symptoms flare up a week before menstruation. Luteal phase flare severity depends on hormone imbalances, specifically low progesterone and high estrogenic activity, which can result from anovulatory cycles and environmental exposure.
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Nash and Schaffner recommend that treatment focuses on the patient’s “terrain,” removes toxicants, and improves gut, kidney, and liver elimination. This treatment addresses the extracellular matrix and lymphatic system to remove toxicants.
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A woman’s immune system changes during her menstrual cycle. In the follicular phase, there are more antibodies and a higher inflammatory response, in order to fight off any infection so that she can conceive. In the luteal phase, there is a low immune response so that the fertilized egg is not attacked, making her more immune to infection. In the late luteal phase comes LPF and an uncoordinated immune response, which can leave women with chronic illness or endometriosis with unchecked inflammation and increased pain sensitivity. Root causes of symptoms like chronic pain, fatigue, etc. must be addressed to help women heal.
Dr. Marylynn Barkley found that, in women with Lyme, night sweats intensified with the “decline of ovarian hormones and onset of menses in women with Lyme.” Night sweats are associated with immune activation. During this time, immune recognition of LUAT and cytokine levels were high. Barkley hypothesized that this increase in immune response heightens symptoms.
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Nash and Schaffner propose treatment dependent on the patient’s menstrual cycle and/or life-stage. For women with a monthly cycle, different treatment is required during the follicular and luteal phases. For perimenopausal and menopausal women, therapies should consider each woman’s history of infection and response.
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Nash, G., & Schaffner, C. (Feb/March 2021). Women and Lyme: Creating Protocols that Honor the Rhythm of Female Hormones and Their Influence on the Immune System. Townsend Letter, (451/52), 44-45.