A staggering 80 percent of women worldwide silently bear the burden of autoimmune diseases, which often manifest as joint pain, hair loss, brain fog, and unexplained weight changes.

These conditions, which often begin with mild symptoms, over time, worsen and develop into chronic illnesses such as Multiple Sclerosis, Lupus, and Rheumatoid Arthritis.

The conditions are challenging to diagnose as symptoms often fluctuate, overlap with other conditions like thyroid disorders or viral infections, and are sometimes affected by gender bias in medicine.

The delayed diagnosis significantly impacts women’s careers and personal lives.

“Approximately 80 percent of patients with autoimmune disorders are women, yet awareness remains low. Diseases such as rheumatoid arthritis, systemic lupus erythematosus, and autoimmune thyroid disease often begin during the most productive years of women’s lives, affecting careers, fertility, heart health, mental health, and overall quality of life,” said Dr. Uma Kumar, Head of Rheumatology at AIIMS, New Delhi, in an interview with HealthandMe.

“Correct diagnosis of autoimmune diseases is frequently delayed, leading to preventable organ damage and disability,” she added.

Autoimmune Diseases Often Speak Softly

There are more than 100 different types of autoimmune diseases. All occur when the immune system mistakenly attacks the body’s own healthy tissues, leading to chronic inflammation and damage to organs, joints, glands, or the nervous system.

Speaking to HealthandMe, Dr. Neeraj Jain, Vice Chairman, Department of Rheumatology at Sir Ganga Ram Hospital, said: “As a rheumatologist, I frequently see women living with persistent symptoms that remain unexplained for years before an autoimmune disease is diagnosed".

Dr. Jain explained that common symptoms include:

• Persistent fatigue
• Joint pain
• Hair loss
• Brain fog
• Unexplained weight changes
• Recurrent inflammation

“Because these symptoms can overlap with stress, hormonal changes, or lifestyle factors, diagnosis is frequently delayed,” Dr. Jain said.

Singer and actress Selena Gomez shared her experience with lupus in 2017.

“I would get fevers, headaches, and fatigue, but I always just kept going. I kind of ignored it, to be honest. … I don’t think I made the right decisions because I didn’t accept it. That’s extremely selfish, and at the same time, really just unnecessary. I’m not really proud of that,” Gomez was quoted as saying to TODAY.

Why Women Are More Affected

While an estimated more than 10 million individuals globally suffer from these disease, women face a fourfold higher risk than men.

The higher prevalence of autoimmune diseases in women is linked to:

• Genetic susceptibility
• Sex hormone influences
• Stress
• Environmental factors such as pollution

A 2020 study by Franklin University in the US found that many autoimmune disorders tend to affect women during periods of high stress, such as pregnancy or hormonal changes.

Research from a 2024 Stanford Medicine study found that inactivation of the X chromosome can trigger autoimmune responses.

Studies have noted the role of estrogen and an overactive immune system in increasing women's susceptibility to autoimmunity.

Environmental factors, including pollution, viruses, and mitochondrial damage, have also recently emerged as reasons driving autoimmune disease rates among women, as per a 2024 study published in the Journal of Clinical Investigation.

Exposure to PM2.5, nitrogen oxides, and ozone has been linked to increased risk of rheumatoid arthritis, particularly for genetically susceptible individuals. Living near busy roads, with constant traffic-related pollution, also correlates with a higher risk.

Why Early Detection Is Important

Early evaluation and timely diagnosis are essential. Appropriate treatment can significantly improve the quality of life and prevent long-term complications.

Persistent or unexplained symptoms should never be ignored, as early medical assessment can make a major difference in outcomes.

Telugu actress Samantha Ruth Prabhu, diagnosed with Myositis in her podcast, recalled subtle early symptoms:

“I remember specifically the year before I was diagnosed… I woke up with this condition. Early signs mimicked overexertion—fatigue during shoots, inability to hold props, and rapid exhaustion. A critical incident during an action sequence led to fainting and a head concussion, forcing me to pause work. I had to take a lot of steroid shots, which really messed up my skin.”

“Autoimmune diseases often speak softly through symptoms, but early listening can change the course of a life,” Dr. Jain said.

Similarly, Tennis star Venus Williams said that she was forced to withdraw from the 2011 U.S. Open after a seven-year struggle with Sjögren's syndrome, which she described as an “invisible” and “miserable” disease.

She suffered from debilitating fatigue, joint pain, numbness, and swelling.

While autoimmune diseases are considered chronic and cannot be cured, some individuals experience remission, where symptoms may lessen or disappear temporarily.

Key medications to treat the host of autoimmune disorders include immunosuppressants, steroids, Nonsteroidal Anti-inflammatory Drugs (NSAIDs), and replacement Therapy.

Beyond medications, adopting lifestyle modifications can also help. Studies have proven that dietary changes such as adopting anti-inflammatory, nutrient-dense diets (e.g., AIP diet) and avoiding processed foods can help autoimmune conditions.

Techniques like yoga and meditation can help manage Stress and boost immune responses. Regular, moderate exercise can also help reduce inflammation and maintain mobility.

Autoimmune Diseases: A Gateway For Comorbidities In Women

The persistent inflammation, immune system dysregulation, and organ stress caused by the disorders often also compound risks for

• Heart diseases like heart attacks, strokes, and atherosclerosis
• Endocrine issues like hypothyroidism, Type 1 diabetes,
• Kidney problems,
• Liver inflammation and scarring,
• Bone loss, including osteoporosis, joint deformities, and fractures
• Mobility, vision, and balance issues
• Recurrent infections
• Brain fog
• Memory problems
• Mental health conditions like depression and anxiety

“Early diagnosis, appropriate treatment, and societal education are key to improving disease outcomes,” Dr. Kumar noted.

“Despite the availability of many effective drugs, there is still an unmet need. We must strengthen gender-sensitive research focused on women’s immune health and build awareness at all levels to address this silent epidemic.”

Obstructive hypertrophic cardiomyopathy (oHCM) remains one of the most misunderstood cardiac conditions, despite being the most common inherited cardiomyopathy. Misconceptions around the disease often lead to fear, delayed diagnosis, and hesitation in seeking appropriate medical care.

While oHCM has historically been associated with sudden cardiac death, particularly in young athletes, advances in diagnosis and treatment have significantly transformed its management. Today, with early diagnosis and appropriate treatment, many patients can lead active and fulfilling lives.

Understanding the facts is essential, not only for patients living with the condition, but also for families, caregivers, and the wider community. Separating myths from medical evidence can help ensure timely diagnosis, informed treatment decisions, and better long-term outcomes.

Understanding oHCM

Obstructive hypertrophic cardiomyopathy (oHCM) is a form of hypertrophic cardiomyopathy (HCM)—an inherited heart muscle disorder caused by genetic mutations that affect heart muscle structure and function. These changes cause the heart muscle to become abnormally thick, most commonly affecting the wall (septum) between the two lower chambers of the heart.

In nearly two-thirds of patients with hypertrophic cardiomyopathy, the thickened heart muscle can block the flow of blood leaving the heart—a condition known as obstructive HCM (oHCM). As a result, the heart must work harder to pump blood throughout the body, often leading to symptoms such as breathlessness, chest pain, fatigue, dizziness, palpitations, or fainting during physical activity.

Myth: A diagnosis of oHCM inevitably leads to sudden death.

Fact: While oHCM was once primarily recognised for its association with sudden cardiac death, advances in medical science have significantly improved patient outcomes.

With timely diagnosis, appropriate medical care, and ongoing monitoring, many people with oHCM can lead active lives with a good quality of life and a near-normal life expectancy. Regular follow-up helps assess disease progression and guides individualized care over time.

Myth: People with oHCM need to avoid physical activities

Fact: Complete avoidance of physical activity is no longer recommended for most patients.

Although high-intensity competitive sports may not be suitable for everyone with oHCM, mild-to-moderate exercise is generally encouraged and offers important cardiovascular benefits. Exercise recommendations should always be individualised after a comprehensive assessment by a cardiologist, taking into account symptoms, severity of obstruction, and overall risk profile.

Myth: Diet and lifestyle are the primary causes of oHCM.

Fact: oHCM is a genetic condition. It is not a lifestyle disease.

Unlike heart conditions caused by high blood pressure, diabetes, or high cholesterol, oHCM develops because of inherited genetic mutations affecting heart muscle proteins. Healthy lifestyle choices remain important for overall cardiovascular health, but they do not cause or prevent the condition itself. Because the disease often runs in families, screening of close relatives may also be recommended.

Myth: Every patient with oHCM will require surgical treatment.

Fact: Surgery is only one of several available treatment options. Care is individualized, and the most appropriate approach depends on each patient's symptoms and clinical condition.

Myth: oHCM cannot go unnoticed.

Fact: The condition can remain silent for years. Some individuals carrying the genetic mutation never develop symptoms, while others experience mild or intermittent symptoms that may be attributed to more common conditions. Typical symptoms include:

• Shortness of breath
• Chest pain
• Fatigue
• Palpitations
• Dizziness or light-headedness
• Fainting, particularly during or after exercise

Given this variability, individuals with persistent symptoms or a family history of cardiomyopathy or sudden cardiac death should undergo appropriate cardiac evaluation.

Myth: Medication can cure the disease

Fact: Advances in treatment have significantly improved disease management, helping many patients lead healthier and more active lives. While current therapies focus on controlling symptoms and reducing complications, ongoing research continues to expand treatment possibilities.

Treatment aims to reduce symptoms, improve blood flow, minimize obstruction, and lower the risk of complications such as abnormal heart rhythms and heart failure. Long-term follow-up remains an important part of care, allowing treatment to be adjusted as the condition evolves.

Myth: There's no benefit to diagnosing oHCM early

Fact: Early diagnosis can make a significant difference. Because oHCM symptoms often resemble those of other conditions, timely testing is important—especially for those with a family history of the disease. Early detection can help patients access appropriate treatment, manage symptoms effectively, and reduce the risk of complications.

Why Awareness Matters

The understanding and management of obstructive hypertrophic cardiomyopathy have evolved considerably over the past decade. Although it remains a lifelong condition, it is no longer viewed through the lens of fear alone. Advances in medical therapies, improved diagnostic tools, and personalized treatment strategies have changed the outlook for many patients.

By challenging common myths and promoting awareness, more individuals can be diagnosed earlier, receive appropriate treatment, and live healthier, more active lives with confidence.

(Dr. Daljeet Kaur, Cardiac Electrophysiologist at AIG Hospital, Hyderabad)

It is a common belief that metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease (NAFLD)—is primarily associated with diet, sedentary lifestyles, and obesity. However, there are other factors as well that affect this aspect. Post-menopausal women experience a significantly higher incidence and faster progression of fatty liver disease, even when maintaining a stable body weight.

In Pre-menopausal women, estrogen plays a central role in metabolism by promoting healthy fat accumulation in subcutaneous tissue (below the skin) rather than around internal organs; it also increases insulin sensitivity and suppresses liver inflammation.

After menopause, when estrogen levels drop, this protective function is lost; there is redistribution of fat leading to more fat accumulation around internal organs, including the liver, thus leading to increased chances of NAFLD and also increasing insulin resistance. Needless to say, with age, our metabolic rate also goes down, which also plays a role in this.

The important part lies not only in understanding the above but in going further in early detection and prevention of menopause associated NAFLD. As we know, fatty liver is a silent disease and often does not cause any signs and symptoms till a very advanced stage.

First and foremost is to change lifestyle with advancing age, changing both the dietary habits and physical activity. Regular screening and monitoring are warranted with blood tests, routine metabolic panels, keeping a tab on weight, sugar, and cholesterol levels, and a basic ultrasound of the abdomen. For someone already diagnosed with second or third stage fatty liver, a simple non-invasive FibroScan can help monitor and assess the response to treatment.

Coming to the treatment part of NAFLD in post-menopausal women, being primarily a lifestyle disease, the core of management also lies in managing lifestyle. Medicines are available for treating and controlling NAFLD in conjunction with lifestyle management. Hormone replacement therapy (HRT), when initiated early in post-menopausal women for symptomatic relief, may offer secondary benefits by maintaining metabolic health. However, HRT should always be initiated after proper evaluation and expert guidance.

NAFLD is a silent epidemic and primarily a lifestyle disease; knowing about it and knowing the triggering and precipitating factors helps with understanding and prevention better. Menopause, being a natural biological phenomenon in every female’s life, makes it essential for us to know how it affects our liver health and overall health as well.

Eating healthy is often associated with loading your plate with salads, fruits, whole grains, legumes, smoothies and sugar-free products. However, a diet that is considered healthy for one person may trigger digestive discomfort in another. Bloating, excessive gas, abdominal cramps, constipation or loose stools after eating “healthy” foods may indicate that your gut is struggling with the quantity or type of foods you are consuming.

One common reason is a sudden increase in dietary fibre. Fibre is essential for bowel health and can support regular bowel movements, but increasing it too quickly can cause fermentation in the large intestine, resulting in gas and bloating. Adults generally need around 22–34 grams of fibre daily, depending on age and sex, but it is better to increase intake gradually rather than making a sudden dietary shift.

Certain nutritious foods can also contain FODMAPs—short-chain carbohydrates that are poorly absorbed in the small intestine. Foods such as onions, garlic, beans, lentils, cauliflower, certain fruits and some dairy products can trigger bloating, abdominal discomfort, diarrhoea or constipation in susceptible individuals, particularly those with irritable bowel syndrome (IBS). A low-FODMAP diet may help selected IBS patients, but it should ideally be undertaken with medical or dietetic guidance and followed by gradual reintroduction of foods.

“Sugar-free” does not necessarily mean gut-friendly either. Sugar alcohols such as sorbitol, mannitol, xylitol and maltitol can be incompletely absorbed and may cause gas, bloating or diarrhoea in some people. Similarly, large quantities of fruit, fruit juices or certain whole grains may aggravate symptoms in people with specific carbohydrate intolerances.

Another overlooked factor is how we eat. Eating very quickly, consuming large meals, drinking fizzy beverages, chewing gum or using straws can increase swallowed air and contribute to belching and bloating. Smaller meals, slower eating and adequate hydration can often make a meaningful difference.

The solution is not to abandon healthy foods, but to personalise your diet. Maintain a food-and-symptom diary, introduce fibre gradually, identify individual triggers and avoid unnecessarily restrictive diets. Persistent symptoms should not simply be attributed to “food intolerance.” Recurrent abdominal pain, unexplained weight loss, anaemia, blood in the stool or black stools require medical evaluation because these may indicate an underlying gastrointestinal condition rather than simple dietary sensitivity.

A healthy diet should nourish your body without consistently making your gut uncomfortable. The goal is not to follow every trending diet, but to understand what works for your individual digestive system.