Hepatitis C, often called hep C, may cause different symptoms and complications in females than in males. Fatigue, weakness, and abdominal cramps are common symptoms.

In addition, women can potentially pass the infection to a baby during childbirth. Detection of hepatitis C is particularly important in premenopausal women.

Hepatitis C is a viral illness that, without treatment, can cause long-term damage to the liver.

This article will describe some of these key differences, as well as treatment options for women.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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We explore some of the issues that affect females with hepatitis C.

Transmission

Hepatitis C is a virus that people can acquire through contact with infected blood. A person can get the virus from sharing needles with a person who has hepatitis C.

In some cases, a person can get the virus during condomless sex if they come into contact with blood, including menstrual blood.

However, the incidence of transmission from sexual activity is lower than that of sharing needles, according to the American College of Obstetricians and Gynecologists (ACOG).

One of the main differences between transmission in males and females is that females can transmit the hepatitis C virus to a baby during childbirth.

According to ACOG, about 4% of women with hepatitis C pass it on during childbirth. The likelihood of this increases if the woman also has HIV or has high levels of the hepatitis C virus in their blood.

Before 1992, the United States’ blood supply was not regulated to detect hepatitis C. This means that women who received blood transfusions during cesarean deliveries before 1992 would have been at risk of contracting the virus.

Anyone who underwent a blood transfusion before 1992 should ask their doctor about hepatitis C testing.

Women cannot spread hepatitis C to a baby through breastfeeding or to another person through contact such as hugging.

Clearance

When a person first gets the hepatitis C virus, they experience an acute infection. The acute infection can last from weeks to months and may cause symptoms that range in severity.

Some people “clear” the virus from their system and do not have further hepatitis C signs. Women are more likely to clear the hepatitis C virus.

Doctors are not sure why this is the case, but it may be due to the higher levels of estrogen in females.

Progression

Disease progression may depend on factors such as when a woman finds out that she has hepatitis C and whether she has co-infections such as HIV.

Hepatitis C rarely causes symptoms until it is more advanced. Often, the person may not know they have hepatitis C until they have a blood test for another condition and discover that their liver enzymes are higher than expected.

However, some symptoms of hepatitis C can include:

  • fatigue
  • itching
  • muscle weakness
  • nausea
  • stomach pain
  • jaundice, or yellowing of the skin or eyes

These symptoms are nonspecific, meaning that many underlying causes may lead to them. This makes hepatitis C more difficult to diagnose.

Doctors diagnose hepatitis C using blood tests. They may first test for antibodies to the hepatitis C virus, which can indicate whether a person has ever had the virus, even if they have since cleared it.

A doctor will also test for active signs of the virus. They may measure a person’s viral load, or how much of the virus is present in a person’s body.

If a woman tests positive for hepatitis C and has a baby, the doctor will usually recommend testing the baby for the virus when they are at least 18 months old. Testing before this age does not always provide accurate results.

Treatment for hepatitis C is very reliable. Medications can help many people clear the virus, as long as people do not have structural abnormalities from hepatitis C, such as liver scarring (cirrhosis).

Examples of these medications include sofosbuvir or velpatasvir (Epclusa) and ledipasvir or sofosbuvir (Harvoni).

All genotypes of hepatitis C are fairly susceptible to the newer antivirals, which are curative in nature. Those who are in the advanced stages of hepatitis C infection and already have cirrhosis may not respond as quickly.

The liver is the body’s main organ for clearing substances, such as toxins in alcohol or medications that a person takes. The liver breaks down the substances into smaller parts so that the body can eliminate them.

Doctors will recommend that anyone with liver damage avoid using alcohol, drugs, and tobacco. They also may review a person’s medications, including vitamins and supplements.

There are vaccines for hepatitis A and hepatitis B, but no vaccine currently exists for hepatitis C.

Because of this, a person should engage in other preventive methods, such as:

  • not sharing needles or other drug-related equipment, including glucose monitors, with others
  • asking about sterilization techniques and practices when getting a tattoo or body piercing
  • following safety precautions such as disposing of all sharp objects correctly, especially in healthcare centers
  • using barrier protection to help prevent blood-to-blood transmission during sex
  • refraining from sharing personal care items that come into contact with blood, such as razors, toothbrushes, nail clippers, and earrings
  • cleaning all blood spills carefully with a mixture of bleach and water, as even dried blood that contains the hepatitis C virus could infect another person

Women are less likely to experience life threatening complications of hepatitis C, but they can still develop liver-related complications. They can also pass the virus to a baby during childbirth.

Prevention and treatment of hepatitis C are vital. If a woman has risk factors for the virus, she should consider talking with her doctor about testing.