Signs and symptoms of hepatitis C in women

Medically reviewed by Neka Miller, PhD on July 15, 2021. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


Hepatitis C is one of the most common viral infections in the country. An estimated 2.4 million people are believed to have hepatitis C in the United States, though the actual number may be between 4.7 million and 2.5 million people.

Part of what makes hepatitis C (and other forms of hepatitis) so common is that Hepatitis C symptoms in females can be extremely difficult to spot. Reportedly about 51 percent of people living with hepatitis C don’t even know that they have the virus. In many cases, people don’t show any noticeable symptoms, and symptoms that do show up are easy to ignore or mistake for other health conditions. Learn more about the signs and symptoms of the hepatitis C virus, how it affects women, and whether or not you should consider STD testing for it below.

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What is Hepatitis C?

Hepatitis C, also known as hep C or HCV, is a virus that is associated with liver problems and chronic liver disease. Hepatitis C can be a mild illness that presents no real complications and lasts just a few weeks or months, but the infection can also present with more chronic forms that can last your entire life. Chronic forms of hepatitis C can lead to severe liver issues, including liver cancer and cirrhosis of the liver.

Transmission of Hepatitis C

Hepatitis C is transmitted through blood, primarily via sharing needles and syringes used for drugs. However, it can also spread via needles used for piercings or tattoos that haven’t been properly sanitized. The virus can also be passed through blood transfusion, and a mother with hepatitis C can potentially pass the virus on to their child during birth.

Hepatitis C is not strictly a sexually transmitted infection, but the virus can be transmitted through sexual contact. This primarily can happen if you have sex during menstruation or during anal sex (tearing and bleeding are more common with anal sex).

General Signs and Symptoms of Hepatitis C

As mentioned, many cases of hepatitis C infection often go unnoticed because they don’t always present symptoms. If you do present symptoms, they manifest about four to 12 weeks after initial exposure to the virus. Symptoms can also vary between acute and chronic forms of the infection. Acute hepatitis C symptoms may include:

  • Pain in your abdomen
  • Jaundice (yellowing in the skin and eyes
  • Stools that appear thick and clay-colored
  • Urine that is dark brown or cola-colored
  • Poor appetite and/or sudden weight loss
  • Physical fatigue and tiredness
  • Joint pain
  • Fever
  • Nausea and/or vomiting

Chronic hepatitis C infections can remain dormant for years, and it usually isn’t apparent until the virus has caused significant damage to the liver.

How Hepatitis C Differs in Women

Overall, the signs and symptoms of hepatitis C, as well as its general disease progression, are essentially the same across all genders. However, there are some slight differences that women should know about.

Infection Rates

Men are statistically more likely to become infected with hepatitis C (particularly for men who have sex with men). Part of this can come from lifestyle and behavioral differences between men and women that may reduce the risk of transmission in the latter. Part of this also comes from the hormone estrogen, which is believed to inhibit the virus’ ability to replicate and spread in the body.

For that same reason, hepatitis C infection rates tend to increase sharply among postmenopausal women. During menopause, estrogen production tends to see a steep drop, often reaching estrogen levels more similar in men.

Birth Control

Hepatitis C infections may reduce the effectiveness of hormonal birth control. Hormonal birth control pills have to go through the liver, where they are broken down and processed before the active components enter the bloodstream. Any scarring or damage to the liver, even liver failure, caused by a chronic HCV infection may contribute to birth control failure.

Talk to your doctor if you have the hepatitis virus and are on some form of hormonal birth control. They may suggest alternate forms of birth control or combining the pill with other types of contraception, like condoms, diaphragms, or non-hormonal IUDs.

Menstruation

As hepatitis C is transmitted via blood, it is possible to contract the infection when having sex with someone during their period. Make sure you wear a condom and practice other forms of safe sex.

Pregnancy and Breastfeeding

Mothers with hepatitis C can potentially transmit the virus to their children during birth. This is a fairly uncommon mode of transmission, but it may still affect up to 8 percent of HCV positive women.

There is generally no known risk of transmitting the virus to a newborn while breastfeeding. However, if your nipples are cracked or bleeding, stop breastfeeding until you have fully healed.

To learn more about STIs and pregnancy, read our blog article about chlamydia while pregnant.

Treating Hepatitis C

For a long time, treatments for hepatitis C were difficult, requiring weekly injections on top of oral medications, both of which could contribute to rough side effects. Today, chronic hepatitis C can be cured using a daily dose of medication for two to six months.

Antiviral Medication

The main treatment for hepatitis C is antiviral medication that is designed to clear the virus from your body at least 12 weeks after treatment. The exact medication that you are prescribed depends on the hepatitis C genotype, any existing liver disease or damage, any prior treatments, and other medical conditions you may have.

Liver Surgery/Liver Transplantation

If the infection has caused severe complications or damage to the liver, your doctor may recommend surgery to remove the damaged liver and replace it with a healthy liver. The liver transplant typically comes from deceased donors, but you may also receive part of a liver from a living donor.

It’s important to know that a transplant on its own will not cure a hepatitis C infection. The infection can return, which is why a transplant has to be used in conjunction with antiviral medication to effectively prevent damage to the new liver.

Vaccination

There currently is no vaccine for a hepatitis C virus infection, but there are vaccines for hepatitis A and B. Your doctor will likely recommend those vaccines. Hepatitis A and B can also contribute to liver damage, which can lead to further complications if you do contract hepatitis C.

Preventing the Spread of Hepatitis C

Avoid Sharing Needles

Sharing needles and other injecting devices is the most common mode of transmission for HCV. Avoid sharing any needles or syringes. If you get a piercing or tattoo, make sure you choose an establishment that uses clean, unopened needles.

Practice Safe Sex

If you are in a committed monogamous relationship, the risk of HCV sexual transmission to your partner is fairly low, though there are still health risks if you or your partner has HIV. Otherwise, it is always a good idea to practice safe sex. Use condoms, especially when having anal sex. Use lubrication to prevent tearing and bleeding.

Get Tested

The most difficult aspect of hepatitis C is that you can have it without ever even knowing it, which means you can potentially spread it to your partner. One of the best ways to prevent the spread of hepatitis C infection is to get tested. Testing includes a simple HCV antibody test, which can determine if you have hepatitis C antibodies. If this test is positive, you also get an RNA test to determine if the virus is active.

Hepatitis C is a common virus that can lead to severe liver problems in both men and women. If you think you have it or are worried about potentially spreading it to your partner, consider the Everlywell STD test for women, which tests hepatitis C and six other common STIs. This kit allows you to collect a sample from the comfort of home, and if you test positive, we can connect you with our physician network to determine the next steps.


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References

1. Viral Hepatitis in the United States: Data and Trends. U.S. Department of Health & Human Services. URL. Accessed July 15, 2021.

2. Hepatitis C Basic Information. U.S. Department of Health & Human Services. URL. Accessed July 15, 2021.

3. Hepatitis C Questions and Answers for Health Professionals. Centers for Disease Control and Prevention. URL. Accessed July 15, 2021.

4. Hepatitis C. National Institutes of Health. URL. Accessed July 15, 2021.

5. Kapp N, Tilley IB, Curtis KM. The effects of hormonal contraceptive use among women with viral hepatitis or cirrhosis of the liver: a systematic review. Contraception. 2009 Oct;80(4):381-6. doi: 10.1016/j.contraception.2009.04.007

6. Hepatitis C. Mayo Clinic. URL. Accessed July 15, 2021.

7. Hepatitis C Questions and Answers for Health Professionals. Centers for Disease Control and Prevention. URL. Accessed July 15, 2021.

8. Hepatitis C. Mayo Clinic. URL. Accessed July 15, 2021.

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