Gender Difference in Patients with Recurrent Neurally Mediated Syncope

Purpose: The gender difference of neurally mediated syncope is not well defined in a large patient population. The aim of this study was to evaluate the gender difference of clinical manifestations in patients with neurally mediated syncope who underwent head-up tilt test. Materials and Methods: The medical records of 1,051 consecutive patients with two or more episodes of syncope, who were diagnosed as having neurally mediated syncope by head-up tilt test, were retrospectively reviewed. Results: Of 1,051 patients, 497 (47.3%) patients were male and 554 (52.7%) patients were female. Female patients were experiencing syncopal episodes for longer periods of their lives (8.2 ± 9.5 years vs. 6.8 ± 9.2 years, p = 0.002) and more episodes of syncope prior to head-up tilt test (HUT) (7.2 ± 9.4 vs. 5.0 ± 6.4, p = 0.001) than male patients. Micturition syncope (20.0 % vs. 5.2%, p < 0.001) was observed more frequently in male patients than in female patients. To the contrary, however, defecation syncope (16.3% vs. 9.3%, p < 0.001) was observed more frequently in female patients than in male patients. Conclusion: Female patients were experiencing syncopal episodes for longer periods of their lives and more episodes of syncope than male patients. Gender difference was also noted with regard to frequency of situational syncope.