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This review will uniquely highlight issues affecting women with MPN and articulate their relevant determinants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Epidemiology and Diagnosis<\/jats:title><jats:p>A higher overall prevalence of MPN has been established in women. The incidence of essential thrombocythemia (ET) predominates, while, conversely, polycythemia vera (PV) and myelofibrosis (MF) are seen in lower frequencies as compared to men. Diagnostic criteria are dictated by sex\u2010driven physiological variances in hemoglobin and hematocrit levels in PV, mandating separate diagnostic thresholds, respectively: &gt;\u200916.0\u2009g\/dL and\u2009&gt;\u200948% in women vs. &gt;\u200916.5 and\u2009&gt;\u200949% in men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Genetic Framework and Phenotype<\/jats:title><jats:p>Women with MPN harbor fewer acquired somatic mutations and a lower frequency of high\u2010risk mutations than their male counterparts; lower <jats:italic>JAK2V617F<\/jats:italic> driver variant allele frequency and attenuated allele burden kinetics have also been reported. Women with MPN are younger at diagnosis than men and, contingent on subtype, display more indolent disease features. Importantly, validated symptom burden assessments consistently disclose higher scores in women vs. men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Thrombosis and Outcomes<\/jats:title><jats:p>Women with MPN have a unique thrombotic diathesis with respect to men, more frequently involving the splanchnic venous system in those ultimately diagnosed with PV. Outcomes data depict female sex as a variable associated with more favorable clinical trajectories, including lower rates of MF\/leukemic transformation and secondary cancers, as well as improved overall survival rates vis\u2010\u00e0\u2010vis men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Life\u2010Cycle Windows, Pregnancy, and Postpartum<\/jats:title><jats:p>Potential challenges at each significant life stage will be addressed: puberty, preconception and fertility, and perimenopause; these include issues surrounding oral contraceptives and hormone use. Prospective studies suggest overall favorable maternal and fetal outcomes with pregnancy in women with MPN. Full details on risks and reported outcomes will be discussed, as well as a risk\u2010adapted approach to management informed by obstetric and thrombosis history. Recommendations include aspirin 81\u2009mg daily in all patients and cytoreduction with interferon\u2010\u03b1 in those with antecedent thrombosis, as well as in low\u2010risk cases with higher\u2010risk features (e.g., poorly controlled hematocrit and recurrent fetal loss). Antepartum anticoagulation with low molecular weight heparin (LMWH) is recommended in cases with previous venous thromboembolism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Future Directions<\/jats:title><jats:p>This review highlights female sex and gender as critical drivers of MPN incidence, presentation, and natural history. It further outlines the impact and management of MPN as related to unique female reproductive phases. A sex\u2010informed lens will be required in order to recalibrate current prognostic tools, a requisite to refining patient counselling and clinical decision\u2010making in line with precision medicine. Moreover, while several mechanisms underpinning sex\u2010defined discrepancies have been defined, these mandate further prospective study. Finally, sex and gender\u2010based differences must be weighted in clinical trials with systematized procedures to correct participation imbalances in favor of sex and gender equity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajh.27665","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T09:24:57Z","timestamp":1741944297000},"page":"74-87","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Topics of Interest in Women With Myeloproliferative Neoplasms"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1499-6171","authenticated-orcid":false,"given":"Natasha","family":"Szuber","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Guglielmelli","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine CRIMM, Center Research and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliera Universitaria Careggi, University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9104-6172","authenticated-orcid":false,"given":"Naseema","family":"Gangat","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21442"},{"key":"e_1_2_12_3_1","first-page":"1","volume-title":"International Review of Cell and Molecular Biology","author":"Moliterno A. 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