Most women with G6PD deficiency don’t know they have G6PDD until they have a child born missing the G6PD enzyme. The reason is that most tests return not deficient for women with G6PDD who have only one affected X chromosome. (http://www.bloodjournal.org/content/110/5/1411?sso-checked=true#F1) However, women with just one affected X will have symptoms due to lyonization.
Lyonization is the process of deciding which X chromosome will be deactivated in a cell. It is a random process and happens early in an embryo’s life. Each cell chooses and X chromosome to deactivate and passes this choice to it’s progeny. How many choose to deactivate the X chromosome affected by G6PDD determines how deficient the woman will be.
Simplified, let’s say a woman has a deactivated X in half of her cells, but half aren’t. If she comes into contact with a contraindicated substance, half of her blood cells will react but half won’t. Or 75% of her cells. Or 10%. It’s completely random.
So, women need to avoid triggers as much as men, but because they will tend to have a lower level hemolyses, women are less likely to be diagnosed with G6PDD because lower level hemolyses are harder to detect.
Due to how genetic inheritance works, if you are a woman and your father, mother, or son has G6PDD, you definitely have G6PD Deficiency. If your brother, daughter, daughter’s son or daughter, son’s daughter, uncle, aunt, or grandparent (except your father’s father) has G6PD Deficiency, you have a 50% chance of having it. And if your first cousin has it, you have a 25% chance. But it would be very unlikely to show up on a blood test. You might not feel very different, but later in life you might develop diabetes or cardiovascular disease, or you might have chronic low-level anemia throughout your life, or get a headache after drinking wine. The damage being being done may not be immediately apparent.
So avoid the triggers and be healthy!