6 Autoimmune Diseases That Are Different For Women Than Men
Research is just starting to explore how different conditions affect female-bodied people differently to male-bodied people. One of these areas in particular is in autoimmune conditions, where the immune system treats healthy tissues and cells as if they're threats. Some of the most common autoimmune diseases show up differently in men and women. That can lead to confusion about what autoimmune conditions 'typically' look like, particularly if you're a woman searching for a diagnosis — so it's important to get the differences right.
The relationship between sex and autoimmune conditions is complicated. Scientists have known for a while that more women than men get autoimmune conditions, though it's not really clear why; a Swedish study published in 2018 suggested that it might be to do with testosterone levels in the spleen, with higher testosterone levels in men protecting against autoimmune conditions, but a lot of work is left to be done to prove that. Medical geneticist Karen Helene Ørstavik wrote in 2017 that it's likely also to do with chromosomes; the 'price' of having two X chromosomes may be a greater tendency to develop autoimmune issues, which is also the case in men with Klinefelter Syndrome, a kind of intersex condition. It should also be noted that the majority of research on how autoimmune disorders present in different sexes focuses on the experience of cisgender people.
Here are a few autoimmune conditions that affect women differently than men.
When it comes to the type of lupus known as systemic lupus erythematosus (SLE), symptoms show up very differently in men and women. A study in 2004 found that there were big differences: women with SLE were more likely to experience Raynaud's phenomenon, in which spasms of the arteries restrict blood flow to places like the fingers and toes. They were also more likely to experience arthritis and headaches. Men with SLE, meanwhile, had more seizures, renal disease, skin problems, and cardiorespiratory issues.
That's not the end of the story, either. In a 2014 review of sex differences in autoimmune conditions, researchers wrote that when it came to SLE, "female patients were more likely to suffer from urinary tract infections, hypothyroidism, depression, esophageal reflux, asthma, and fibromyalgia." Menopause also seems to affect lupus symptoms in women, reducing the frequency of symptom flares while also potentially increasing organ damage. The immune system difficulties caused by lupus target different areas in each gender, and it's not clear why.
2. Sjögren’s Syndrome
Sjogren's is a condition that causes dry eyes and mouth, as the immune system attacks the mucus membranes, tear ducts and salivary glands that keep them moist. A study in 2017 found that there's actually quite a lot of difference in how Sjogren's shows up; men tend to be younger when they first show symptoms, around 47, while women are often post-menopause.
Men were also more likely to have lung disease, vasculitis, lymphoma, and had higher levels of the antibodies that were causing issues with tissues — even though both women and men had the same levels of dry eye and mouth. A 2015 study also noted that women with Sjogren's tend to have a higher amount of depression, fibromyalgia, and thyroiditis than men who have the condition.
3. Autoimmune Hypothyroid
Autoimmune hypothyroidism, otherwise known as Hashimoto's thyroiditis, occurs when the immune system attacks the thyroid gland and it stops producing enough hormones, which can cause fatigue, slowed heart rates, and cognitive issues over time. A study in 2015 found that, while men are less likely than women to have Hashimoto's, they often have more severe symptoms, including frequent shortness of breath and tiredness. By contrast, women are more likely to experience fertility issues with Hashimoto's, and can experience thyroid dysfunction after they give birth.
4. Axial Spondylitis
The Spondylitis Association of America estimates that about one% of U.S. adults may have symptoms of Axial Spondylitis. It's an autoimmune condition that affects the bones of the spine, and a 2018 study found that, while it seems to affect more men than women, women tend to be 'hit hard' by it. They often take longer to reach a diagnosis because they don't have the classic symptom of lower back pain as often as men; instead, they tend to have neck or higher back pain. They're also more likely than men to have enthesitis, or inflammation of the tendons at the point where they meet bones.
5. Rheumatoid Arthritis
Rheumatoid arthritis is one of the most common autoimmune disorders. A groundbreaking study in 2009 found that women tended to show worse symptoms than men over time, including fatigue and pain, and had smaller rates of remission, while men tended to experience more nodules and lung issues. Rheumatoid arthritis also affects women at a younger age than men, and that they may show less responsiveness to normal treatments for rheumatoid arthritis in general.
Psoriasis is an autoimmune condition of the skin and joints, in which the life cycle of cells is accelerated. Its most distinct symptom is flaking, cracking, rashy areas of skin. Psoriasis affects men and women differently in intriguing ways; a study in 2017 of psoriasis in Sweden found that women tend to have lower symptom levels than men, though men and women had the same levels of psoriasis on their heads — which the researchers thought might have something to do with the influence of shampoos and hair length in women. Men overall had more severe symptoms, which, the researchers explained, was why they tended to take up the lion's share of psoriasis treatment.
Autoimmune conditions are a source of frustration for patients and researchers alike. If you think you may be living with an autoimmune disorder, but your doctor says you're not showing "typical symptoms," it's worth doing more research.