Why Autoimmune Diseases Affect More Women Than Men

Medically reviewed by Do-Eun Lee, MD

Autoimmune diseases, also known autoimmune disorders, are the third most common category of disease in the United States, after cancer and cardiovascular disease. An autoimmune disease happens when your immune system cannot tell the difference between your own cells and foreign cells, causing the body to attack healthy cells. One study estimated that about 80% of all patients diagnosed with autoimmune diseases are women. Scientists hypothesized that this may be related to genetic variations and hormonal changes. There are more than 100 types of autoimmune diseases, affecting more than 23.5 million Americans.

More Women Than Men Have Autoimmune Diseases

Research estimates that autoimmune diseases are twice as likely to affect women than men. The exact mechanism of autoimmune diseases remains unclear, but scientists have pinpointed two possible reasons why they are more common in women than in men:

• Genetics: The larger number of genes originating from the X chromosome (women have two while men have one) creates a far greater possibility of a larger number of mutations occurring, putting women at a greater risk for the development of autoimmune diseases.

• Hormonal changes: Autoimmune diseases tend to affect women during major endocrine transitions, such as puberty, pregnancy, and menopause. These changes influence the immune system in significant ways because of the interaction between hormones, the immune system, and other organs in the body such as skin in psoriasis. Women typically experience more hormonal changes than men, making autoimmune diseases more prevalent in this population.

Women are also more likely to be diagnosed with multiple autoimmune disorders.

Related: An Overview of Endocrine Issues and Autoimmune Diseases

Risk Factors

The known risk factors of autoimmune diseases in women include:

• Age associated with major hormonal changes: Mainly puberty, pregnancy, and menopause. Autoimmune diseases often affect women starting in their childbearing years because pregnancy often results in an influx of hormonal changes. The changes in hormone levels in women going through puberty and menopause also increase their risk of developing autoimmune diseases.

• A family history of autoimmune diseases: Some autoimmune diseases run in families, such as lupus and multiple sclerosis. The higher risk is attributed to an inherited genetic variation. Certain environmental triggers can activate parts of the genome.

• Having an autoimmune disease: Women who already have an autoimmune disease are more likely to develop another one. Having more than three autoimmune diseases is known as multiple autoimmune syndrome.

• Obesity: Excess weight has been linked to increased risk of autoimmune diseases. Obesity sends the body into a chronic state of low-grade inflammation and can threaten an otherwise healthy immune response.

• Smoking: Inhaling cigarette smoke impacts the immune system through various complex interactions, including inflammatory responses, immune suppression, dysregulation of cytokines (signaling molecules involved in autoimmunity), and the development of autoantibodies.

• Medications: Certain blood pressure medications, statins, and antibiotics can trigger drug-induced autoimmune conditions like lupus, myopathy, or autoimmune hepatitis.

• Infections: Some viruses can turn on certain genes that impact the immune system’s function, such as the Epstein-Barr virus, which has been linked to lupus and rheumatoid arthritis.

Related: Causes and Risk Factors of Autoimmune Disease

Autoimmune Conditions Are Difficult to Diagnose

Autoimmune diseases can be particularly difficult to diagnose because many of them share the same symptoms or have symptoms similar to other conditions. While there are blood marker tests and tissue biopsies that can be used to help diagnose certain conditions, such as Hashimoto's thyroiditis, Graves' disease, celiac disease, and rheumatoid arthritis, there is no singular test that can verify the presence of all autoimmune diseases.

It is common to begin the diagnosis process with a family healthcare provider and move on to a specialist.

Common Symptoms Across Autoimmune Diseases

Despite the varying types of autoimmune disease, many of them share similar symptoms, including:

• Fatigue

• Joint pain and swelling

• Skin problems

• Abdominal pain or digestive issues

• Recurring fever

• Swollen glands

Women should seek treatment when they notice new symptoms to identify or rule out an autoimmune disease early.

Types of Autoimmune Diseases More Commonly Affecting Women

The following diseases affect more women than men and are listed from most to least common, according to Autoimmune Registry, a nonprofit that provides research, statistics, and patient data on all autoimmune diseases.

Psoriasis

Psoriasis causes new skin cells that typically grow deep in your skin to rise to the surface and accumulate into what looks like red patches or scales. The prevalence of psoriasis in the United States is 8 to 12 million.

Symptoms include thick red patches, covered with scales, usually appearing on the head, elbows, and knees. Itching and pain, which can make it hard to sleep, walk, and care for yourself, also occur.

Learn More: What Does Psoriasis Look Like?

Celiac Disease

Celiac disease is marked by an intolerance of gluten. Consuming gluten causes your immune system to attack your small intestine lining. The incidence of celiac disease is highest among women and children.

Symptoms include:

• Abdominal bloating and pain

• Diarrhea or constipation

• Weight loss or weight gain

• Fatigue

• Missed menstrual periods

• Itchy skin rash

• Infertility or miscarriages

Learn More: Symptoms of Celiac Disease

Inflammatory Bowel Disease (IBD)

The most common forms of IBD are Crohn’s disease and ulcerative colitis, but in general, it is defined by chronic inflammation of the digestive system. The prevalence of IBD is about 1.3% of U.S. adults or 3 million.

Symptoms include abdominal pain and diarrhea, which may be bloody.

Learn More: Symptoms of Inflammatory Bowel Disease (IBD)

Graves’ Disease

Graves’ disease occurs in those with overactive thyroid. Symptoms may or may not be present. The prevalence of Graves' disease in the United States is 1.2%.

Symptoms include:

• Insomnia

• Irritability

• Weight loss

• Heat sensitivity

• Sweating

• Fine brittle hair

• Muscle weakness

• Irregular menstrual periods

• Loose stool

• Bulging eyes

• Shaky hands

Related: What Does the Thyroid Gland Do?

Hashimoto's Disease

Hashimoto’s disease, also known as Hashimoto's thyroiditis, most commonly presents when the thyroid does not make enough thyroid hormones, though in some cases thyroid hormone levels are normal or even elevated. The prevalence of Hashimoto's disease in the United States is reported to be 10% to 12%.

Symptoms include:

• Fatigue

• Weakness

• Weight gain

• Sensitivity to cold

• Muscle aches and stiff joints

• Facial swelling

• Constipation

Rheumatoid Arthritis

Rheumatoid arthritis (RA) refers to a disease in which the immune system attacks joint linings throughout the body. The prevalence of rheumatoid arthritis in the United States is 0.73% to 0.78% in women.

Primary symptoms include painful, stiff, swollen, and deformed joints and reduced movement and function.

Learn More: Symptoms of Rheumatoid Arthritis

Type 1 Diabetes

In type 1 diabetes, your immune system attacks and inhibits the cells that make insulin (the hormone that controls blood sugar). The result is too much sugar in your blood, which can lead to heart disease, nerve damage, kidney disease and other problems. Type 1 diabetes affects nearly 1.6 million people in the United States.

Symptoms include:

• Being very thirsty

• Urinating often

• Feeling very hungry or tired

• Losing weight without trying

• Having sores that heal slowly

• Dry, itchy skin

• Losing the feeling in your feet or having tingling in your feet

• Having blurry eyesight

Multiple Sclerosis (MS)

This is a disease that affects the brain and spinal cord. It occurs when the immune system attacks the protective coating around nerves. Like many other autoimmune diseases, symptoms can vary widely. The prevalence of multiple sclerosis in the United States is nearly 1 million.

People with MS usually have:

• Weakness and trouble with coordination, balance, speaking, and walking

• Paralysis

• Tremors

• Numbness and tingling feeling in arms, legs, hands, and feet

Related: An Overview of Relapsing-Remitting Multiple Sclerosis

Alopecia Areata

While less of a threat to general health than other conditions on this list, having alopecia areata means your immune system attacks your hair follicles and this can be distressing to the person’s body image. The possible lifetime prevalence of alopecia areata in the United States is 2.51%.

Symptoms include patchy hair loss on the scalp, face, or other areas.

Related: Alopecia Areata Self Care and Medical Treatment

Sjögren's Syndrome

The immune system attacks the tear glands and salivary glands. Symptoms are therefore associated with excessive dryness. The prevalence of Sjögren's syndrome in the United States is 15%.

Symptoms include:

• Dry eyes or eyes that itch

• Dryness of the mouth, which can cause sores

• Trouble swallowing

• Loss of sense of taste

• Severe dental cavities

• Hoarse voice

• Fatigue

• Joint swelling or pain

• Swollen glands

• Cloudy eyes

Related: What Is Secondary Sjögren’s Syndrome?

Vitiligo

People with vitiligo have immune systems that attack the cells responsible for skin pigmentation and those inside your mouth and nose. The prevalence of vitiligo in the United States is 0.5-2%.

Symptoms include:

• White patches on areas exposed to the sun, or on armpits, genitals, and rectum

• Hair turns gray early

• Color loss inside mouth

Related: What Is Skin Pigmentation?

Systemic Lupus Erythematosus (SLE)

Also referred to simply as lupus, this disease can damage primary organs like the heart, skin, lungs, kidneys, joints, and other areas. The prevalence of systemic lupus erythematosus in the United States is unknown but conservatively estimated to be between 161,000 and 322,000 cases per year.

Symptoms include:

• Fever

• Weight loss

• Hair loss

• Mouth sores

• Fatigue

• Butterfly rash across the nose and cheeks

• Rashes on other parts of the body

• Painful or swollen joints and muscle pain

• Sensitivity to the sun

• Chest pain

• Headache, dizziness, seizure, memory problems, or changes in behavior

Related: Differences Between Lupus and MS

Antiphospholipid Antibody Syndrome (aPL)

Characterized by problems in the inner lining of blood vessels, this disease results in blood clots in the arteries and veins. The prevalence of antiphospholipid antibody syndrome in the United States is expected to be between 1% and 5%.

Other symptoms include:

• Multiple miscarriages

• Lacy, net-like red rash on the wrists and knees

Primary Biliary Cirrhosis

The immune system dysfunction in this disease slowly causes damage to the liver’s bile ducts, which are essential to proper digestion. As a result, bile accumulates, causing damage to the liver and eventually failure. The prevalence of primary biliary cirrhosis in the United States is 3%.

Symptoms include:

• Fatigue

• Itchy skin

• Dry eyes and mouth

• Yellowing of skin and whites of eyes

Autoimmune Hepatitis

In this disease, your immune system will not only attack but actively destroy liver cells, causing hardening, scarring, and even liver failure. The prevalence of autoimmune hepatitis in the United States is 2%.

Symptoms include:

• Fatigue

• Enlarged liver

• Yellowing of the skin or whites of eyes

• Itchy skin

• Joint pain

• Stomach pain or upset

Autoimmune Hemolytic Anemia

Hemolytic anemia is characterized by the immune system attacking and destroying red blood cells that are necessary for carrying oxygen throughout the body. The body cannot replenish red blood cells fast enough to prevent the heart from having to work harder to circulate oxygen-rich blood. The prevalence of hemolytic anemia in the United States is 2%.

Symptoms include:

• Fatigue

• Shortness of breath

• Dizziness

• Headache

• Cold hands or feet

• Paleness

• Yellowish skin or whites of eyes

• Heart problems, including failure

Learn More: Understanding the Many Types of Hemolytic Anemia

Scleroderma

This disease causes abnormal growth of connective tissues in the skin and blood vessels, leading to noticable changes in the skin’s appearance. The prevalence of scleroderma in the United States is 1%.

Symptoms include:

• Fingers and toes that turn white, red, or blue in response to the heat and cold

• Pain, stiffness, and swelling of fingers and joints

• Thickening of the skin

• Skin that looks shiny on the hands and forearm

• Tight and mask-like facial skin

• Sores on the fingers or toes

• Trouble swallowing

• Weight loss

• Diarrhea or constipation

• Shortness of breath

Learn More: Symptoms of Scleroderma

Myasthenia Gravis (MG)

The immune system attacks nerves and muscles throughout the body in this disease. The prevalence of myasthenia gravis in the United States is 1%.

Symptoms include:

• Double vision, trouble keeping a steady gaze, and drooping eyelids

• Trouble swallowing, with frequent gagging or choking

• Weakness or paralysis

• Muscles that work better after rest

• Drooping head

• Trouble climbing stairs or lifting things

• Trouble talking

Learn More: Symptoms of Myasthenia Gravis

Inflammatory Myopathies

This refers to a group of diseases that involve muscle inflammation and weakness. In women, the two most common types of myopathies are polymyositis and dermatomyositis. The prevalence of inflammatory myopathies in the United States is below 1 %.

Symptoms include:

• Slow but progressive muscle weakness beginning in the muscles closest to the trunk of the body

• Polymyositis affects muscles involved with making movement on both sides of the body

• Dermatomyositis is a skin rash that comes before or at the same time as muscle weakness

Guillain-Barre Syndrome (GBS)

In Guillain-Barre syndrome, your immune system attacks the nerves connecting your brain and spinal cord to the rest of your body, which severely interferes with your muscles’ ability to respond to the brain’s signals. The prevalence of Guillain-Barre syndrome in the United States is below 1%.

Symptoms typically include weakness or tingling feeling in the legs that might spread to the upper body and paralysis in severe cases.

Idiopathic Thrombocytopenic Purpura (ITP)

ITP is caused by the immune system attacking and destroying blood platelets, which are necessary for blood clotting. The prevalence of idiopathic thrombocytopenic purpura in the United States is below 1%.

Symptoms include:

• Very heavy menstrual period

• Tiny purple or red dots on the skin that might look like a rash

• Easy bruising

• Nose bleed or mouth bleeding

When to See a Healthcare Provider

If you notice any new symptoms that could indicate an autoimmune disease, contact your healthcare provider immediately. If you have been diagnosed with an autoimmune disease, schedule regular follow-ups and check-ins. Having an ongoing communication about your experience can prove invaluable when coming up with and updating treatment plans.

For more information about autoimmune diseases, call the Office on Women's Health Helpline at 1-800-994-9662 (TDD: 888-220-5446).

Prevention

You cannot change your genetic susceptibility to an autoimmune disease, but genetics alone do not cause them. You can take action by avoiding certain risk factors of autoimmune disease like obesity and medications, including:

• Eating a nutritious diet and limiting processed foods

• Incorporating regular physical activities into your daily life

• Staying up-to-date on the latest information about your medications

• Avoiding cigarettes or quitting smoking

Treatment

While treatment cannot cure an autoimmune disease, it can help reduce the risk of symptom flare-ups. The exact treatment plan depends on the condition.

Generally, the goals of treatment include:

• Relieving symptoms: People may find relief with over-the-counter drugs like aspirin or ibuprofen for pain or creams for rashes and other skin issues. If these do not work, it may be necessary to begin prescription drug treatment. Prescriptions can be used for a wide array of symptoms, including depression, anxiety, and sleep and fatigue issues

• Replacing vital substances: Some autoimmune diseases impair your body’s natural ability to produce essential substances and therefore require support from outside sources like insulin in diabetes to regulate blood sugar or thyroid hormone treatment in Hashimoto's disease. People may also find relief from supplements that support healthy system functioning, like taking collagen supplements to support healthy joints. More research is needed, however, on the effectiveness of these alternative methods

• Suppressing the immune system: There is nothing you can take to reverse an autoimmune disorder, but suppressing the immune system through drugs therapies has been shown to help control disease progression and preserve organ function. They can be used to reduce or even block inflammation and prevent organ transplant rejection

A Word From Verywell

There are currently no cures for autoimmune diseases, so being diagnosed with one can be stressful and scary. Know that early diagnosis can help you start managing your condition as soon as possible. Disease-modifying medications for conditions like multiple sclerosis can slow down the progression of your disease and minimize the impact it has on your life.

Symptoms of autoimmune disease are often non-specific, so seek medical attention when you experience new symptoms like fatigue or joint stiffness. Remember that women (and men) with autoimmune diseases can still lead healthy, fulfilling lives.