Women and autoimmune disorders

WHILE BOTH MEN AND WOMEN CAN DEVELOP AUTOIMMUNE DISEASES, THEY ARE MORE PREVALENT IN WOMEN. THEY AFFECT UP TO 8% OF THE FEMALE POPULATION, COMPARED TO 5% OF MEN.1

Autoimmune diseases are a group of disorders which occur when the immune system mistakenly attacks healthy cells in the body. These disorders can affect any part of the body, including the joints, skin, and internal organs.

There are more than 80 autoimmune diseases, and they can vary in their severity and symptoms. Common autoimmune diseases affecting women include rheumatoid arthritis, lupus, multiple sclerosis, and thyroid disorders.1

These diseases can be difficult to diagnose, as their symptoms can mimic other illnesses. Common symptoms include fatigue, joint pain, fever, skin rashes, and digestive problems.2 Depending on the type of autoimmune disease, other symptoms may also be present, such as hair loss, vision problems, and breathing difficulties.

Why are women more affected?

Autoimmune diseases may be more prevalent in women due to hormonal differences. Oestrogen, a hormone more abundant in women, can play a role. Studies have shown that oestrogen can influence the immune system by increasing the production of antibodies and inflammatory cytokines (proteins which control the growth and activity of immune system cells), which can trigger autoimmune responses.3

Genetics may be another factor. Women with a family history of autoimmune diseases are at a higher risk of developing these disorders themselves.3 Exposure to toxins and infections may also trigger autoimmune responses in susceptible individuals.

Chromosomes are another possible factor. Women have two X chromosomes compared to men who typically have an X and a Y, and the X contains over double the amount of genetic material of the Y chromosome. As a foetus with two X chromosomes develops, it undergoes ‘X inactivation’ whereby X chromosomes in some cells are inactivated. This varies between foetuses, and the variance is thought to cause an immune response that can cause the body to attack itself, creating an autoimmune disorder.3

Common autoimmune disorders

One autoimmune disease which is particularly common in women is rheumatoid arthritis. This is a chronic inflammatory disorder affecting the joints, which causes pain, stiffness and swelling. Women are two to three times more likely to develop it than men, often during the reproductive years.

Another autoimmune disease more prevalent in women is lupus, or systemic lupus erythematosus. Lupus can affect multiple organs including the skin, kidneys, and lungs.4 Women are nine times more likely to develop lupus than men, and the disease often develops during the childbearing years.

Multiple sclerosis (MS) is also seen more often in women. MS is a chronic inflammatory disorder that affects the central nervous system, causing symptoms such as fatigue, muscle weakness, and vision problems. Women are twice as likely to develop MS as men, often during the fertile years.

Thyroid disorders, such as Hashimoto's thyroiditis and Graves' disease, are more prevalent in women. These occur when the immune system attacks the thyroid gland, causing either an underactive or overactive thyroid.5 Women are up to eight times more likely to develop thyroid disorders than men, and the risk increases with age.

Impact of autoimmune diseases

Autoimmune diseases can seriously affect women's health. Many are chronic conditions requiring ongoing medical management, which can be emotionally and financially draining. Women with autoimmune diseases may also experience social isolation, as their symptoms can make it difficult to participate in social activities or work 6

Pregnancy can also be a concern, as these autoimmune conditions can increase the risk of complications. Women may be at a higher risk of miscarriage, pre-term birth, and pre-eclampsia. Some medications may also be harmful to the foetus, so women with these conditions should work closely with their healthcare providers to manage their symptoms and minimise risks during pregnancy.

Treatment

Treatment typically involves medications to suppress the immune system and reduce inflammation. In some cases, lifestyle changes such as a healthy diet and regular exercise may also help manage symptoms. Individualised treatment plans can address personal symptoms and needs but may change depending on the type of autoimmune condition. For instance, someone suffering from a condition that affects their skin would receive advice on bathing, creams, and the sun. However, someone with coeliac disease would follow a gluten-free diet.

Self-care is an important aspect of managing autoimmune diseases, too. This may include dealing with stress, getting enough sleep, and avoiding triggers which can worsen symptoms. Women with autoimmune diseases may also benefit from support groups, which can provide emotional help along with resources for managing their condition. Some people with an autoimmune condition may find managing symptoms very effective and be able to lead typical lives that are hardly affected by illness.

The outlook

While there is currently no cure for autoimmune diseases, ongoing research is exploring new treatments and potential causes. Advances in genetics and immunology may help to improve our understanding of autoimmune diseases and lead to more effective treatments in future.7

In the meantime, it is important for women to be aware of the signs and symptoms and to seek medical attention if they suspect they may have one of these disorders. Early diagnosis and treatment can help prevent long-term damage and improve quality of life.8

1Autoimmune disease in women: https://www.frontiersin.org/articles/10.3389/ fendo.2019.00265/full

2What are common symptoms of autoimmune disease?: https://www. hopkinsmedicine.org/health/wellness-and-prevention/what-are-common-symptomsof-autoimmune-disease

3The prevalence of autoimmune disorders in women: https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC7292717/

4Autoimmune diseases: https://www.womenshealth.gov/a-z-topics/autoimmunediseases

5Autoimmune disorders: https://w ww.betterhealth.vic.gov.au/health/ conditionsandtreatments/autoimmune-disorders

6Social isolation stress exacerbates autoimmune disease in MRL/lpr mice: https:// pubmed.ncbi.nlm.nih.gov/15589047/

7Treating human autoimmunity: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4061980/

8Autoimmune diseases: https://www.healthdirect.gov.au/autoimmune-diseases