From hormones to genetics: Rheumatologist decodes why autoimmune diseases impact women more than men

Autoimmune disease impacts men and women very differently. Rheumatologist explain why women are more prone to them than men.

An autoimmune disease is a condition where the immune system mistakenly attacks the body’s own tissues, affecting nearly 8% of the world’s population. This not only causes a cascade of physiological issues, but also severely impacts the quality of life in the long-term. The bigger problem lies in the fact that most women do not realise the severity of the condition for years after their symptoms first appear. In an interview with HT LIfestyle, Dr Ankush PM, Consultant Rheumatologist, Fortis Hospital Jalandhar, decodes why the female immune system is more vulnerable to autoimmune conditions than men’s.

Common autoimmune diseases in women

Dr Ankush highlighted that Hashimoto’s Thyroiditis is a chronic autoimmune condition that progressively impairs the metabolic functions of the thyroid gland. It is one of the most common causes of hypothyroidism in women, with a female-to-male ratio of approximately 10:1. Systemic Lupus Erythematosus (SLE), commonly known as Lupus, is a primary example of an autoimmune disorder affecting multiple organs, such as skin, kidneys, and the nervous system. Rheumatoid Arthritis (RA) remains one of the most prevalent conditions, where the immune system attacks the synovial lining of the joints, leading to chronic pain and potential deformity.

Estrogen enhances immune activity, which helps women fight infections more efficiently than men.

Why are women prone to autoimmune conditions?

Dr Ankush said, “Estrogen enhances immune activity, which helps women fight infections more efficiently than men. However, high levels of estrogen can overstimulate the system.” When this process becomes hyperactive, the body may begin to target its own healthy tissues. “Life transitions like puberty, pregnancy, and menopause involve major changes in estrogen, progesterone, and testosterone levels,” he added. These hormonal changes increase the risk of diseases like lupus and multiple sclerosis.

The genetic factor

Females possess two X chromosomes, while males have an X and a Y. The X chromosome contains a high concentration of genes related to the immune system. Although one X chromosome is largely “silenced,” it is not completely inactive.

Women’s immune systems are often more alert, and estrogen helps drive that stronger response.

The risk of all autoimmune conditions depends on the immune system's ability to distinguish between its own healthy tissue and potential infections. Women’s immune systems are often more alert, and estrogen helps drive that stronger response. However, that stronger defense can become a drawback when the immune system loses tolerance and starts attacking healthy tissue.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.