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Why are 90% of Lupus Patients Women?

A woman sitting with a doctor during a medical consultation.

Lupus is a long-term autoimmune disease. An autoimmune disease is a disease where the body’s immune system mistakenly attacks healthy tissues. This can lead to pain, swelling, and even organ damage. Not everybody has the same chance of developing lupus, however, as about 90% of adults with lupus are women — most often between the ages of 15 and 44.

This article explains why women are more likely to develop lupus and ongoing clinical research that seeks to help those who are affected.

Hormones and Lupus

One big reason is hormones — especially estrogen. Women usually have much higher estrogen levels than men, and estrogen can affect how the immune system works. Research shows that estrogen can make the immune system more active, which could cause more autoimmune problems for women and may also influence when symptoms flare.

This hormonal link may also help explain why some women notice lupus symptoms more often at times when estrogen levels fluctuate, such as:

Before their period

During pregnancy

When using certain birth control methods that contain estrogen

While hormones are only one part of the picture, understanding these patterns can help women and their care teams better recognize and manage symptom changes.

Chromosomes and Immune Differences

Hormones are only part of the story — genetics also play an important role. Women have two X chromosomes, while men have one X and one Y chromosome. Normally, one X chromosome in women is usually turned off in each cell. Sometimes it stays active. When more X-linked immune genes stay active, it may increase the chance of developing an autoimmune disease like lupus.

Women’s immune systems also tend to be stronger than men’s. This can be helpful for fighting infections, but it may also raise the risk of the immune system attacking healthy tissue, as happens with lupus.

Illustration of DNA strands and genes representing chromosomal differences between sexes

Illustration of the earth representing geographic and racial disparities in lupus diagnosis

Race and Ethnicity

Lupus risk and outcomes also vary by race and ethnicity. In the United States, lupus is diagnosed more often in Black, Latina/Hispanic, and Asian women than in white women. These groups also experience the disease more severely. These differences are likely caused by a mix of factors, including genetics, environmental exposures, and socioeconomic factors like access to timely, high-quality healthcare.

Lupus and Women’s Heart Health

Lupus can also impact the heart and blood vessels. As a result, women with lupus are more likely to develop heart disease, high blood pressure, and strokes at a younger age than women without lupus. One reason for this increased risk is the inflammation caused by lupus, which can damage blood vessels, increase plaque in arteries, and force the heart to work harder.

Some lupus treatments, like steroids, can also add to their cardiovascular risk. Because of this, women with lupus should pay close attention to their cardiovascular health. Regular check-ups, a balanced diet, staying active, and managing blood pressure and cholesterol levels are very important.

Illustration of a woman with a heart symbol representing women's cardiovascular health

Symptoms of Lupus That Women Should Watch For

Women should talk to their doctor if they notice any of these signs:

Fatigue

Joint pain or swelling

Muscle pain

Skin rashes, especially on the face (possibly in the form of a butterfly-shaped rash)

Unusual sensitivity to sunlight

Fever without a clear cause

Hair loss

Sores in the mouth or nose

Swelling in the hands, feet, or around the eyes

Chest pain or shortness of breath

These symptoms have many causes, but it is important to get checked early, especially if several happen at the same time or keep coming back.

Ongoing Research

Despite all that is known about lupus, scientists still don’t fully understand why it is more common in women than in men. There is no single cause, but researchers are studying how genetics, hormones, immune system differences, and environmental factors may contribute to impacting women far more than men. These findings could help doctors diagnose, prevent, and treat lupus better.

Researchers are also testing new lupus treatments in late-stage clinical trials. Some potential medicines block the signals that cause inflammation. Others reduce harmful interferons – immune signaling proteins that can drive lupus activity. Other investigational medications work to calm the immune system by limiting or removing overactive B and T cells. Together, these medicines aim to reduce inflammation and prevent organ damage.

Like with so many diseases, early detection is key for lupus. The disease can look very different from person to person, so speaking with a healthcare provider early can help manage symptoms, protect the heart, and prevent complications. With proper care and ongoing research, many women with lupus can live healthier lives.

CONTRIBUTING EXPERT

Chandar Abboy, MD

Dr. Abboy is a physician board-certified in internal medicine, pulmonary disease, critical care medicine, and sleep medicine. He is a Principal Investigator at Care Access, overseeing multiple clinical trials.

SOURCES

DISCLAIMER

The information provided on Care Access is intended for informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Our products and content are not intended to diagnose, treat, cure, or prevent any disease.

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