Autoimmune conditions and why sex matters

Many autoimmune diseases are more common in women, though anyone can get them. Joint swelling, tiredness that won’t go away and rashes can happen with these conditions. But they can also have other causes. These symptoms, and the difference between the sexes, can’t on their own tell you what’s causing a change.

What an autoimmune condition involves

Your immune system usually helps protect you from infection. In an autoimmune disease, it attacks the body’s own healthy tissues by mistake. Which organs or tissues are affected depends on the condition. Some conditions mainly affect one organ. Others can affect several parts of the body.

Symptoms may come and go. A time when symptoms settle is called remission. A time when they get worse is often called a flare. Treatment depends on the disease, how severe it is and the symptoms it causes.

Why researchers study sex differences

The Office on Women’s Health says many autoimmune diseases are more common in women than men. That wording reflects the people its information is for. Symptoms deserve attention in anyone.

NIH describes research into differences in genes and hormones that might help explain this pattern. It says many parts of the explanation are still missing. Most autoimmune disease is thought to come from a mix of genes that make you more likely to get it, and other triggers or stresses on the body.

The research is still going on. It can’t tell you whether your symptoms come from a hormone problem. At an appointment, describe the symptoms themselves and how they affect your daily life. Your clinician can think about the possible causes.

Lupus, thyroid disease and rheumatoid arthritis

Lupus can affect the joints and skin, causing pain, rashes and tiredness. It can also affect organs such as the kidneys, lungs and heart. Symptoms may flare and settle, though some people have symptoms more of the time.

In Hashimoto’s disease, the immune system attacks the thyroid. This can lead to an underactive thyroid. Possible symptoms include tiredness, finding it hard to cope with the cold, constipation, dry or thinning hair, and heavy or irregular periods. These symptoms need checking to find out whether a thyroid problem is the cause.

Rheumatoid arthritis affects the lining of the joints and can cause pain, swelling and stiffness. The small joints of the hands and feet are often affected early on. Stiffness may be worse in the morning or after keeping still. Other parts of the body can be affected too.

Medicines do different jobs in autoimmune care. Some ease symptoms. Some calm down the immune system. Others replace something the body can’t make enough of any more. For example, an underactive thyroid can be treated by replacing thyroid hormone. Ask what each of your medicines does and what follow-up you need. Your pharmacist, GP or specialist can advise about the treatment you’ve been prescribed.

Plan pregnancy with the care team

Having an autoimmune condition doesn’t rule out pregnancy. The Office on Women’s Health says women with autoimmune diseases can safely have children, but the risks depend on the condition and how severe it is. Some people’s symptoms get better in pregnancy. Others have flares.

If you want to get pregnant, talk to your specialist and your GP or family doctor before you try. They may suggest waiting until the disease is in remission, and reviewing your medicines. Some medicines for autoimmune disease aren’t suitable in pregnancy, and you may need specialist pregnancy care.

If you find out you’re pregnant while taking regular medicines, contact your GP or prescribing specialist now (UK), or your prescribing doctor (US or elsewhere), so they can review your treatment soon. Don’t stop a prescribed medicine without talking to them. Stopping treatment that keeps you well can harm you or your baby. Ask who will join up care between your specialist and your maternity team.

When to get help

Get an urgent medical check today through your GP or NHS 111 (UK), or your doctor or an urgent care service (US or elsewhere), for sudden severe joint pain, especially in one joint, or a joint that is hot, swollen or a different colour. Do the same if you have trouble moving the joint, or joint pain with fever, shivering or feeling generally unwell. Don’t wait for a routine review of a flare.

Book a GP appointment in the UK, or see your doctor in the US or elsewhere, for joint swelling or pain that keeps coming back, tiredness that won’t go away, or rashes that worry you. Bring a record of your symptoms and any family history that might matter, including symptoms that don’t seem linked.

If you already have an autoimmune condition and think a flare is starting, contact your care team. Ask which changes need an urgent check, who to contact out of hours and when your next check is due. Bring any questions about managing activity, work or pregnancy to that conversation.