Why women face higher risk of autoimmune diseases? Doctors explain

International Women's Day: Doctors highlight how hormones, genetics and immune responses make women more prone to autoimmune diseases and why awareness can improve early diagnosis

Autoimmune diseases are increasingly being recognised as a major health concern for women across the world. Conditions such as lupus, rheumatoid arthritis, and autoimmune thyroid disorders affect millions, and doctors say women make up the vast majority of patients. While these conditions can develop at any age, certain biological and hormonal factors mean women are far more vulnerable than men.

 

Experts say the reason lies in the very system designed to protect us. Women tend to have stronger immune responses, which help them fight infections effectively, yet the same strength can sometimes cause the immune system to mistakenly attack healthy tissues.

 

 

Why women face a higher risk

 

Autoimmune diseases occur when the immune system fails to distinguish between the body’s own tissues and harmful invaders. As a result, the immune system begins attacking healthy cells, which can lead to inflammation and long-term damage.

 

According to Dr Beenish Nazir, Consultant Rheumatologist at Apollo Hospitals, Sheshadripuram, women’s immune systems are naturally more active than men’s.

 

“Women have a stronger immune system than men. This helps them fight off infections, but it also means their immune system can sometimes attack their own body. This is called autoimmunity,” she explains.

 

She adds that a majority of patients with autoimmune conditions are women. “Most people with diseases like lupus, rheumatoid arthritis and thyroid problems are women. Around 75–80 per cent of patients with these diseases are women.”

 

Dr Nazir says several factors combine to increase risk.

 

• Hormones
• Genetic influences 
• Immune system differences
• Environmental triggers - infections, stress, smoking, certain medications

 

The disease therefore develops because of a complex interaction between biology, genetics and environmental factors.

 

The role of hormones

 

Hormones are one of the most important reasons behind women’s increased susceptibility to autoimmune disorders.

 

Dr Yathish G C, Lead Consultant – Rheumatology at Aster Whitefield Hospital, explains that female hormones influence the immune system behaviour. Estrogen in particular stimulates immune activity.

 

“Estrogen activates immune cell functions specifically through its effects on B cells, which produce antibodies. Elevated estrogen levels lead to increased immune response and stronger antibody-based defences,” Dr Yathish notes.

 

Dr Nazir adds, “Female hormones help the immune system function efficiently, but when there are underlying genetic tendencies, these hormones can make the immune system overactive,” she adds.

 

Progesterone, on the other hand, tends to calm immune activity, especially during pregnancy, although hormonal fluctuations during the menstrual cycle or menopause can influence disease symptoms.

 

The role of genetic factors

 

Another key factor lies in genetics, particularly the X chromosome. Women have two X chromosomes while men have one X and one Y chromosome, and the X chromosome carries several genes linked to immune function.

 

Dr Nazir explains that this genetic difference may increase susceptibility.

 

“The X chromosome has genes that affect the immune system. Having two X chromosomes means women have a greater chance of immune system problems. Sometimes the normal process of shutting down one X chromosome does not happen completely, which can lead to overactive immune genes.”

 

Family history also increases risk because certain genetic markers are associated with diseases such as lupus and rheumatoid arthritis.

 

Different life stages - Different risks

 

Experts say autoimmune diseases often emerge or worsen during major hormonal transitions in a woman’s life. These include:

 

• Puberty: Rising estrogen levels may trigger conditions such as lupus or juvenile arthritis in individuals who are genetically prone
• Pregnancy: Some conditions, such as rheumatoid arthritis, may improve during pregnancy, although lupus can worsen because the immune system adjusts to support the developing baby
• Post-pregnancy period: Doctors say this phase carries a higher risk of disease flare-ups, including lupus, thyroid disorders and rheumatoid arthritis
• Menopause: Hormonal shifts during menopause may increase symptoms such as fatigue, inflammation and joint pain

 

Dr Yathish explains that these phases place additional pressure on the immune system.

 

“Hormonal transitions represent important times when people experience their most vulnerable state. The body experiences its highest estrogen production during puberty and autoimmune diseases often first emerge during adolescence or early adulthood,” he says.

 

Why diagnosis is often delayed

 

Despite their prevalence, autoimmune diseases in women are frequently diagnosed late.

 

Symptoms such as fatigue, joint pain, hair thinning and weight fluctuations are often dismissed as stress, hormonal imbalance or lifestyle issues.

 

Dr Yathish notes that the overlap of symptoms can make diagnosis difficult.

 

“The initial signs of the disease, which include fatigue and joint pain and mood changes and hair thinning and weight fluctuations can resemble other health issues. This is why diagnosis sometimes takes years,” he says.

 

Dr Nazir adds that limited awareness and delayed specialist referrals also contribute to the problem.

 

“Women’s symptoms might be seen as just stress or age-related changes. Lupus is particularly difficult to diagnose because it can affect multiple organs and mimic other conditions.”

 

Symptoms women should not ignore

 

Doctors urge women to seek medical advice if certain symptoms persist for more than a week. Key warning signs include:

 

• Persistent joint pain or swelling
• Morning stiffness lasting more than 30 minutes
• Extreme or unexplained fatigue
• Hair thinning or facial rashes, particularly the butterfly rash seen in lupus
• Recurrent mouth ulcers
• Unexplained weight changes or thyroid swelling

 

“Early diagnosis allows for timely treatment with medications that can prevent joint damage, kidney problems and other long-term complications,” Dr Nazir says.

 

Why awareness matters

 

Doctors emphasise that autoimmune diseases are manageable when detected early, although many women remain unaware of their symptoms.

 

On International Women’s Day, health experts say greater awareness about autoimmune disorders can help women seek medical attention sooner and reduce the risk of severe complications.

 

With timely diagnosis, appropriate medication and healthy lifestyle habits, many women with autoimmune diseases can lead full and active lives.     

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This report is for informational purposes only and is not a substitute for professional medical advice.