New Delhi: Women account for a disproportionately large share of people living with autoimmune diseases, with nearly 80% of those affected being women, according to medical experts. Yet many early symptoms can appear ordinary and are often attributed to stress, lack of sleep, hormonal changes or the demands of everyday life.
Persistent fatigue, joint pain, hair loss, skin rashes, recurrent mouth ulcers, unexplained fevers, digestive problems and brain fog can have many possible causes. But when such symptoms persist, recur or begin interfering with daily life, doctors say they should not simply be ignored.
There are more than 80 known autoimmune diseases, including lupus, rheumatoid arthritis, multiple sclerosis, psoriasis, Hashimoto’s thyroiditis and Sjogren’s syndrome. These conditions occur when the immune system mistakenly attacks healthy cells, tissues or organs.
The reasons women are more vulnerable remain the subject of ongoing research. Experts believe that a combination of genetics, hormones and environmental factors may influence the immune system and contribute to the higher burden among women.
What are autoimmune diseases?
The immune system is designed to protect the body from infections and other harmful threats. In autoimmune diseases, however, the immune response becomes misdirected and attacks the body’s own healthy tissues.
Different autoimmune diseases can affect different parts of the body. Some primarily involve the joints, while others can affect the skin, thyroid, nervous system, digestive tract or multiple organs.
The symptoms can therefore vary substantially from one person to another.
This variation is one reason autoimmune diseases can be difficult to recognise in their early stages.
A person may initially experience symptoms such as tiredness, joint discomfort or a skin change that does not immediately suggest an immune-related condition.
Why are women more affected?
Researchers believe that women’s greater susceptibility to autoimmune diseases is linked to a combination of biological and environmental factors.
Women generally develop stronger immune responses than men. While a more active immune response can provide advantages in fighting infections, it may also increase the risk of immune system dysfunction in some circumstances.
“Women have a more active immune system, and hormones, genetics and environmental factors can all influence how that immune response behaves. We are still trying to understand why this translates into a much higher burden of autoimmune disease in women,” said Dr (Lt Gen) Ved Chaturvedi, senior consultant and professor in the Department of Rheumatology and Clinical Immunology at Sir Ganga Ram Hospital.
Hormonal changes are also believed to influence the development or activity of some autoimmune diseases. This may be one reason why several such conditions emerge during a woman’s reproductive years.
However, there is no single explanation for why women develop autoimmune diseases at higher rates, and researchers continue to study the interaction between hormones, genes, immune responses and environmental triggers.
Symptoms that should not be ignored
One of the difficulties in identifying autoimmune disease is that its early symptoms can resemble those of several common conditions.
Fatigue, for instance, can result from inadequate sleep, stress, anaemia, infections or a range of other health problems. Similarly, joint pain may have numerous causes.
According to Dr Ved, symptoms that warrant medical attention when they persist or recur include fatigue that does not go away, swollen or painful joints, recurrent mouth ulcers, unexplained rashes or fevers, hair loss, digestive problems and brain fog.
“None of these symptoms automatically means you have an autoimmune disease. But when they persist, recur or start interfering with everyday life, they deserve to be investigated,” he said.
The important factor is therefore not necessarily the presence of one isolated symptom, but whether a pattern develops over time.
Why diagnosis can take time
There is no single blood test that can diagnose every autoimmune disease.
Doctors generally have to consider the complete clinical picture, including symptoms, medical and family history and findings from a physical examination.
Depending on the suspected condition, blood tests, imaging and other investigations may also be required.
“One of the biggest challenges is that the early symptoms of autoimmune disease can look very ordinary. Fatigue, joint pain or a skin rash may not immediately point to an autoimmune condition, which is why persistent or recurring symptoms should not simply be ignored,” Dr Ved said.
Because autoimmune diseases can overlap with other conditions, reaching a diagnosis may require multiple consultations and investigations.
Keeping a record of symptoms can therefore be useful. Noting when symptoms began, how frequently they occur, whether they follow a particular pattern and how they affect everyday activities can help doctors assess the situation more effectively.
Early diagnosis can make a difference
Recognising an autoimmune disease earlier can allow appropriate treatment and monitoring to begin sooner.
The importance of timely diagnosis varies depending on the specific condition. However, persistent uncontrolled inflammation can, in some autoimmune diseases, eventually affect organs and cause lasting damage.
Treatment also differs considerably between conditions. Some patients may require medicines to control inflammation or modify the immune response, while others may need long-term monitoring of particular organs or systems.
This is why self-diagnosis based on individual symptoms or internet searches can be misleading.
Women experiencing persistent symptoms should discuss them with a doctor rather than assuming that they are simply the result of stress, ageing or hormonal changes.
Which specialist should women consult?
The appropriate specialist depends on the symptoms and the suspected condition.
A rheumatologist may evaluate conditions affecting the joints, muscles and connective tissues. An endocrinologist may be involved when autoimmune thyroid or other hormonal disorders are suspected.
Depending on symptoms, a dermatologist, gastroenterologist or neurologist may also be involved.
A primary-care doctor can help determine which specialist, if any, is appropriate.
If symptoms continue without a clear explanation and a woman feels her concerns have not been adequately addressed, seeking a second medical opinion can also be reasonable.
Lifestyle measures can support treatment
There is no universal diet or lifestyle plan that can prevent or cure all autoimmune diseases.
Lifestyle measures should also not be viewed as substitutes for prescribed medical treatment.
However, maintaining overall health can support people living with autoimmune conditions. A balanced diet, adequate sleep, regular physical activity suited to an individual’s health and appropriate ways of managing stress can contribute to general wellbeing.
The specific approach may need to be adjusted according to the disease, symptoms, medications and other health conditions.
Experts also caution against unproven “miracle” cures or restrictive diets promoted as universal solutions for autoimmune diseases.
Women should not dismiss persistent symptoms
For many women, the challenge can extend beyond managing the disease itself. Getting persistent symptoms recognised and investigated can also be difficult when those symptoms are repeatedly attributed to stress, hormones, ageing or the pressures of daily life.
Not every episode of fatigue, pain or hair loss indicates an autoimmune disorder. But symptoms that repeatedly return, worsen or begin changing a person’s quality of life deserve appropriate medical attention.
A woman who repeatedly feels that she is “not herself” should be able to discuss those concerns with a healthcare professional without feeling that she is overreacting.
The goal is not to assume that every unexplained symptom is an autoimmune disease, but to recognise when a persistent pattern needs investigation.
Awareness can help women seek timely care
Autoimmune diseases are complex and can affect women in very different ways. Their symptoms may be subtle at first, and diagnosis can require a combination of clinical assessment and investigations.
Awareness can nevertheless help women recognise when symptoms deserve attention.
Tracking changes in health, discussing persistent or recurring symptoms with a doctor and asking questions about possible causes can help patients participate more actively in their care.
As medical experts continue to investigate why women carry a greater burden of autoimmune disease, one message remains important: persistent symptoms should not automatically be dismissed as an unavoidable part of being a woman.