Lupus Symptoms in Women - The Why and How - Sanguine

Lupus is a lifelong condition that the very brave learn how to navigate. It’s been classified as an autoimmune disease because of the process in which your own body’s immune system begins to confuse itself with foreign invaders and attacks. The exact reasons why certain autoimmune conditions occur are unknown but there is agreement that chromosomes, genes, and your environment greatly influence them. Also, your gender seems to be a key player in dictating when, how, and to whom which illnesses will present. 

Why does Lupus predominantly affect women? 

Research shows that women have higher evolutionary protective response rates to infections as compared to men. They respond really well to vaccines because of this. However, they also have higher rates of autoimmune conditions. Its unclear why this is the case, but this sex-bias is clear in many autoimmune conditions including lupus. 

The ratio of lupus diagnosis for men to women is one man for every nine women. Oftentimes men have a delayed diagnosis because doctors do not suspect that lupus could even be the culprit. However men with lupus tend to have more rapid clinical progression including renal involvement and impairment. 

What causes such a gender bias in autoimmune conditions, particularly lupus? Research has developed some pretty good theories including

• Chromosomes – Our genetic makeup is made unique by our DNA which exists inside our chromosomes. Women have two X chromosomes and men have one. This means women can express twice as many of the same genes. This repeated expression of certain genes can lead to autoimmune disease. 

• Hormones – Calcineurin, testosterone, estradiol, estrogen, and progesterone help to regulate the immune systems. Estrogen which is found in both men and women is considered a key player in autoimmune disease. It’s known to increase the activity of the immune system and testosterone is known to suppress it. Women have higher levels of both of these hormones, so if they also happen to have certain genes or environmental exposures they are more vulnerable to developing autoimmune diseases, like lupus. One evidence for this in that the incidence of lupus peaks during premenopausal years and is much lower in childhood or post menopause. This pattern coincides with estrogen levels present in the body at various stages of life.   

• Microchimerism – in a simple way, this is when a fetus leaves its own genetically unique cells inside its host. There is some conflicting evidence that the remaining cells can cause autoimmune disease in some mothers. 

How does lupus affect your period and menopause?

A period or “menstruation” is the term used for the monthly cycle in which the uterus sheds its lining. It is controlled by the body’s hormones. This monthly vaginal bleeding goes on every month until pregnancy or the end of the reproductive years “menopause.” Some symptoms include abdominal cramping, back pain, bloating due to fluid retention, breast tenderness, headaches, fatigue, anemia, and mood changes. Since lupus appears to be tied to hormonal levels, periods do influence lupus symptoms in women. In fact, many people experience lupus flares before or during their menstrual cycle.

Some of the unique lupus symptoms women experience in regards to period changes can include: 

• Anemia – low levels of iron in the blood 
• Irregular or fewer cycles
• Complete absence of a cycle
• Early menopause – which can be brought on by use of certain lupus treatments 

Getting through your period with or without lupus is challenging but here are some helpful tips to remain comfortable: 

• Heating pads
• Over the counter pain medication
• Resting 
• Hydration and healthy food

By Nadia Bhatti