Lupus (systemic lupus erythematosus, or SLE) is an autoimmune disease in which the immune system attacks healthy tissues. It’s a condition that affects many parts of the body: joints, skin, kidneys, heart, and brain, and it hits women much harder than men.
In many countries, about 9 out of 10 people diagnosed with lupus are women, often during their childbearing years. Therefore, it’s essential to understand the causes and know how to access the appropriate support and treatment.
Why Lupus Affects Women More
There’s no single cause, but here are three reasons why lupus may affect women:
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Genetics and the X chromosome: Women have two X chromosomes, and one is typically inactivated to maintain a balanced immune system. A molecule called Xist plays a crucial role in this process. When it doesn’t work properly, immune-related genes can remain overactive, confusing the immune system and causing it to attack the body’s own tissues, which is a key cause of Lupus.
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Hormones: Sex hormones, especially estrogen, can impact women’s immune systems, enhancing immune activity, which is beneficial against infections but potentially harmful when the immune system overreacts. This explains why lupus often appears or flares during puberty, pregnancy, postpartum, or around menopause.
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A More Reactive Immune System: On average, women have a stronger immune system than men, which helps them fight infections and respond more effectively to vaccines. However, this strength can also increase the likelihood that the immune system will turn against the body.
Typical Symptoms of Lupus
Lupus can present itself in many ways, and the common early signs include:
Because symptoms vary and overlap with those of other conditions, diagnosis can be a time-consuming process. If several of these signs appear together and persist, see a Doctor.
How Lupus Affects Women’s Health Long-term
Here are long-term risks for women who have untreated lupus:
Diagnosis of Lupus in Women
Diagnosis is based on a combination of symptoms, physical examination, blood tests (including ANA and other antibodies), urine tests (for kidney involvement), and, in some cases, imaging tests.
Additionally, because lupus affects different organs, your doctor may order tests over time to better understand the disease's progression. Early diagnosis and a clear care plan improve outcomes.
Treatment of Lupus in Women
There’s no cure yet for lupus, but treatment can control symptoms, reduce flares, and limit organ damage. Common treatments are:
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Hydroxychloroquine (HCQ): A foundational medicine for most people with lupus, as it reduces flares and helps protect organs.
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Immunosuppressants or biologics: Medications like azathioprine, mycophenolate, rituximab, and belimumab are used when lupus threatens the organs or when HCQ/steroids aren’t enough.
Finally, pain control, blood pressure and cholesterol management, bone protection, and vaccinations are administered appropriately in conjunction with immunosuppressant drugs. However, all treatments are tailored to the individual.
Lupus and Pregnancy
Many women living with lupus want to have children, and with the right planning and medical care, many are able to have safe and healthy pregnancies. The key is to make sure lupus is under control before conception. Pregnancy is generally safest when the disease has been stable for at least several months.
Antibodies like antiphospholipid antibodies or anti-Ro/SSA can raise the chances of complications with blood clots, miscarriage, or neonatal lupus, so doctors usually test for these and manage them carefully during pregnancy.
Ideally, care should involve both a rheumatologist and an obstetrician who are experienced in high-risk pregnancies, so that mother and baby receive the best possible support.
Practical Self-care for Women With Lupus
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Plan pregnancy when lupus is stable and with the doctor's input.
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Many people with lupus are photosensitive, so it's essential to use sunscreen, hats, and seek shade to reduce skin flares.
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Because lupus increases cardiovascular risk, it is essential to manage blood pressure, cholesterol levels, stay active, and avoid smoking.
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Stay up to date with vaccines (timed with treatments) and talk to your doctor about infection risks.
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Watch for warning signs, such as intense fatigue, new swelling, shortness of breath, severe headaches, changes in urine, and seek prompt medical care.
Conclusion
Lupus is a lifelong condition that affects women, especially during the reproductive years. However, modern care, hydroxychloroquine, targeted immunosuppression, and coordinated reproductive planning can help women live well with Lupus.
The key is to get diagnosed as early as possible, so treatment can start before serious complications develop.
Tell me, are you just hearing about lupus for the first time? Do you suspect anyone who could be dealing with this?
Researched by Mercy Adeniyi.
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