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Lupus in Women: From Puberty to Menopause

posted in hormones and lupus on June 11, 2023 by

Donald Thomas, MD

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Lupus in women occurs much more often than in men. There are many reasons this occurs. Also, lupus tends to be more severe in younger women and often flares around the menstrual cycle.

Watch the video below that I made along with Kaleidoscope Fighting Lupus to know why these occur. They range from the bizarre (microchimerism) to the straightforward (effects of estrogen on the immune system). Make sure to join KFL so you are notified when other interesting KFL blog posts and videos are posted.

Interesting trivia in the video about lupus in women:

  • How severe is lupus in women during various stages of their life?
    • Does lupus get better after menopause?
  • Is it also true that lupus can flare around menstrual cycles (periods, menstruation)? If so, why?
  • There are 9 women with lupus for every man with lupus. Why does lupus in women occur more often?
    • Much has to do with the X-chromosome and how lupus genes will remain active when they should turn off
    • The children of women with lupus may even contribute by spreading fetal cells into their mother during pregnancy, then those cells can persist, causing immune system problems (called microchimerism)
    • The female hormones can cause increased immune system activity
    • Many women are born with an X-chromosome. However most do not realize this. It increases their risk for lupus, anxiety disorder, and learning disabilities
    • Some men are born with an extra X-chromosome that subsequently greatly increases their risk for lupus
    • Some women have only one X-chromosome and have a very low likelihood of getting lupus
  • Is it safe for women to take birth control pills containing estrogen? How about taking hormone replacement therapy at menopause to decrease life-altering hot flashes?
  • What are some of the triggers of lupus? Follow The Lupus Secrets to learn how to avoid these triggers.

What has your experience been with lupus at different stages of life, menses, or if you took hormones? Comment below…

Click on the video below to answer all these questions about lupus in women and more.

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6 Comments

  1. My first impossible-to-ignore flare of whatever I was struggling with 40 years ago happened within 6 months after the birth of my first baby, a boy. Every time I read about the potential impact of microchimerism I wonder if that may be a cause of my issues. Is there a test for that? No one else in the extended family, that I know of, has autoimmune issues.

    • Carolyn: Not that I know of. Plus, you would not know what organs to biopsy to look for it. Thus far, studies have specifically evaluated organs affected by lupus (such as the kidneys), then performed extensive chromosomal analysis looking for Y chromosomes. These are only research tools at the moment, I believe. The topic you bring up is interesting though. We typically think of postpartum flares being related to the hormonal changes. We should not discount microchimerism playing a possible role.

      Thanks for your comments

      Donald Thomas, MD

  2. My first impossible-to-ignore flare of whatever I was struggling with 40 years ago happened within 6 months after the birth of my first baby, a boy. Every time I read about the potential impact of microchimerism I wonder if that may be a cause of my issues. Is there a test for that? No one else in the extended family, that I know of, has autoimmune issues.

  3. I was undiagnosed as a child, though I had to stay at home when the weather was cold because my legs ached so much. Then at 40, I began to have mobility issues. Saw lots of different doctors with no diagnosis. At 50 I began to have significant fatigue issues. Was diagnosed at 55 by Mayo. Had menopause at 52. I’m 64 and have to take plaquinil and mexotrexate.

  4. Have been on birth control for many years continuously. Ok’ed by my rheumatologist and gyno; I am negative e for Anti-Phospholipid Antibodies. This prevents me from getting a period, which turns my body and world upside down and an extreme amount of inflammation/flare ups. I think everyone responds to birth control pills differently.

    • Dawn: Thank you for your comment and sharing your experience. This is a great example of using oral contraception in an appropriate way in SLE. They are not contraindicated in everyone. Hope you continue to do well.

      Donald Thomas, MD

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