Autoimmune conditions in women: why they are more common

SASian Anderson, Writer and editor, MyGLP. Sources checked 5 November 2026.

What autoimmune means

In an autoimmune condition, the immune system attacks the body's own tissue. In Hashimoto's disease, the NHS says, the target is the thyroid. Lupus can reach the joints, skin, heart, kidneys and other organs. The conditions below are the ones women meet most often.

The numbers: women carry most of the load

The largest UK study so far used the health records of 22 million people and looked at 19 common autoimmune conditions. Conrad and colleagues, writing in The Lancet in 2023, found about 1 in 10 people had at least one. The University of Oxford summary gives the split: about 13% of women and 7% of men.

For some conditions the gap is far wider. A 2026 review in Exploration of Immunology puts women at nearly 85% of diagnosed autoimmune cases, and gives these ratios:

Why women are more affected

The same review sets out the main reasons researchers have found. Women have two X chromosomes. One is mostly switched off, but around 15 to 30% of its genes escape, and some of these genes help run the immune system. Oestrogen tends to step up immune responses, while progesterone and androgens tend to calm them. Pregnancy often brings a quieter spell, and the months after birth are a common time for a flare as hormone levels drop.

For decades, much of this research treated the male body as the default. The Women's Health Strategy for England, published in 2022, said women are under-represented in important clinical trials. Its call for evidence found 84% of respondents had times when a health professional did not listen to them. This is about evidence catching up, not women against men.

Lupus

The NHS lupus page says lupus is more common in women, and more common in women of African, Caribbean, Asian or Chinese background. The three main symptoms are:

• Joint and muscle pain.
• Extreme tiredness that does not improve with rest.
• A rash, often over the nose and cheeks, which can appear after time in the sun.

Lupus often flares for a few weeks, then settles. Other signs include mouth ulcers, hair loss, fever, swollen glands and Raynaud's, where fingers and toes change colour in the cold. Puberty, childbirth and the menopause are listed as possible triggers. Diagnosis rests on blood tests for certain antibodies plus your symptoms, and the NHS says it is not always easy because lupus looks like other conditions.

Rheumatoid arthritis

The NHS rheumatoid arthritis page describes pain, swelling and stiffness, often starting in the small joints of the hands and feet, and usually on both sides of the body. Morning stiffness tends to last longer than 30 minutes. Stiffness from wear-and-tear arthritis usually eases within 30 minutes. Tiredness, a high temperature, sweating and weight loss can come with it. Symptoms can come and go in flares.

Hashimoto's and an underactive thyroid

Hashimoto's is the most common cause of an underactive thyroid in the UK. The NHS underactive thyroid page says it is most common in women and usually starts between about 30 and 50. Symptoms build slowly: tiredness, feeling cold, weight gain, constipation, low mood, dry skin, thinning hair, and irregular or heavy periods. Our thyroid checks guide covers the blood test to ask for.

Coeliac disease

NICE guideline NG20 says you should be offered a coeliac blood test if you have long-lasting gut symptoms with no other explanation, ongoing tiredness, unexplained weight loss, or anaemia or low B12 or folate. People with autoimmune thyroid disease or type 1 diabetes should be considered for testing too. The Lancet study found autoimmune conditions often occur together, above all thyroid and joint conditions. NICE also lists fertility problems and repeated miscarriage among the reasons a test may be offered.

One rule matters: keep eating gluten before the test. NICE says to eat gluten in more than one meal a day for 6 weeks before the blood test. The test looks for antibodies, and they need gluten in your diet to show up. If you have already cut gluten out, tell your GP before the test.

Getting symptoms that come and go taken seriously

An appointment on a good day can make a flare look like nothing. Bring the evidence with you.

1. Keep a diary for 4 to 8 weeks: joint pain, stiffness and how long it lasts, rashes, tiredness, gut symptoms, and where you are in your cycle.
2. Take photos of rashes, swollen joints and colour changes in your fingers when they happen.
3. Write down any family history of thyroid disease, lupus, arthritis or coeliac disease.
4. Ask for tests by name where they fit: thyroid function, coeliac antibodies, full blood count, and inflammatory markers.
5. If a test is normal and symptoms go on, ask what else could explain them and when to come back.

Our guide to getting heard at the GP has more on asking for a longer appointment and a second opinion. If tiredness is the main problem, our tired all the time guide covers the other common causes.

Heart risk and autoimmune conditions

NICE says heart risk tools may underestimate risk in people with autoimmune and inflammatory conditions, and QRISK3 includes lupus as a factor. If you have an autoimmune condition, ask your GP to take it into account when they check your heart risk. Our heart health guide has the detail.

Sources

1. Incidence, prevalence and co-occurrence of autoimmune disorders over time and by age, sex and socioeconomic status (Conrad et al, The Lancet, 2023)
2. Autoimmune disorders found to affect around one in ten people (University of Oxford, May 2023)
3. Autoimmune diseases are more common in women: insights into sex and gender differences in autoimmunity (Calabro et al, Exploration of Immunology, 2026)
4. Women's Health Strategy for England (Department of Health and Social Care, 2022)
5. Lupus (NHS)
6. Rheumatoid arthritis: symptoms (NHS)
7. Underactive thyroid (hypothyroidism) (NHS)
8. Coeliac disease: when you should be tested (NG20) (NICE)
9. Cardiovascular disease: risk assessment and reduction (NG238) (NICE)