Though rare, many men do have lupus. Researchers don’t understand why some males develop lupus or why their symptoms are often more severe.
Lupus is an autoimmune condition that causes widespread symptoms such as pain, swelling, fatigue, and a skin rash. Lupus is often thought of as a female health condition. However, about 10% of all people diagnosed with lupus are male.
Researchers don’t currently know why lupus is more common among females, what causes some males to develop the condition, or why symptoms in males are typically more severe.
Treatment of lupus in males is the same as treatment in females and includes symptom management with medications such as immunosuppressants and corticosteroids.
Lupus is a relatively rare condition for people of any gender. About 1.5 million Americans have lupus, and about 16,000 people are diagnosed with lupus each year. For comparison, about
Among Americans with lupus, about 10% or 1 in 10 people with the condition is male. Often, males with lupus are surprised by their diagnosis, because lupus is commonly thought of as a “women’s health” condition.
In this article, we use “male and female” to refer to someone’s sex as determined by their chromosomes, and “men and women” when referring to their gender (unless quoting from sources using nonspecific language).
It should be noted that most of the studies quoted in this article did not include transgender or intersex individuals within their populations. At the time of publication, gender-inclusive clinical studies on lupus are limited in number and scope.
One 2022 review found that some trans women who exhibit signs of immune-mediated inflammatory rheumatic diseases later developed comorbidity with lupus after undergoing hormone treatment. However, in one trans man, lupus-related skin lesions improved after testosterone hormone treatment.
The review concluded that more studies on how lupus presents and develops in the trans community are needed. If you’re transgender or intersex and want to help scientists learn more about how lupus is affected by hormone treatments, check out ClincialTrails.gov.
Medical experts don’t know exactly what causes lupus. The condition is an autoimmune disorder. It tends to run in families.
However, researchers don’t know why it’s more prevalent in these groups, or why it’s more common in females than in males. It’s possible that hormonal differences could be a factor, as some research indicates that high levels of estrogen could increase the risk for lupus.
Additional research has looked at possible chromosomal differences, or at likely environmental exposure factors. And there’s evidence for several pathways to lupus development. Right now, experts can only say lupus results from dysregulation of the immune system which can be triggered by a variety of things:
- inherited genetic predisposition
- genetic differences in sex chromosomes
- epigenetic or environmental factors (including certain microbes and smoking)
- hormonal changes
The symptoms of lupus in males are the same as the symptoms of lupus in females. However, there are some symptoms that are slightly more common or are more likely to be severe in males. These include:
- unintentional weight loss
- blood clots
- chest pain (while talking)
- kidney disease
- heart disease
- blood vessel damage
- Raynaud’s syndrome
- mucosal ulcerations
Signs and symptoms of lupus that are common no matter a person’s gender include:
- pain in the joints
- swelling in the joints
- swelling in the hands and feet
- swelling around the eye
- a rash on the face
Is lupus severe in males?
Symptoms of lupus are the same in all genders. However, reports and research suggests males sometimes experience a more severe form of lupus.
Males have been shown to be prone to specific symptoms being more severe. This includes:
- blood clots
- organ damage
If you’re concerned that you may be showing signs of lupus, it’s important to talk with your doctor about a diagnosis.
Getting diagnosed with lupus can be a lengthy process for anyone. Often, the process is longer for men and those assigned male at birth. The average age of lupus diagnosis for women is 30. For men, the average age of diagnosis is 40.
There’s no one test that can confirm a diagnosis of lupus. Instead, a series of tests can help doctors rule out other conditions. You might have tests such as:
- a physical exam
- blood tests
- an antinuclear antibody (ANA) blood test
- a urinalysis
- a kidney biopsy
- Corticosteroids: Corticosteroids can reduce swelling to help control pain.
- Immunosuppressive medications: Immunosuppressive medications can lower your body’s immune response to control inflammation.
- BLyS-specific inhibitors: BLyS-specific inhibitors can help block the cytokine BLys/BLISS that is produced by immune cells that are overactive in lupus.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs can reduce pain and swelling.
- Anifroluma: (Saphnelo) has been shown to block cytokine Type 1 infections and allow for less steroid use in your treatment plan.
- Anti-malarials: For example, hydroxychloroquine, which can also be a platform therapy for lupus. Anti-malarials can prevent disease progression and flares, as well as lower the risk of blood clotting.
Can lupus be left untreated?
Without treatment, lupus can lead to severe complications. It can cause damage to internal organs and tissues and can cause stroke or heart attack, especially in males.
In fact, before modern lupus treatments were available, people with lupus had a shortened lifespan, and a lupus diagnosis was considered a terminal diagnosis. Today, people with lupus manage their condition with medication and have a typical life expectancy.
Lupus is often thought of as a women’s health condition, but that’s not the case. Although most people who get lupus are women or assigned female at birth, about 10% of all people diagnosed with lupus are men or assigned male at birth.
Research shows that some symptoms, such as anemia and blood clots, can be more severe in males. However, most symptoms are the same no matter a person’s gender. Diagnosis and treatment are also the same for everyone.