Autoimmune diseases occur when the immune system, responsible for defending the body, starts to attack healthy cells and tissues by mistake. The first signs usually appear discreetly and often end up being confused with other health problems. Among the most common symptoms are persistent tiredness, body aches, changes in sensitivity, muscle discomfort and even changes in vision.

Despite their widespread occurrence, they are still frequently underdiagnosed, especially among women. Estimates from international medical societies indicate that autoimmune diseases affect between 5% and 8% of the world’s population. The incidence is higher among women, who account for the majority of cases and have a risk of developing them up to four times higher, especially between the ages of 30 and 40.

The topic has gained visibility in recent years with public figures in Brazil and abroad. Singer Selena Gomez, diagnosed with lupus, and actresses Selma Blair and Cláudia Rodrigues, who live with multiple sclerosis, helped to broaden the debate about diseases that, despite being relatively common, are still diagnosed late in many cases.

Initial symptoms of autoimmune diseases

According to the rheumatologist at Hospital São Marcelino Champagnat, Ana Cristina Boni Lenci, the onset of autoimmune diseases is usually marked by common and non-specific symptoms, which contributes to their being underestimated. “We often observe, in the office, that signs such as fatigue, fever and body pain end up being attributed to stress or routine overload. As a result, the patient takes a long time to seek help and, when they do, they are not always referred to the appropriate specialist”, he explains.

This delay in seeking care, combined with the variety of symptoms, is one of the main factors for late diagnosis. There is also a relevant biological component: the higher incidence in women is related to the hormonal influence on the immune system, especially in phases of greater hormonal variation throughout adult life.

Autoimmune diseases in women

Below, check out the most common autoimmune diseases in women and the symptoms of each one:

1. Lupus

Among systemic conditions, lupus is one of the best known — and also one that generates the most confusion in the early stages, as signs can easily be attributed to common situations, such as sun exposure or physical exhaustion.

Estimates from the Brazilian Society of Rheumatology (SBR) indicate that the disease affects between 150,000 and 300,000 people in the country, mainly young women. On average, diagnosis takes three to six years. “The initial signs of lupus depend greatly on the organ affected. Among the most common are skin lesions on the face, with redness that is often confused with rosacea or a reaction to the sun. Joint pain is also common, but, as there is generally no swelling or heat, the patient tends to attribute it to excessive use of the joints”, explains Ana Cristina Boni Lenci.

The condition may involve persistent fatigue, localized hair loss and, in more advanced stages, involvement of organs such as the kidneys and heart. Inflammatory pain has a characteristic pattern: it tends to be more intense upon waking, with stiffness, and improves throughout the day, with movement.

Without treatment, the disease can progress and lead to serious complications. On the other hand, with adequate monitoring, it is possible to control the condition and preserve quality of life. “The patient can lead a normal life. The main risk lies in late diagnosis, when the disease has already caused damage”, reinforces the doctor.

2. Rheumatoid arthritis

This type of inflammatory pain is also present in arthritis rheumatoid, which mainly affects the joints and can be confused with natural wear and tear, such as osteoarthritis. The disease affects twice as many women as men, according to SBR. “The pain is usually accompanied by morning stiffness and difficulty with simple movements, such as closing the hands, and improves throughout the day. It is different from osteoarthritis, which tends to worsen with use”, explains Ana Cristina Boni Lenci.

3. Sjögren’s syndrome

Another condition that predominantly affects women is Sjögren’s syndrome, characterized by intense dryness of the eyes and mouth. Unlike temporary conditions, the symptom is continuous and does not improve even with hydration or the use of eye drops, which can compromise oral and eye health. In some cases, the disease is also associated with more serious complications, such as an increased risk of lymphoma.

4. Multiple sclerosis

Among neurological diseases related to the immune system, multiple sclerosis occurs most frequently in women in early adulthood, between 20 and 30 years old. Visual changes, tingling, loss of strength and motor difficulties can appear in isolation and are often interpreted as temporary conditions.

“Every new neurological change must be investigated, especially when there is no obvious cause. Early initiation of treatment is essential to avoid sequelae and preserve quality of life”, warns the neuroimmunologist at Hospital São Marcelino Champagnat, Mariana Trintinalha.

5. Myasthenia gravis

Myasthenia gravis is another condition that also affects women, usually around the age of 30, and its main characteristic is fluctuating muscle weakness. Unlike common tiredness, symptoms tend to worsen throughout the day. “It’s a different fatigue: the person starts the day well and gets worse. They may have double vision and difficulty with simple tasks. This fluctuation in symptoms is very characteristic”, details Mariana Trintinalha.

Why these diseases arise — and how they can accumulate

Despite the different manifestations, the autoimmune diseases share a common mechanism. Its exact causes are not yet fully known, but they involve a combination of genetic, hormonal and environmental factors. Infections, stress, exposure to external agents and hormonal changes can act as triggers in predisposed people, which helps to explain both the higher frequency in women and the appearance at specific stages of life.

Furthermore, people who already have an autoimmune disease must maintain continuous monitoring. According to experts at Hospital São Marcelino Champagnat, there is a greater likelihood of developing other conditions over time, which makes monitoring essential for early diagnosis and adequate control.

Por Bruna Fioroni