Lupus is an autoimmune disorder that affects an estimated 1.5 million people in the U.S. A healthy immune system produces antibodies that attack foreign bodies, such as the flu virus. In a person with lupus, however, the immune system confuses healthy tissues for foreign bodies. Autoantibodies are produced, which attack the healthy tissues. This causes pain, swelling, and damage in the healthy tissues being attacked. Women are more likely to be diagnosed than men, and African American and Hispanic women have an even higher likelihood of diagnosis. That this condition is only understood by 33% of the U.S. is one of the reasons why Lupus Awareness Month is such an important time to look at the symptoms of lupus, especially lupus symptoms in women, as they are the most affected group of people.
1. Unexplained fever
Fever is often the first indication of infection in the body, and it is one of the first lupus symptoms to present itself. This is not the only way to diagnose lupus, as unexplained fever is present in many other conditions, but it can be an early warning sign.
Ninety percent of those with lupus symptoms report fatigue that is unrelieved by sleep. This can be an especially difficult symptom to cope with, as napping during the day can lead to insomnia at night.
3. Joint stiffness and swelling
Autoimmune disorders often head straight for the tissues in the joint, causing painful inflammation and swelling. Joint stiffness and swelling combined with unexplained fever can be two lupus symptoms that start to point towards a diagnosis.
4. Hair loss
Of the lupus symptoms in women, hair loss can be one of the most traumatic. In general, hair will begin to thin due to inflammation of the skin and on the scalp. Lesions may form, and if they are not able to be successfully treated, scars may prevent hair from growing back. If treatment is successful, the majority of people will see regrowth.
5. Skin rash and lesions
One of the tell-tale markers of lupus is a butterfly-shaped rash that appears across the bridge of the nose and cheeks. For people already diagnosed, this is one of the symptoms of lupus that can indicate that a flare-up is imminent. Another serious (typically uncommon) form of lupus rash is a “bullous” lupus rash, which results in large blisters.
6. Chest pain
Pulmonary issues can be one of the more serious lupus symptoms. It occurs when the delicate tissues and blood vessels of the lungs become inflamed, making breathing difficult and painful. This is often referred to as pleuritic chest pain. Over time, the size of the lungs can actually decrease, causing chronic chest pain and shortness of breath.
7. Kidney inflammation
Kidney inflammation, also called nephritis, causes inflammation in the kidneys that make it difficult for them to function. Toxins in the body and blood build up, causing swelling in the lower extremities, high blood pressure, darker urine, and pain in the side. When this symptom of lupus goes untreated it can lead to end-stage renal disease (untreatable kidney failure). Signs of nephritis require immediate attention.
8. Thyroid problems
Lupus attacks all systems of the body, and the thyroid is included. The thyroid helps control metabolism and appetite. Any changes to this gland can result in weight loss or gain. If lupus patients are taking corticosteroids to control pain and inflammation in joints, this could result in thyroid-related weight gain as well. Approximately 6% of people with lupus have hypothyroidism (underactive thyroid) and about 1% have hyperthyroidism (overactive thyroid)
9. Sjogren’s syndrome
Sjogren’s syndrome is one of the lupus symptoms in women that cannot be ignored, especially for women who are pregnant. This is an autoimmune condition that makes it possible for a woman to pass neonatal lupus on to her child in utero. Pregnant women with a previous diagnosis of Sjogren’s (or lupus in general) should let their doctors know immediately, as neonatal lupus can cause serious issues for newborns, including congenital heart defects.
Dryness in people with lupus is caused by Sjogren’s syndrome, a condition that affects the glands responsible for tears, saliva, and other mucous membranes in the body (e.g., the vagina). People with Sjogren’s may wake up with a gritty feeling in their eyes and mouth.
As with many chronic illnesses, depression can be a complicated comorbid condition. Approximately 33% of lupus patients report clinical depression, nearly double the incidence in the general population. Some of the causes of depression may be dealing with lupus itself, but medications like steroids taken for inflammation may also play a part.
12. Gastrointestinal issues
Many people with lupus experience gastroesophageal reflux disease (GERD), a disease that can cause severe heartburn. Peptic ulcers can also form due to some medications for lupus.
Although not necessarily gender exclusive and not necessarily a specific symptom of lupus in women, the risk for osteoporosis rises for women who are taking prednisone as a treatment for this condition. This is more of a comorbid condition than a symptom, but it is worth considering the risks that can occur due to steroid medications that decrease bone density.
Some people with lupus will experience anemia, a condition marked by a low red blood cell count that can result in weakness and fatigue. This can be detected by a complete blood count, a diagnostic tool often used when screening specifically for lupus.
15. Raynaud’s disease
Raynaud’s disease is when fingers and toes turn white or purple in response to stress or exposure to cold. Arteries delivering blood to the extremities spasm, resulting in poor circulation. In severe cases, this can lead to gangrene in the fingers and toes.
16. Heart disease
EverydayHealth reports that one of the most alarming lupus symptoms in women is their increased rates of heart disease: “Women with lupus are 50 times more likely than others of the same age to have a heart attack or chest pain.” If you’re suffering from lupus symptoms, make sure to talk to your doctor about this related risk factor as well, so you can take steps to reduce your risk.
17. Mouth sores
One of the more common lupus symptoms is mouth or nasal sores. As Health.com explains:
“Mouth ulcers are one of the most common symptoms of lupus. But what makes a lupus mouth ulcer unique, says Dr. Gilkeson, is that it usually comes pain-free. And rather than developing on the sides of the mouth or gums, these sores typically reside on the roof of the mouth. Lupus-related ulcers can also appear inside the nose.”
Anxiety is another mental health condition that often affects people with chronic pain conditions. It’s no different with lupus, women in particular. Self.com notes that a lot of the anxiety may be related to noticing and living with these other lupus symptoms.
19. Blood in urine
One of the more obvious lupus symptoms is one that can also be indicative of other health conditions. With lupus, it’s related to kidney inflammation. Blood in urine, persistent bladder infections, and other changes in urine are all lupus symptoms that should be closely monitored.
20. Sun, or light, sensitivity
The National Institute of Arthritis and Musculoskeletal and Skin Diseases reports that sun sensitivity is another highly common symptom of lupus.