5 Autoimmune Diseases Men Should Keep on Their Radar

ABOUT 5.7 MILLION men could have an autoimmune disease, according to a 2024 study published in the Journal of Clinical Investigation. The authors believe it’s the first to estimate the prevalence of these conditions using a large, nationwide sample size of more than 580,000 people.

These diseases are often overlooked in men for a simple reason: Women are diagnosed with these inflammatory conditions at disproportionately higher rates—rheumatoid arthritis (about 3-to-1 women to men), multiple sclerosis (also 3 to 1), and lupus (9 to 1), to name a few.

Still, that means about 10% of people with lupus and 30% with rheumatoid arthritis are men, notes Louis Bridges, Jr., MD, PhD, chief of the division of rheumatology at the Hospital for Special Surgery and NewYork-Presbyterian/Weill Cornell Medical Center. And while there’s more robust data on women, it’s worth noting that experts don’t fully understand the exact causes of these diseases in either sex.

So guys shouldn’t brush off the possibility of a diagnosis—nor should their doctors. “I think physicians sometimes tend to forget these diseases do exist in men,” says Caroline Whitacre, PhD, an emeritus professor of microbial infection and immunity who researches sex differences in autoimmune diseases at The Ohio State University College of Medicine.

Scientists have identified at least 105 autoimmune diseases, each with unique symptoms, risk factors, potential causes, and treatments. Here’s what we’ve learned so far, including a few specific autoimmune diseases men should keep on their radar.

Meet the experts: Louis Bridges, Jr., MD, PhD, is chief of the division of rheumatology at the Hospital for Special Surgery and NewYork-Presbyterian/Weill Cornell Medical Center. Caroline Whitacre, PhD, is an emeritus professor of microbial infection and immunity who researches sex differences in autoimmune diseases at The Ohio State University College of Medicine. Brian Capell, MD, PhD, is an assistant professor of dermatology who researches sex differences in cancer and autoimmune disease at the University of Pennsylvania Perelman School of Medicine.

What is an autoimmune disease, exactly?

Your immune system is an intricate network of cells, tissues, and organs designed to fight off invaders like bacteria and viruses. An autoimmune disease is, in a simplified sense, “an error of the immune system,” Whitacre explains. Your body mistakenly attacks healthy cells and organs, causing chronic inflammation linked to symptoms that are “all over the map,” she says.

Symptoms that signal this inflammation—like fatigue, recurring fever, and painful or swollen glands or joints—are common, but it depends on what part of your body is weathering the assault. For example, in type 1 diabetes, the immune system goes after your pancreas, which can make you feel really thirsty, hungry, and tired. In rheumatoid arthritis, various joints can take a hit, leading to stiffness, swelling, and pain, per the National Institutes of Health (NIH). The symptoms ebb and flow in flare-ups (when they get more severe) and periods of remission (when they improve or disappear).

Scientists don’t fully understand why this immune system glitch happens, but genetics seems to play a big role. If your body is already predisposed to developing one of these diseases, outside forces may kick off the onset—research points to bacterial or viral infections, exposure to toxic chemicals, an abnormal response to UV light, as well as other environmental factors.

What We Know About Autoimmune Diseases in Men vs. Women

A bulk of the data on autoimmune diseases understandably explores why they’re more likely to crop up in women. But some studies can clue us in on what this potentially means for guys, too.

Sex chromosomes may be a key player, says Brian Capell, MD, PhD, an assistant professor of dermatology who researches sex differences in cancer and autoimmune disease at the University of Pennsylvania Perelman School of Medicine. Quick refresher: Females have XX chromosomes, while males have XY chromosomes; each chromosome carries gene sequences, or specific pieces of DNA. Because the X chromosome carries a bunch of genes related to immunity, having two of them may partially explain the higher rate of autoimmune diseases in women.

Hormones are also part of the story—namely, estrogen in women and testosterone in men. “Those hormones affect the immune system,” Whitacre says. Scientists posit that higher testosterone in men is likely protective against chronic inflammation, though this is largely based on animal data.

This may also clarify why some guys experience certain autoimmune diseases differently. Whitacre points to multiple sclerosis as an example: “About a quarter of the MS population is male. Their disease tends to be more progressive than women. You could hypothesize that people with low testosterone levels may be more prone to MS. That hasn’t been definitively proven, but it’s a theory that’s out there.”

All the experts Men’s Health spoke with also noted that men are less likely to book time with their doctors, which may impact the discrepancies between sexes. They theorize that many men could be going undiagnosed, or only flagging their symptoms once their disease has progressed and become harder to treat. “Many autoimmune disease symptoms start out vague. Only after a while do they become more prominent,” Whitacre explains. “Of course, you could drive yourself crazy if you seek medical attention every time you sleep on your neck wrong, but men do tend to go to the doctor less.” Dr. Capell agrees: “There’s no doubt that behavioral factors are also part of this equation.”

Autoimmune Diseases Men Should be Aware Of

Most autoimmune diseases appear in both men and women. The following are either more common or affect guys in a notable way. Here’s what to know:

Psoriasis

What it is: Between 2% to 4% of people in the U.S. grapple with this inflammatory skin condition, and it’s thought to affect men and women similarly (about 2.8% of males and 3.2% of females). It’s likely caused by an overactive immune system that triggers skin cells to multiply quickly, the NIH notes.

There are several types of psoriasis, and each can look and feel a little different. The most common is plaque psoriasis: It leads to thick, raised patches of skin on areas like your scalp, lower back, elbows, and knees. Depending on your skin tone, these plaques can appear pink to red (fairer skin) or purplish to brown (deeper skin), with silvery to gray scaling. Psoriasis can feel desperately dry, itchy, sore, or straight-up painful. Sometimes, the skin may crack and bleed.

What men should know: Small studies suggest men may be more likely to develop psoriasis around their genitals and butt than women. These areas can be prone to inverse psoriasis, which looks like smooth, raw skin (though plaques can also show up in these sensitive spots).

Psoriasis can lead to a host of complications, including psoriatic arthritis in up to about 40% of people diagnosed with psoriasis. This inflammatory condition inflames the joints, leading to pain, swelling, and stiffness. In men, this may more frequently crop up as spondyloarthritis, a progressive disease that primarily affects the spine.

That’s a big reason why treatment is so crucial. For psoriasis, the options include topical or oral steroids, immunosuppressive creams, light therapy, and injectable biologics (powerful therapies that target parts of the immune system).

Ankylosing spondylitis (AS)

What it is: Ankylosing spondylitis is marked by inflammation of the spine’s joints and ligaments, which causes back pain and stiffness. Ankylosis specifically means the vertebrae (bones in the spine) have fused. This can potentially lead to deformities, immobility, and even fractures.

What men should know: While the condition is rarer than others on this list, AS is one of the few autoimmune diseases that’s thought to affect men more than women—and at a younger age, usually below 40, Dr. Bridges says. One often-cited 2018 study from South Korea found that AS was 3.6 times more prevalent in men than women, though it’s not clear why. (The numbers are still mixed: Newer research from the U.S. suggests the burden could be similar between sexes.)

Back pain is no joke—and it’s easy to assume that a bad mattress, crappy posture, or a muscle strain is the root cause. That could be the case, but it’s worth getting checked out if the pain is dragging on, Dr. Bridges says. The earlier you catch AS, the sooner you can get treated and blunt its progression (and get your quality of life back). Physical therapy and anti-inflammatory meds can help you manage the condition, though surgery may be necessary in severe cases.

Type 1 diabetes

What it is: The data is far from conclusive, but type 1 diabetes may be slightly more common in men than women. Studies on the potential disparities are a mixed bag: Some have found that women with type 1 have a greater risk of poor blood sugar control, vascular issues, and earlier death. Others show that men with type 1 have a greater risk of poor blood pressure control and heart-related deaths.

Unlike type 2 diabetes—which is caused by a complex mix of genetic and lifestyle factors—type 1 is an autoimmune disease in which the immune system attacks specialized, insulin-producing cells in the pancreas. This impairs its ability to produce insulin, a hormone that guides blood sugar into cells to be used for energy.

Without enough insulin, this sugar builds up in the blood and can cause symptoms like excessive thirst, frequent peeing, intense hunger, and weight loss, among others. Over time, without consistent treatment (in the form of insulin therapy, like daily injections), type 1 can also set the stage for complications like nerve, kidney, and cardiovascular damage.

What men should know: Both types of diabetes up your risk of erectile dysfunction (ED) because persistently high blood sugar harms the nerves and blood vessels that help you get hard, among other potential factors.

One small 2016 study published in the International Journal of Impotence Research found that nearly 60% of 151 men being treated for type 1 diabetes had mild ED. These men were between 18 and 35 years old—a notable range considering ED is more common in older guys. They also had higher feelings of depression compared to other young men without the condition. A mix of ED-specific medications and lifestyle changes may get things back on track.

Inflammatory bowel disease (IBD)

What it is: The most common forms of IBD are Crohn’s disease and ulcerative colitis (UC), autoimmune conditions that take hold in the digestive system. In Crohn’s, chronic inflammation damages any part of the GI tract, from your mouth to your anus. In UC, your colon and rectum are the primary targets.

The CDC notes the conditions have overlapping symptoms, including heavy fatigue, nausea, weight loss, abdominal pain, and diarrhea or other changes in your stool. UC, in particular, can cause blood in your stool (thanks to ulcers), intense cramping, and the urgent need to go. A mix of anti-inflammatory medications and lifestyle changes, like eating a low-FODMAP diet under medical supervision, can help keep symptoms in check. Your doc may consider surgery to remove or widen parts of the intestines if more conservative treatments don’t work.

What men should know: Because of chronic inflammation in the gut, IBD spikes your risk of colorectal cancer. One 2023 paper published in the journal Cancers noted that, based on an analysis of 60 studies, men with IBD faced a higher risk of developing colorectal cancer than women with IBD. It’s not clear why, but this is a scenario where estrogen may have a slightly protective effect.

IBD and colorectal cancer can show up in similar ways, so it’s crucial to get checked out if you’re persistently dealing with changes in your bowel habits (like seeing blood in your stool), abdominal pain, and a sudden drop in weight. If you’re diagnosed with IBD, you should be screened for colorectal cancer regularly, even if you’re young.

The Bottom Line

If you have vague symptoms you just can’t shake, it’s worth getting checked out—even if it’s to rule out something like an autoimmune disease. While experts are still trying to figure out why these conditions form in the first place (and how they may affect men specifically), there are various ways to treat them. Don’t be the guy who avoids the doctor and suffers needlessly.