How Lupus Differs in Men
Systemic lupus erythematosus is a very challenging disease. Although some features of lupus are common, such as joint pain and fatigue, lupus is different in every person. It is truly a disease that seemingly provokes more questions than it provides answers.
While the pathogenesis, or reasons for development, of lupus remains unknown; genetic, environmental, and hormonal factors certainly play a role. Most people think of lupus as a disease of women of childbearing age-and with good reason: 90% of lupus patients between the ages of 15 and 45 are women. However, after the age of 50 (approximately the age of the onset of menopause) the percentage of women with lupus falls to 75% and the percentage of men with the disease rises to 25%. Therefore it is a mistake to think of lupus as exclusively a women's health concern.
Role of Sex Hormones
The role of sex hormones in the development and clinical expression of lupus is complex. For instance, flares in women may be influenced by their hormonal status; one example is that pregnancy can trigger a flare.
Simply put, two broad types of sex hormones exist. Estrogens are typically considered the "female hormones," and androgens are considered to be the "male hormones." Both types are produced in both sexes. However, estrogens-in addition to their role in the development of secondary sex characteristics (i.e., facial hair in males or breast development in females)-may encourage autoimmune disorders, while androgens may be protective instead.
Some studies have noted lower levels of a specific androgen, testosterone, in some men with lupus. Men with lupus, however, are in no way less masculine than men without lupus, and sexual activity, potency, and fertility in men with lupus does not differ from men without lupus.