Women Are More Likely to Develop Autoimmune Disease. Here’s How to Prevent It.

Did you know that nearly 80% of all autoimmune disease cases occur in women? It’s not a coincidence — so what gives?

Let’s unpack the reasons why and what you can do to protect and support your immune system.

What Exactly Is Autoimmunity?

According to Dr. Karrie Hohn, functional medicine physician at PALM Health, “Autoimmune disease essentially refers to a malfunctioning immune system.”

This occurs when your immune system, which is supposed to defend you from infections and threats, mistakenly targets your own cells, tissues, or organs. “The immune system malfunctions and goes into overdrive, seeing everything as a threat — even that which is not usually a threat,” says Dr. Hohn.

This misfire creates chronic inflammation and a wide range of symptoms depending on which part of the body is under attack. Fatigue, joint pain, brain fog, digestive issues, and skin problems are common early warning signs of autoimmune disease — and they are often misdiagnosed or dismissed.

Of the 80+ known autoimmune diseases, the most common include:

• Hashimoto’s thyroiditis
• Rheumatoid arthritis
• Systemic lupus erythematosus (also known as lupus)
• Multiple sclerosis
• Celiac disease
• Type 1 diabetes

And yet, despite their prevalence, autoimmune diseases remain underdiagnosed and misunderstood, especially in women.

Why the Disproportionate Prevalence in Women?

It’s most likely a mix of interactions between biology, hormones, genetics, and the environment.

1. Hormones and the Immune System Are Deeply Intertwined

Estrogen isn’t just a reproductive hormone. It has other functions that can both play to your favor and increase your risk.

“Estrogen is one of the most naturally potent anti-inflammatory compounds in the body, which can protect women from inflammation,” says Dr. Hohn. “At the same time, it has immune-stimulating properties that can make women more effective at fighting off infections, but in too-high concentrations, it can lead to immune overactivity.”

Normal levels of estrogen can keep women at a lower risk of autoimmune disease during their younger years if they have an active and regular menstrual cycle. However, elevated or imbalanced estrogen levels can cause the immune system to go into overdrive and spark autoimmune activity.

Then, as menopause settles in, estrogen levels plummet, taking away that natural anti-inflammatory agent. As this happens, inflammation can rise, bringing with it a higher risk of autoimmune disease.

In essence, the same biology that helps protect women can also leave them more vulnerable to internal misfires, especially when hormone levels fluctuate.

2. Genetic Differences Play a Role

The X chromosome carries a number of genes involved in immune regulation. Because women have two X chromosomes (compared to the one-X, one-Y configuration in men), they’re exposed to a double dose of immune-modulating genes.

This genetic configuration may increase both immune vigilance and immune reactivity, setting the stage for autoimmune tendencies.

3. Environmental and Lifestyle Triggers Hit Women Differently

From personal care products and household cleaners to stress load and dietary patterns, women are often exposed to a unique mix of epigenetic triggers — factors that can influence gene expression without changing the DNA itself.

Consider these examples:

• Toxin exposure: Many conventional beauty products contain endocrine disruptors, which can interfere with immune balance.
• Chronic stress: Women tend to carry disproportionate emotional and caregiving burdens, which keep the nervous system in a heightened state of alert.

“While genetic predispositions may remain dormant, your environmental factors can pull the trigger to activate them,” says Dr. Hohn.

How to Prevent and Treat Autoimmune Conditions from the Inside Out

Prevention, remission, and long-term resilience are all possible with a comprehensive, root-cause, lifestyle-first approach.

Because women are more susceptible to autoimmune disease, treatment may also involve working on hormone balance as a root cause.

Prioritize Anti-Inflammatory Foods

Inflammation is both a driver and a symptom of autoimmune disease, acting in a cycle. One of the most powerful things you can do to break that cycle is to bring down inflammation.

Start with food. Dr. Hohn suggests:

• Focusing on anti-inflammatory whole foods: leafy greens, berries, fatty fish, olive oil, turmeric, ginger.
• Cutting back on refined sugar, processed foods, and seed oils.
• Considering an elimination diet to identify potential triggers like gluten, dairy, or eggs (a functional medicine provider can help you plan and carry out this experiment properly).

Maintaining an anti-inflammatory diet can also help to heal your gut (which has a major impact on every other area of health) and balance your hormones.

Pro tip: keep a food and symptom journal to track connections between what you eat and how you feel. Read more here on how to follow an anti-inflammatory diet.

Manage Chronic Stress

Stress isn’t just mental. It has real physiological effects that trickle down into every system in your body, including the immune system.

When your nervous system is overactive in a chronic stress response, your body naturally stays in a defensive state, not only paving the way for an autoimmune response of self-attack, but also elevating your levels of cortisol and compromising your sex hormones. This perpetuates the imbalances that can make autoimmune disease common for women.

Regulate the nervous system and support a healthy stress response with:

• Daily breathing (We recommend Cardiac Coherence: learn more about it here.)
• Mindful movement (Take time for stretching, yoga, Qi Gong, etc.)
• Stress-targeting services (We love the PALM Signature Stress Reduction Massage.)
• Taking a true break from daily stressors and stimulation (The Global Burnout Recovery Program in St. Louis provides a structured retreat that helps deeply re-regulate the nervous system.)

When your body feels safe, it can lower its defenses from overactivity to regular activity. Plus, dialing down stress can help break that inflammation cycle we discussed earlier.

Establish a Regular Sleep Cycle

Sleep is when your immune system resets and repairs itself. Chronic lack of sleep can inhibit this restoration, giving way to dysregulation.

Aim for 7 to 9 hours of quality sleep by:

• Creating a consistent bedtime and wake time
• Limiting blue light and caffeine in the afternoon and evening
• Using wind-down tools like herbal teas, baths, turning the lights down, and magnesium

Read more about how to find the best sleep schedule for yourself here.

If sleep is elusive, talk to your provider: there could be other root causes such as blood sugar imbalances or nighttime cortisol spikes.

Work With a Functional Medicine Provider

Autoimmune conditions rarely resolve with a one-size-fits-all approach. Particularly for women experiencing a hormone imbalance or going through perimenopause or menopause, working closely with a provider to keep your system balanced through the changes can make all the difference.

A functional medicine provider can help you:

• Run advanced testing (hormones, gut microbiome, food sensitivities, toxin levels, inflammatory markers) to rule out other conditions that can complicate your condition
• Identify hidden drivers of immune dysfunction
• Build a personalized plan that includes lifestyle and environmental considerations, potential medication, supplementation, and advanced treatments like hormone replacement therapy

When it comes to autoimmunity, the bottom line for women to keep in mind is the importance of awareness and action.

“Whether you’re in your 30s focusing on prevention or in your 50s managing menopause-related changes, understanding your risk factors allows you to take targeted, proactive steps,” says Dr. Hohn. Supporting your immune system, reducing chronic inflammation, and maintaining hormone balance are all areas you can influence with lifestyle changes and personalized care.

Autoimmunity is complex, but it’s treatable and preventable. The more informed and mindful you are, the more effectively you can work with your body instead of against it.