While lupus is more common in females, it can also occur in males and occur at any age. Some research also suggests that males with lupus may experience a more severe form of the disease.

Lupus is a complex autoimmune condition, where the body mistakenly attacks healthy tissue. Some health experts may refer to it as the “disease of a thousand faces” due its wide variety of potential symptoms.

While the condition occurs predominantly in females, evidence suggests that roughly 1 in 10 people with lupus are male. Lupus most often develops in females between the ages of women ages 15–44. However, lupus can develop in anyone of any age.

Similar to breast cancer, lupus is a condition that some people may think only affects females. However, it is possible for both breast cancer and lupus to develop in males. In fact, some evidence suggests that males with lupus may experience more severe symptoms of the condition.

In this article, we will discuss lupus in males.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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While lupus is rarer in males, it is possible for males to develop lupus. Not only is the condition more common in females, but they typically develop the condition earlier in life. Females usually develop lupus between the ages of 15–44, while the peak age of onset in males is typically 45–60 years of age.

According to the Lupus Foundation of America, health experts report around 16,000 new cases of lupus in the United States each year, and up to 1.5 million people living with the condition in the U.S. As roughly 10% of people with lupus are male, this suggests that approximately 150,000 males in the U.S. have lupus.

However, the Centers for Disease Control and Prevention (CDC) estimates that there are 4–12 females with lupus for every one male.

While researchers are currently unsure why lupus is less prevalent in males, some theories include:

  • females having a stronger immune reaction and being more likely to develop autoimmune conditions
  • the role of the X chromosome and immune responses
  • the role of hormones, such as estrogen
  • epigenetics and environmental factors

As such, it is worth highlighting that the notion that lupus is a female condition is a misconception. A male with lupus is not less masculine than other males. Most males with lupus have similar levels of sex hormones and sexual function as those without the condition. As such, they are usually sexual active, potent, and have normal reproductive histories.

Typically, males will develop the same clinical manifestations of lupus as females. However, certain symptoms, such as kidney problems, may be more severe or prominent in males. Additionally, males are less likely to experience Raynaud’s phenomenon or photosensitivity and are less likely to notice alopecia.

Symptoms may include:

  • low blood count
  • heart and blood vessels complications
  • unexplained fever and weight loss
  • antiphospholipid antibodies
  • kidney disease
  • serositis
  • extreme fatigue
  • pain or swelling in the joints
  • swelling in the hands, feet, or around the eye
  • headaches

Growing evidence suggests that when males develop lupus, it is often more complex and more severe. While lupus is typically more aggressive in males and the severity of symptoms can vary, evidence suggests that the spectrum of lupus symptoms between males and females is very similar.

Researchers are currently unsure why lupus appears to be more complex in males. More research is necessary to understand lupus and why its symptoms may be more severe in males.

Lupus can be a difficult condition to diagnose due to its variety of symptoms that people may mistake as signs of another condition. As some people may think that males do not get lupus, they may find it harder or experience a delay receiving a diagnosis.

To diagnose lupus, a doctor will typically ask about symptoms, carry out a physical examination, and take a personal and family medical history. To consider a lupus diagnosis, a doctor will look for at least four of the following 11 criteria:

  1. malar rash
  2. discoid rash
  3. photosensitivity
  4. mouth or nose ulcers
  5. nonerosive arthritis
  6. pericarditis or pleuritis
  7. neurologic disorder
  8. kidney disorder
  9. blood disorder
  10. immunologic disorder
  11. positive antinuclear antibodies (ANA) test

A medical professional may also request further tests — such as blood tests, urine tests, imaging scans, and biopsies — to help confirm a diagnosis and monitor the potential effects of lupus on the body.

The treatment options for males with lupus are the same as anyone with the condition. Treatment aims to reduce inflammation, protect organs from damage, and prevent flare-ups. A variety of medications are available and a person’s treatment plan may vary depending on the type of lupus, the extent of the inflammation, and the condition of their organs.

Types of medications may include:

However, there might be some differences due to certain how drugs may impact fertility. For example, if a male is considering starting a family, they may wish to avoid using a chemo drug known as cyclophosphamide as it can impact sperm production.

If a male begins to notice potential signs of lupus, such as fever, weight loss, and fatigue, it is advisable that they contact a doctor. Due to the difficulty of diagnosing lupus, it is recommended to try and manage symptoms and start the diagnostic process early.

Lupus is an autoimmune condition that can affect males. Although it is more common in females, it is not a female disease and may present in males. The symptoms of the condition are largely the same in both males and females. However, some evidence suggests that the condition may be more severe in males.

Diagnosis can be difficult, and it may be a long process that requires multiple tests. Treatments are largely the same between males and females. They typically involve medications to help manage symptoms and protect organs against damage.