Autoimmune diseases are among the most enigmatic and challenging conditions in modern medicine. They emerge silently, turning the body's defense system against itself, often with no clear warning and little regard for the devastation they leave in their wake. But perhaps the most overlooked aspect of autoimmune disorders is not found in a blood test or a biopsy—but in the hearts and histories of the women who suffer from them.

A staggering 80% of autoimmune disease cases occur in women, with a prevalence ratio of about 2:1 compared to men. This glaring disparity invites a closer look not only at biological mechanisms but also at the societal and emotional dimensions of female life that might help explain this imbalance.

From hormonal upheavals during pregnancy to the psychological toll of emotional repression and strained relationships, the story of autoimmune disease in women is as much about immune cells as it is about unspoken pain.

Autoimmune disorders occur when the immune system mistakenly attacks the body’s own healthy tissues. One common example is Rheumatoid Arthritis (RA), a condition in which the immune system targets the lining of the joints, leading to chronic pain, swelling, stiffness, and in severe cases, joint deformity. It is more common in women and often worsens during periods of emotional stress or hormonal changes.

Another example is Hashimoto’s Thyroiditis, where the immune system attacks the thyroid gland, resulting in hypothyroidism. This condition causes symptoms like fatigue, weight gain, depression, and sensitivity to cold. It primarily affects middle-aged women and can significantly impact energy levels and mood.

A third example is Systemic Lupus Erythematosus (SLE), a complex autoimmune disease in which the immune system can attack multiple organs and tissues, including the skin, joints, kidneys, and brain. Symptoms vary widely but often include fatigue, joint pain, skin rashes, and fever.

The Biology of Burden

The female body is in a state of near-constant flux, its immune system uniquely responsive to hormonal changes. Puberty, menstruation, pregnancy, and menopause are all periods of immunological vulnerability.

When Emotions Turn Inward

Decades of social conditioning have taught women to smile through discomfort, to nurture instead of confront, and to silence their anger rather than speak it aloud. This emotional repression—the act of self-silencing—has tangible effects on the body. Chronic stress activates the hypothalamic-pituitary-adrenal (HPA) axis, flooding the bloodstream with cortisol and other stress hormones. Over time, this constant state of alertness erodes immune function, leading to inflammation and, eventually, disease.

Clinical observations and emerging research underscore the link between emotional suppression and autoimmune disorders. Women who bottle up their emotions, especially anger, report higher levels of fatigue, pain, and immune dysfunction. The body, it seems, may express what the voice cannot.

The Marital Mirror

The role of intimate relationships in health is often underestimated, but for women with autoimmune disorders, relationship quality can be a critical factor in disease trajectory. Studies show that women in distressed marriages suffer greater immune decline over time than those in nurturing partnerships. Marital conflict, spousal infidelity, bread-winning, low spousal support, and emotional neglect all correlate with heightened levels of inflammation markers like C-reactive protein—predictors of autoimmune flare-ups.

Interestingly, this association is far stronger in women than in men, suggesting a heightened sensitivity to interpersonal stress.

Where does Africa Fit Into This?

African and African American women are particularly affected, with studies indicating that African American women are about three times more likely to develop lupus than European women. They also tend to experience more severe symptoms and complications, including significantly higher rates of kidney failure.

Among African women, common autoimmune diseases include rheumatoid arthritis, type 1 diabetes mellitus, multiple sclerosis, and autoimmune thyroid diseases. Although multiple sclerosis is generally less common in Africa compared to other regions, awareness and diagnosis of the disease are increasing, especially among women. Multiple sclerosis has been rising across the continent, with diagnosed cases increasing by 59% between 2013 and 2020.

A New Model for Healing

Traditional treatment models for autoimmune diseases have focused almost exclusively on immunosuppressive drugs, diet, and symptom management. But these approaches, while necessary, may be incomplete. To truly address the root causes of autoimmune dysfunction in women, medicine must make room for the emotional, relational, and psychological dimensions of health.

Mindfulness practices, body-based therapies, emotional expression, and trauma-informed care are no longer fringe interventions—they are fast becoming essential components of a comprehensive healing strategy. By attending to the emotional lives of women, clinicians may not only reduce disease severity but also help prevent autoimmune disorders from developing in the first place.

Conclusion: Listening to the Body’s Protest

Autoimmune diseases in women may, in some cases, be the body’s last resort—the only way it knows how to express decades of emotional silencing, invisible labor, and relational strain. They are not just malfunctions of the immune system but may also be metaphors for unacknowledged pain.

To truly heal, women must be allowed—encouraged, even—to express what they feel, to receive support in their relationships, and to be seen not only as patients but as whole human beings shaped by biology, emotion, and society alike. The fire within, if not extinguished, must at least be heard.