Sjögren’s syndrome is commonly viewed as a women’s health issue because it disproportionately affects females, especially those over the age of 40. However, this autoimmune disorder does not exclusively affect women. Men can, and do, develop Sjögren’s syndrome. The gender disparity has led to an under-recognition of the condition in male patients, contributing to diagnostic delays, mismanagement, and underrepresentation in research. In this article, we explore the prevalence of Sjögren’s in men, how their symptoms may differ, and why raising awareness of gender differences is essential for improving care.

Overview of Sjögren’s Syndrome

Sjögren’s syndrome is a chronic autoimmune disease in which the immune system attacks the body's moisture-producing glands. This results in hallmark symptoms such as:

  • Dry eyes (keratoconjunctivitis sicca)

  • Dry mouth (xerostomia)

It can also cause systemic issues like fatigue, joint pain, lung involvement, kidney problems, nerve dysfunction, and an increased risk of lymphoma. There are two types:

  • Primary Sjögren’s: Occurs alone without another autoimmune condition.

  • Secondary Sjögren’s: Occurs in conjunction with other autoimmune diseases such as lupus or rheumatoid arthritis.

The disease affects all genders, but it is estimated that about 90% of diagnosed cases are women, leaving only 10% attributed to men.

Can Men Get Sjögren’s? Absolutely.

Despite being much less common, men can absolutely develop Sjögren’s. The low reported prevalence among men is more reflective of diagnostic and social biases than biological impossibility. Studies suggest that because of the assumption that Sjögren’s is a "women's disease," many men are either misdiagnosed or diagnosed much later.

Why Is It Less Recognized in Men?

Several factors contribute to the lower recognition of Sjögren’s syndrome in men:

1. Diagnostic Bias

Healthcare providers are more likely to suspect Sjögren’s in women. When men present with fatigue, dry mouth, or joint pain, these symptoms may be attributed to other causes, such as medication side effects, dehydration, depression, or aging.

2. Underrepresentation in Research

Most Sjögren’s studies and clinical trials focus on female participants. As a result, sex-specific differences in disease presentation and progression are poorly understood. This limits medical understanding and guidelines for men.

3. Differences in Symptom Reporting

Men may be less likely to report symptoms such as dry eyes or fatigue or may describe them differently. This can lead to less thorough evaluation and reduced chances of referral to a rheumatologist.

Gender Differences in Symptoms and Disease Course

While core symptoms like dryness and fatigue appear in both sexes, some research has identified differences in how Sjögren’s manifests in men compared to women:

1. More Severe Systemic Disease

Men with Sjögren’s may be more likely to experience extraglandular manifestations (i.e., disease affecting organs beyond the glands), including:

  • Lung involvement (e.g., interstitial lung disease)

  • Kidney inflammation

  • Peripheral neuropathy

  • Vasculitis (blood vessel inflammation)

2. Higher Risk of Lymphoma

One of the most serious complications of Sjögren’s syndrome is lymphoma. Men with Sjögren’s may have a higher relative risk for developing lymphoma compared to women with the disease, although the absolute number of cases is still higher in women due to their greater representation.

3. Delayed Diagnosis

Men often receive a diagnosis of Sjögren’s later than women, sometimes years after symptom onset. This delay may lead to more advanced disease at the time of diagnosis and poorer long-term outcomes.

Diagnostic Tools and Challenges in Men

The diagnostic criteria for Sjögren’s are the same regardless of sex, including:

  • Positive blood tests for autoantibodies (e.g., anti-SSA/Ro and anti-SSB/La)

  • Low salivary flow rates

  • Abnormal Schirmer’s test (measuring tear production)

  • Lip or salivary gland biopsy

However, because men are less frequently suspected of having Sjögren’s, these tests may not be ordered promptly. Delayed diagnosis can result in under-treatment of early symptoms and reduced opportunities to prevent complications.

Importance of Awareness and Advocacy

Improving outcomes for men with Sjögren’s requires increasing awareness among healthcare providers and the public. Here’s what can help:

1. Provider Education

Training healthcare professionals to recognize that Sjögren’s affects both men and women is key. This includes educating dentists, ophthalmologists, and general practitioners who may be the first to see early symptoms.

2. Patient Advocacy and Support

Men with Sjögren’s should be encouraged to share their experiences and seek specialized care. Support groups and online communities can offer connection and insight.

3. Gender-Inclusive Research

Encouraging researchers to include male participants in clinical studies will help clarify how the disease differs by gender and how treatment approaches may need to be adapted.

Living with Sjögren’s as a Man

Men diagnosed with Sjögren’s often face both physical and emotional challenges, particularly due to feelings of isolation. Practical tips for managing the condition include:

  • Moisture support: Using artificial tears, saliva substitutes, and humidifiers

  • Regular check-ups: Monitoring for systemic involvement (e.g., lung, kidney, and blood-related complications)

  • Healthy lifestyle: Balanced diet, exercise, and stress management to support immune function

  • Open communication: Talking with healthcare providers about all symptoms, even those that may seem unrelated

Conclusion

While Sjögren’s syndrome is more common in women, men are not immune. They can experience significant symptoms and complications, often with greater diagnostic delays and more severe systemic disease. Recognizing that Sjögren’s affects men—and adapting our clinical awareness and research focus accordingly—is essential to improving care and outcomes. With timely diagnosis, proper treatment, and inclusive support, men living with Sjögren’s can manage the disease effectively and maintain a good quality of life.