The Overlooked Intersection of Lyme Disease and Women’s Hormonal Health

By Fred Diamond

The International Lyme and Associated Diseases Society (ILADS) is a nonprofit, international, multidisciplinary medical society dedicated to the diagnosis and treatment of Lyme and other complex inflammatory diseases. With these educational blog posts from experts and members of our board, ILADS aims to promote awareness and understanding of health and wellness, especially as it relates to complex inflammatory diseases, so that we can all learn and grow together. If you have any questions or want more information, you can email us at contact@ilads.org. 

Disclaimer: Every patient is an individual with unique characteristics. This blog article is not medical advice. It does not constitute a physician-patient relationship. It is for educational purposes only. Do not try out what is in this article without medical advice, working with your licensed physician and licensed healthcare providers

Author of “Love, Hope, Lyme: What Family Members, Partners, and Friends Who Love a Chronic Lyme Survivor Need to Know” and Host of the Love, Hope, Lyme Podcast.

The clinical picture of Lyme disease is already multifaceted, but for women, it is further complicated by hormonal fluctuations that can obscure diagnosis and affect disease progression. In a recent episode of the Love, Hope, Lyme podcast, Dr. Jaquel Patterson, a nationally recognized naturopathic physician and the author of Women and Lyme: An Integrative Guide to Better Health, shared vital clinical observations and personal experiences that highlight the urgent need for Lyme-literate medical practitioners to incorporate gender-specific perspectives into diagnosis and care.

Dr. Patterson, who practices in Connecticut, has spent over 16 years treating patients with Lyme disease, co-infections, autoimmune conditions, and associated psychiatric disorders. Her book, which became an Amazon bestseller, was written to fill a longstanding gap in Lyme literature: a clear, evidence-informed guide focused on how Lyme disease uniquely affects women, especially as it interacts with hormonal health across different life stages.

A Delayed Diagnosis: A Common Experience for Women

Dr. Patterson’s motivation to write Women and Lyme was rooted in both clinical experience and personal history. While in medical school, she developed hallmark Lyme symptoms—debilitating fatigue, cognitive dysfunction, and severe heat intolerance that mimicked hot flashes. Like many women, her symptoms were initially misattributed to anxiety and stress. It wasn’t until she began treating patients with similar presentations that she recognized the overlap and pursued her own testing, ultimately confirming Lyme disease along with Babesia and Bartonella co-infections.

Her story is not unique. Many of the women she treats report visiting an average of seven to nine physicians—often more—before receiving a correct diagnosis. “Women are frequently told their symptoms are stress-related, hormonal, or psychosomatic,” Patterson said. “While hormones do play a role, they’re often used as an excuse to dismiss serious symptoms.”

Tick-borne infections like Lyme, Babesia, and Bartonella can have profound effects on the hypothalamic-pituitary-adrenal (HPA) axis, leading to cortisol dysregulation, thyroid disruption, and sex hormone imbalances. In clinical practice, Dr. Patterson observes that women’s symptoms often worsen in concert with hormonal changes. These include menstruation, perimenopause, menopause, and postpartum periods—times of natural endocrine transition that can amplify underlying inflammation or immune dysregulation.

For example, many menstruating women with Lyme report significant symptom flares just before their period. Dr. Patterson attributes this to the release of prostaglandins and increased IL-6 levels—a pro-inflammatory cytokine—prior to menstruation. “Patients will say their brain fog, joint pain, and mood disturbances spike a few days before menstruation, and then improve once bleeding begins,” she said. In such cases, regulating estrogen dominance, improving detoxification pathways, and reducing inflammation pre-cycle with agents like turmeric or Boswellia have proven helpful.

Perimenopausal and menopausal women often face more severe and persistent symptoms due to the sharp decline in estrogen, progesterone, and testosterone. These hormones are not only reproductive but also play immunomodulatory roles. Estrogen can be both pro- and anti-inflammatory depending on levels, while progesterone and testosterone are largely anti-inflammatory. Their absence can weaken immune resilience and contribute to flares or new onset autoimmune conditions.

A Whole-Person Approach to Care

In treating women with Lyme disease, Dr. Patterson emphasizes the importance of seeing beyond the infection. “Lyme may be the trigger, but there are often multiple layers—endocrine, immune, psychological—that must be addressed for full recovery,” she said.

Her approach includes:

• Comprehensive Testing: Beyond standard Lyme diagnostics, she assesses adrenal function, thyroid markers, and sex hormone panels—especially in patients whose symptoms worsen cyclically or around menopause.
• Personalized Herbal Protocols: Dr. Patterson frequently uses herbs from the Buhner and Cowden (Nutramedix) protocols, particularly artemisia, cryptolepis, and Samento (cat’s claw), which have both antimicrobial and anti-inflammatory effects. She also integrates biofilm busters like serrapeptase and Stevia when treating long-term infections.
• Endocrine and Mitochondrial Support: When needed, hormone replacement therapy is considered on a case-by-case basis. In many cases, adrenal support and mitochondrial supplements such as CoQ10 are used to restore energy and immune balance.
• Inflammation and Cycle Management: For women experiencing flares around ovulation or menstruation, Dr. Patterson uses targeted anti-inflammatory supplements and explores estrogen metabolism pathways to reduce symptom intensity.

Lifestyle Interventions with Clinical Implications

Dr. Patterson also recommends practical lifestyle strategies tailored to the needs of chronically ill women:

• Exercise: Many patients experience post-exertional malaise. Instead of intensive exercise, Dr. Patterson encourages walking, yoga, or Pilates, with slow progression based on energy levels and cardiovascular tolerance.
• Hydration: Especially during Herxheimer reactions or while taking antibiotics/herbs, adequate hydration is essential for detoxification. However, she cautions against overhydration that can stress the kidneys.
• Sauna Therapy: Far-infrared saunas are used to help reduce inflammatory markers and support detoxification. Sessions are limited to 15–20 minutes until the patient builds tolerance.
• Nutrition: An anti-inflammatory diet is strongly recommended—emphasizing colorful vegetables and avoiding gluten, dairy, alcohol, and excessive caffeine. These dietary changes support gut health, reduce systemic inflammation, and nourish mitochondria.
• Mental Health and Mindfulness: Dr. Patterson notes that psychiatric symptoms—including depression, anxiety, and even rage (commonly seen with Bartonella)—are common and often underrecognized. Mindfulness practices, journaling, and gentle grounding are integrated into her treatment protocols.

Clinical Outcomes and Gender Disparities

According to data cited by Dr. Patterson, women comprise a high majority of those with long-term chronic Lyme symptoms. While infection rates may be similar between men and women, the symptom burden, duration, and complexity are disproportionately higher in women.

Moreover, because many Lyme symptoms overlap with those of hormonal imbalance, autoimmune disease, and psychiatric conditions, women are more likely to be misdiagnosed—or not diagnosed at all.

These disparities point to the need for increased awareness among clinicians. By incorporating hormonal health into Lyme evaluations, practitioners can more effectively tailor treatment, shorten diagnostic delays, and improve outcomes for female patients.

Medical practitioners treating Lyme disease are encouraged to consider the full scope of hormonal, inflammatory, and immune system interactions in their female patients. As Dr. Patterson’s work demonstrates, a gender-informed, whole-person model is not only more accurate—it is essential for healing.