Sex and Menopause Influence Early Lyme Disease Presentation, Johns Hopkins Study Finds

A new study from Johns Hopkins Medicine reveals that early Lyme disease manifests differently in men and women, with menopause status also playing a significant role. The research, published February 7, 2026, in Clinical and Experimental Medicine, highlights the importance of considering sex and hormonal changes when diagnosing this common tick-borne illness.

Key Findings of the Study

Researchers analyzed data from 243 adults (118 females and 125 males) diagnosed with early Lyme disease, both before and after treatment. Participants ranged in age from 20 to 84. The study found that men were more likely to test positive for Lyme disease and exhibit more pronounced disease indicators, including laboratory abnormalities, at the time of diagnosis. Notably, there was no difference in the duration of illness between men and women.

However, specific symptoms were reported more frequently by one sex. Women were more likely to experience heart palpitations, vomiting, and light sensitivity, while men reported sleep disruption more often. Specifically:

• Heart palpitations: 11.9% of females vs. 4% of males
• Vomiting: 7.6% of females vs. Less than 1% of males
• Light sensitivity: 17% of females vs. 8.8% of males
• Sleep disruption: 40% of males vs. 24.6% of females

According to John Aucott, M.D., Director of the Johns Hopkins Lyme Disease Clinical Research Center, the male group’s presentation was more similar to that of post-menopausal women and more distinct from pre-menopausal women. “Males and females are different. For both findings, the male group was more similar to females who had undergone menopause and more different from females who had not,” Dr. Aucott stated.

Implications for Diagnosis and Treatment

These findings underscore the need to consider sex and menopause status when evaluating patients for Lyme disease. The researchers suggest that hormonal factors may play a role in these differences, and further investigation is warranted to understand the underlying mechanisms. The next step, according to Dr. Aucott, is to identify these mechanisms, such as hormone levels.

Lyme disease is a bacterial infection transmitted through tick bites, often characterized by a red, round skin lesion. The Centers for Disease Control and Prevention (CDC) estimates that approximately 476,000 Americans are diagnosed and treated for Lyme disease annually.

Johns Hopkins Lyme Disease Research Efforts

The Johns Hopkins Medicine Lyme Disease Research Center is dedicated to improving the understanding and treatment of Lyme disease. Established in 2015, the center focuses on patient-based, multidisciplinary research across all manifestations of the disease. Learn more about their perform. The Johns Hopkins Lyme and Tickborne Diseases Research and Education Institute, led by Nicole Baumgarth, PhD, DVM, further advances research in this area.

This research builds upon the center’s commitment to translating pioneering research into improved patient care, education, and health outcomes. More information on the center’s work can be found here.