The gender gap in early Lyme disease detection and signs

In a new Johns Hopkins Medicine study, researchers found that male and female patients with early Lyme disease present with different signs of the disease in the symptoms they report, their physical exams, and their laboratory test results.

The study was published on February 7th, 2026, in Clinical and Experimental Medicine.

Researchers found that males were more likely to have a positive test and to have more obvious, severe disease indicators, including other laboratory abnormalities, at diagnosis, yet there were no differences in how long males and females had been sick. They studied data from 243 adults (118 females and 125 males) with early Lyme disease before and after treatment. The age range was 20–84.

According to the Centers for Disease Control and Prevention (CDC), approximately 476,000 Americans are diagnosed and treated for Lyme disease each year, nearly half a million cases annually. Lyme disease is a bacterial infection obtained through a tick bite that often presents with a red, round skin lesion.

Additionally, researchers found a small number of Lyme disease symptoms that were reported more frequently among females (heart palpitations, vomiting, and light sensitivity) and one symptom (sleep disruption) reported more frequently among males. Heart palpitations occurred in 4% of males versus 11.9% of females. Vomiting occurred in less than 1% of males versus 7.6% of females. Light sensitivity occurred in 8.8% of males versus 17% in females. Sleep difficulty occurred in 40% of males versus 24.6% of females.

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."

John Aucott, M.D., Director, Johns Hopkins Lyme Disease Clinical Research Center

These findings suggest that sex and menopause status are important to consider in understanding early Lyme disease. More research is needed to determine the cause of these differences and their impact on patients' time to diagnosis and risk of developing later conditions after treatment. Aucott says the next step will be to identify the mechanisms, such as hormone levels, underlying these differences.