Lyme Disease in Women: Why Many Symptoms are Often Overlooked (and Misdiagnosed)

You’ve been told 'everything looks normal’ but you still have substantial symptoms and don’t feel like yourself. There may be more going on beneath the surface.

By: Dr Cynthia Hall, ND

4 min read

Many times, if you’ve been told ‘everything looks normal’ on labs but you still don’t feel like yourself, there may be more going on beneath the surface.

Many women struggling with persistent fatigue, brain fog, joint pain or hormonal symptoms are often told it is related to stress, anxiety or burnout. In many cases you may have been treating these symptoms for months with no significant progress.

In some cases, these symptoms can be linked to the presence of Lyme disease or other tick-borne infections (incl: Babesia & Bartonella) — conditions that are frequently overlooked or misdiagnosed, especially in perimenopausal women.

What is Lyme Disease?

Classic Lyme disease is an infection most commonly transmitted through tick bites by the bacteria Borrelia burgdorferi.

While early treatment can be effective, Lyme disease is often missed in its early stages — leading to more complex and severe long-standing symptoms.

Why Lyme Disease is Often Missed in Women

There are a few key reasons Lyme disease is underdiagnosed in women:

1. Symptoms mimic other conditions. Symptoms of Lyme disease can look like:

   • Thyroid dysfunction

   • Chronic fatigue syndrome

   • Fibromyalgia

   • Hormone imbalances

   • Autoimmune conditions

   • Anxiety / depression

   • Joint pain

2. The Bull’s Eye rash doesn’t always appear after a tick bite. This characteristic rash is indicative of the presence of Lyme disease and warrants immediate treatment. The issue is that this rash doesn’t always appear despite the presence of Lyme disease. Many people may never see the rash, or recognize it — leading to a missed opportunity to treat right away.

3. Standard lab testing has limitations. Conventional Lyme testing measures immune response and can miss cases, especially in:

   • Early infections

   • Chronic or complex cases

   • Reinfection

   • Tick-borne infections caused by similar bacteria that can mimic symptoms of Lyme disease

4. Symptoms experienced by women are often dismissed or misunderstood. Unfortunately, women may report generalized symptoms of fatigue, pain or brain fog. These symptoms are told they’re stress-related without a thorough investigation being done and delaying appropriate treatment.
   

Common Lyme Disease Symptoms in Women

Symptoms can vary widely, but commonly include:

1. Physical Symptoms

   • Chronic persistent fatigue

   • Joint and muscle pain

   • Headaches

   • Sensitivity to light and/or sound

   • Increased inflammation (ex. gut and skin)

2. Cognitive Symptoms

   • Brain fog

   • Memory issues

   • Difficulty concentrating

   • Difficulty sleeping or waking

3. Hormonal Symptoms

   • Underactive thyroid

   • Irregular menstrual cycles

   • Anxiety or mood changes

   • Difficulty conceiving/unexplained fertility challenges

When to Consider Lyme Disease as a Root Cause

You may want to explore this further if:

• You have persistent symptoms with no clear diagnosis or significant improvement with tried treatments

• Your labs are ‘normal’ but you still feel unwell

• You have been diagnosed with multiple conditions without clear answers or connection

• Your symptoms fluctuate or worsen over time

A Root-Cause Approach to Care

A more comprehensive approach may include:

• Detailed health history

• Expanded and/or speciality functional lab testing

• Evaluation of patterns in your immune, hormonal and inflammatory systems

The goal is not simply symptoms management - but understanding what is driving your symptoms.

You are not Imagining Your Symptoms

If you have felt dismissed or unheard, you are not alone.

Many women spend years searching for answers before being able to accurately identify underlying contributors like Lyme disease or other chronic infections.

When to Seek Support

If this sounds familiar to you, it may be worth exploring a more in-depth and robust evaluation.

Lyme disease is complex, but it can be an important piece of the puzzle for women managing persistent and unexplained symptoms.

With the right approach, it is possible to move beyond symptoms management and toward a deeper understanding of your health.

Lyme Disease support is available via telehealth across California and New Hampshire.

Join Dr Hall’s appointment wait list to be the first to know when she is accepting new patients September 2026.