Sex Variation and Drug Therapy

Abstract

A literature review of gender differences with drug therapy is presented. Physiological differences between the sexes in basal metabolic rate and in levels of certain of the circulating hormones and enzymes affect or influence the metabolism of various drugs. Differences in muscle mass, disposition of adipose tissue and vascular resistance can lead to variations in response between the sexes to IM injections, while plasma levels of orally administered drugs can be influenced by sex differences such as gastric motility and secretion, metabolic rate, pregnancy, and differences in drug distributive compartments. These differences in gender response to a given therapy can vary according to the patient's age. Adverse reactions to drugs are also affected by the patient's gender, and certain drugs have been shown to induce adverse reactions predominantly in one sex. The review illustrates the confusion surrounding this subject and stresses the importance of sex differences in the consideration and monitoring of drug therapy. Information on sex and age of patients, and possible sex differences in response to drug therapy is requested of all future therapeutic studies. It was further suggested that the dual genetic coverage may be the mechanism by which the sex difference in susceptibility to infection can be explained. Support for this theory can best be found in a brief discussion of sex-linked diseases. The transmission from parents to offspring of defects, which may manifest themselves as disease, may be genetic in origin (Table 2).41 Due to the transmission of these diseases by the sex chromosomes, the male, having only one X-chromosome, is afflicted more often by these diseases. This leads one to conclude that given like conditions, females are better adapted to cope with many human diseases because they are genetically and chemically better evolved.