Sex- and Gender-Sensitive Medicine Unit, Medical Faculty OWL, Bielefeld University, Bielefeld, Germany.
Gender Unit, Departement of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Handb Exp Pharmacol. 2023;282:3-23. doi: 10.1007/164_2023_688.
Sex and gender play a pivotal role in health and disease. Differences can be identified in symptoms, biomarkers, lifetime experiences of diseases, incidence, prevalence, therapeutic options, health-related behavior, and resiliency. However, awareness of sex and gender differences in medicine is still limited. Systematic implementation of sex and gender-sensitive research is not yet the norm, resulting in gaps in evidence especially in the diagnosis and treatment of diseases in women. For decades research has predominantly included male persons and animals, leading to a lack of information about symptoms in female individuals or the classification of their symptoms as "atypical". Currently, the inclusion of female participants in clinical marketing access trials is mandatory. However, this does not automatically translate into sex-disaggregated analyses potentially limiting the discovery of sex-specific targeted therapeutic schemes. Consistent consideration of sex and gender in planning, conducting, analyzing, and dissemination of pharmacological research projects is an important prerequisite for closing the gender data gap. Targeted implementation strategies might help to include sex and gender aspects in different parts of the health system and thereby support the improvement of health care for all patients. Health economic aspects could be a further drive for the implementation of sex- and gender-sensitive medicine.The current chapter focuses on the role of sex and gender in biomedical research and, consequently, their potential role in pharmacology. We will explore the commonly used terminology in the field, the historical development of sex and gender-sensitive medicine (SGSM), the relevance of sex and gender to research and clinical practice and conclude with an outlook on future developments in the field.
性别在健康和疾病中起着关键作用。在症状、生物标志物、疾病的终身经历、发病率、患病率、治疗选择、与健康相关的行为和恢复能力方面都可以发现差异。然而,医学中对性别差异的认识仍然有限。系统地实施性别敏感研究尚未成为常规,导致证据存在差距,特别是在女性疾病的诊断和治疗方面。几十年来,研究主要集中在男性个体和动物身上,导致缺乏关于女性个体症状的信息,或者将其症状归类为“非典型”。目前,在临床市场准入试验中纳入女性参与者是强制性的。然而,这并不自动转化为按性别分类的分析,从而限制了发现针对特定性别的治疗方案的可能性。在规划、进行、分析和传播药理学研究项目时始终考虑性别和性别差异,是缩小性别数据差距的重要前提。有针对性的实施策略可能有助于在卫生系统的不同部分纳入性别和性别方面的内容,从而支持改善所有患者的医疗保健。卫生经济学方面可能是实施性别敏感医学的进一步动力。
本章重点介绍性别在生物医学研究中的作用,以及其在药理学中的潜在作用。我们将探讨该领域常用的术语、性别敏感医学的历史发展、性别对研究和临床实践的相关性,并对该领域的未来发展进行展望。