Glezerman Marek
Gender and Sex Conscious Medicine, Faculty of Medicine, Tel Aviv University, The Israel Society for Gender and Sex Conscious Medicine.
Harefuah. 2024 Jul;163(7):457-461.
Sex- and Gender-Conscious Medicine aims to raise awareness among the general public and among professionals to the phenomenon that the function of all body systems in women and men can be different. The differences may be small but significant for the health and disease and also affect pharmacokinetics and pharmacodynamics. Since medications are still studied mostly in men and the results are applied to women, pharmacokinetics and pharmacodynamics of men have actually become the "gold standard", which is applied in practice to both sexes. This is the case, despite the fact that the body weight of women is usually lower than that of men and the compartmental distribution of fat, muscle and water is different between the sexes. In addition, metabolism and clearance of drugs through the kidneys can differ between them. As a result, women sometimes find themselves undertreated or over-treated with regard to various medications and suffer twice as much from adverse drug reactions than men. Even the involvement of regulatory institutions such as the FDA in the USA was not enough to change the situation decisively. In this review, I will discuss various aspects of the problem, present examples of different groups of drugs and will especially refer to the problem of the side effects of medications in women.
男性和女性所有身体系统的功能可能存在差异。这些差异可能很小,但对健康和疾病具有重要意义,并且还会影响药物代谢动力学和药效学。由于药物研究大多仍以男性为对象,研究结果应用于女性,男性的药物代谢动力学和药效学实际上已成为“金标准”,并在实践中应用于两性。尽管女性体重通常低于男性,且脂肪、肌肉和水分的分布在两性之间存在差异,但实际情况依然如此。此外,药物经肾脏的代谢和清除在两性之间也可能不同。结果,女性有时会发现自己在使用各种药物时治疗不足或过度治疗,并且药物不良反应的发生率是男性的两倍。即使像美国食品药品监督管理局这样的监管机构参与其中,也不足以彻底改变这种状况。在这篇综述中,我将讨论该问题的各个方面,列举不同药物组的例子,并特别提及女性用药的副作用问题。