Individualized medicine: Sex, hormones, genetics, and adverse drug reactions

AbstractClinically relevant adverse drug reactions differ between men and women. The underlying physiological and pharmacological processes contributing to these differences are infrequently studied or reported. As gene expression, cellular regulatory pathways, and integrated physiological functions differ between females and males, aggregating data from combined groups of men and women obscures the ability to detect these differences. This paper summarizes how genetic sex, that is, the presence of sex chromosomes XY for male or XX for female, and the influence of sex hormones affect transporters, receptors, and enzymes involved in drug metabolism. Changing levels of sex steroids throughout life, including increases at puberty, changes with pregnancy, and decreases with age, may directly and indirectly affect drug absorption, distribution, metabolism, and elimination. The direct and indirect effects of sex steroids in the form of exogenous hormones such as those used in hormonal contraceptives, menopausal hormone treatments, transgender therapy, and over ‐the‐counter performance enhancing drugs may interfere with metabolism of other pharmaceuticals, and these interactions may vary by dose, formulation, and mode of delivery (oral, injection, or transdermal) of the steroid hormones. Few drugs have sex‐specific labeling or dosing recommendations. Furthermore, there is limited literature evaluating how the circulating levels of sex steroids impact drug efficacy or adverse r...
Source: Pharmacology Research and Perspectives - Category: Drugs & Pharmacology Authors: Tags: ORIGINAL ARTICLE Source Type: research

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n Restless legs syndrome is a relatively common neurologic disorder considerably more prevalent in women than in men. It is characterized by an inactivity-induced, mostly nocturnal, uncomfortable sensation in the legs and an urge to move them to make the disagreeable sensation disappear. Some known genes contribute to this disorder and the same genes contribute to an overlapping condition—periodic leg movements that occur during sleep and result in insomnia. Dopamine and glutamate transmission in the central nervous system are involved in the pathophysiology, and an iron deficiency has been shown in region-sp...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Communication Source Type: research
Conclusionshp-HMG and rFSH did not lead to significantly different treatment outcomes in patients with poor ovarian response undergoing in vitro fertilization/intracytoplasmic sperm injection with a gonadotropin-releasing hormone antagonist protocol, although significantly higher serum insulin-like growth factor-1 level and insignificantly lower serum insulin-like growth factor binding protein-1 level on the day of oocyte retrieval associated with hp-HMG might suggest a beneficial endocrine environment. (Curr Ther Res Clin Exp. 2020; 81:XXX–XXX)
Source: Current Therapeutic Research - Category: Drugs & Pharmacology Source Type: research
ConclusionsDrug-free IVA could be a useful therapeutic option for patients with POI, leading to successful IVF outcomes.
Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research
BY JESSICA DAMASSA, WTF HEALTH Ava Science is a FemTech company best-known for their fertility-predicting wearable device that collects biometric data from a woman’s wrist in order to track ovulation. The device predicts fertility with 89% accuracy (according to published clinical trial data) and is among one of the most well-funded FemTech startups out there, having raised a cumulative $47M. So what’s next? Lea von Bidder, Ava’s CEO, explains the data-driven vision for the company, which is currently one of the few medical device wearables that is approved for collecting digital biomarkers. The startu...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Tech Jessica DaMassa WTF Health Ava Science HLTH HLTH 2019 Lea Von Bidder Wearables Source Type: blogs
This study examined the association between endogenous estrogen exposure and cognitive decline, taking into account age at menarche to age at menopause, adjusted for pregnancy and breastfeeding.Menopause
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Ob/Gyn & Women ' s Health Journal Article Source Type: news
Abstract Reproductive events, such as ovulation, trigger an inflammatory cascade. Few studies have examined their long-term influence on inflammatory profiles. We included 3,393 premenopausal and 3,915 postmenopausal women with intact ovaries/uterus from the Nurses' Health Studies, and estimated lifetime ovulatory years (LOY) as age at menopause (age at blood collection for premenopausal women) minus age at menarche, years of oral contraceptive (OC) use, and one year per pregnancy. After adjusting for other inflammation-related factors (e.g., BMI, exercise, diet, etc.), every 5-year increase in LOY was associated ...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research
Conclusions: Administration of low-dose hCG from the early follicular phase for PCOS patients undergoing ovarian stimulation with progesterone protocol may lead to slightly more early preovulatory follicles and marginally, but not significantly, higher clinical pregnancy rates. A continuous trial should be performed to explore the effects of supplementation with different doses of hCG from the start of ovarian stimulation in PCOS patients using the progesterone protocol.Clinical Trial, identifier: ChiCTR-IOR-15007165
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Abstract Funding agencies in North America and Europe are recognizing the importance of the integration of sex differences into basic and clinical research. Although these mandates are in place to improve our knowledge of health for both men and women, there have been a number of implementation issues that require vigilance on the part of funders and the research community. Here we discuss issues on simple inclusion of both sexes in studies to specialisation of sex differences with attention paid to statistics and the need for sex-specific treatments. We suggest differing mandates need to be considered regarding s...
Source: Frontiers in Neuroendocrinology - Category: Endocrinology Authors: Tags: Front Neuroendocrinol Source Type: research
Discussions about sexuality and reproduction are an important part of transition planning and must be done with an awareness of the adolescent’s developing understanding and maturity. Pregnancy imposes a hemodynamic load on the heart which may lead to cardiac, obstetric, and fetal/neonatal complications in women with CHD. Prepregnancy counselling must include an assessment of maternal and fetal risk according to several well developed models. Counselling should also include discussions about fertility and alternatives to pregnancy when appropriate. Recommendations for contraception must be made according to the patie...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
by Fr édéric Thomas, Mathieu Giraudeau, François Renaud, Beata Ujvari, Benjamin Roche, Pascal Pujol, Michel Raymond, Jean-François Lemaitre, Alexandra Alvergne Why a postfertile stage has evolved in females of some species has puzzled evolutionary biologists for over 50 years. We propose that existing adaptive explanations have underestimated in their formulation an important parameter operating both at the specific and the individual levels: the balance between cancer risks and cancer defenses. During their life, most multicellular organisms naturally accumulate oncogenic processes in their bo...
Source: PLoS Biology: Archived Table of Contents - Category: Biology Authors: Source Type: research
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