These 9 Common Medicines Affect Men & Women Differently
Men and women have several biological
differences, and their systems react differently to certain chemicals
and stimuli. Therefore, some conditions are more common in women than in
men, and vice-versa. But it is only recently that medical science
started paying attention to the different reactions men and women have
to certain types of medication. Previously, most research was performed
on male subjects, leading to a misunderstanding of how women would react
to certain types of medication.
In this article, we discuss the development of gender-based medicine,
which works to provide appropriate medication for each gender. We will
also list the 9 most common types of medications that have diverse
effects on men and women.
The Evolution of Gender-Based Medicine
For decades, medical research was performed
almost exclusively on men. In some cases, the reason was to protect
women who may be pregnant during the study, and in other cases, it was
women’s menstrual cycles that prevented them from participating, because
hormonal and chemical changes would prevent the correct assessment of
the results. This also led to neglect in studying the effects of
medicine on women during their menstrual cycle. Even nowadays,
two-thirds of the illnesses that affect both genders are still studied
on male subjects, and most experimental drugs are tested on men.
The emergence of gender-based medicine occurred during the 1970s, but
only during the 90s were these issues discussed in a wider forum. When
it came to conditions that were considered “women only”, such as breast
cancer and osteoporosis, men were not included as test subjects. The
result was that it became much harder to diagnose these conditions in
men, despite the fact that they do appear in them, as well as providing
appropriate treatment for each gender.
At this time, medical science is finally
aware of the different effects medication has on men and women. In a
2001 study, it was found that 11% of cases where women were hospitalized
resulted due to incorrect medication, while in another study it was
found that women seem to suffer more from side effects compared to men
by a ratio of 50-70 percent.
Why Do Medicines Affect Men and Women Differently
There are several reasons why men and women have different reactions to
certain types of medications:
1. Physical size and anatomy
Even though women are often physically
smaller than men, they receive the same dosage. This means that they
have a higher concentration of the medicine in their body, which could
explain the differences in how the body reacts to it. At the same time,
anatomical differences between genders can lead to increased sensitivity
to certain types of medication in women.
2. Differences in how the body processes medication
Our kidneys play a vital role in clearing
toxins and excess medication from the body. In older women, however,
there is a decrease in kidney functions, which some studies suggest is
considerably higher than in men. This means that some women end up being
exposed to higher concentrations of the active ingredients in the
medication. Additionally, enzymes in the stomach lining and the liver,
which are part of a system called “P450” that also helps remove excess
medicine in the body, behave differently in men and women.
3. Stomach acidity levels
The digestive system in men and women works
differently, so medication taken orally can affect each gender
differently. In women, stomach acidity is lower than in men, leading to a
slower emptying process. This means that the active ingredients in the
medicine absorb in the stomach for longer periods, which affects women
more than men.
Medication that Reacts Differently in Men and Women
Since the subject of the different effects medication has on different
genders is still being studied, the following list cannot be considered
as comprehensive or complete since more types of medication are likely
to be added to it in the future. If you’re taking medication that
appears on this list, are planning on changing your medication, or are
experiencing unusual side effects, consult with your physician.
1. Antidepressants
Serotonin is a known antidepressant, but
women naturally produce less of it than men. The result is that
serotonin-based antidepressants are far more effective in women than in
men. Men, however, seem to react better to imipramine, a tricyclic
antidepressant.
2. Valium
Valium is used to reduce anxiety and is
often prescribed in the same dosage for both men and women, despite the
fact that women process it faster than men, reducing its efficacy. The
reason is that the high level of estrogen in women affects an enzyme
called A43, which breaks down the Valium in the body. Since the
breakdown is greater, women may require higher doses of Valium than men.
3. Zolpidem-based insomnia drugs
Many women who were taking zolpidem
containing sleeping pills suffered from side effects such as night
terrors, difficulty in waking up, headaches, etc. In 2013, following a
study into the matter, the U.S. FDA instructed women to reduce their
dosage by half. The reason is that women seemed to process the drug at a
slower rate, thus increasing its efficacy. The side effects of zolpidem
on women also increased the risk of car accidents.
4. Statins-based cholesterol-lowering drugs
Statins based cholesterol medication is
commonly used as a treatment for high cholesterol and as a preventative
measure for coronary diseases, despite the fact that these drugs were
only tested on males. More recent studies found that while these drugs
lower the risk of heart attacks in men, their effects on women are
significantly lower, even compared to men with a history of heart
problems.
5. Losartan-based blood pressure medication
While the increased activity of the A43
enzyme lowers the efficacy of certain medications in women, in some
cases it can do the opposite and cause an overdose. The effects of
losartan in women who take it for high blood pressure may lead to much
stronger effects than in men who take the same dosage, thus causing
their blood pressure to drop dangerously low.
6. Aspirin
There are women who take this NSAID on a
daily basis as a form of prevention for coronary diseases, yet all the
studies that recommended this practice were performed on men. In fact,
aspirin does not protect women’s cardiovascular system in the same way
it does for men, and doctors often recommend a considerably higher
dosage to women who have been through a coronary event. However, in
recent studies, it was found that aspirin does more to protect women
from stroke compared to men.
7. Anesthetics
Though there are very few cases of people
who have woken up during surgery or that report that they heard what was
happening in the operating room, the number of women who reported these
experiences is three times higher than men. Researchers have found that
each gender reacts differently to the anesthetics because of the
distribution of fat, which differs between males and females. For this
reason, anesthetics that are fat soluble, such as Propofol, are more
effective on men, while water-soluble anesthetics are more effective on
women.
8. Painkillers
There are known differences in pain
sensitivity and threshold between men and women, very few studies have
been performed on the efficacy of painkillers for each gender. This is
troubling because it is directly related to their efficacy and risk of
addiction. In one of the few studies on this topic, it was found that
the difference between male and female metabolism, women tend to enjoy a
more powerful effect from opioid painkillers. This means that women
need a dosage that is 30-40% smaller than men. Men, on the other hand,
respond better to Nonsteroidal anti-inflammatory drugs (NSAID).
9. Epilepsy medicine
The hormonal changes women experience
during their menstrual cycle has a significant effect on the efficacy of
many types of medication. For example, progesterone may speed up the
system that cleanses drugs from the body. In some women who suffer from
epilepsy, this hormone may lead to a multitude of seizures prior to
menstruation. Some women don’t make the connection between the increase
in the frequency of attacks and their menstrual cycle, and many doctors
won’t even ask them about it, despite the fact that this can easily be
resolved by changing medication or dosage.
In conclusion, as mentioned at the beginning of this article, the most
important thing is to be aware and vigilant of whatever type of
medication you take. Avoid taking anything before consulting with a
doctor, and don’t be afraid to ask if the dosage is right for your
gender, age, weight, and medical history.