Medizinische Universität Graz - Research portal
Selected Publication:
Stoisser, S.
Gender related differences of selected diseases concerning prevalence, pathophysiology, diagnosis, therapy and outcome
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2017. pp. 70
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- Authors Med Uni Graz:
- Advisor:
- Amrein Karin
- Matzhold Eva-Maria
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- Abstract:
- Introduction: In preclinical and clinical trials women are underrepresented and animal studies are often performed only on male animals. This leads to treatment in women with drugs mostly tested on men and therefore may lead even to more adverse drug reactions in females. This diploma thesis aims to discuss selected common diseases regarding differences between the sexes concerning prevalence, pathophysiology, diagnosis, treatment and outcome. Methods: The method was a literature research. The discussed diseases were carefully chosen to report both differences regarding the female and the male population. PubMed and GoogleScholar were searched for relevant and recent articles. The library of the Medical University of Graz and the library of the Karl-Franzens University were also used. Results: Concerning cardiovascular diseases (CVD), women are usually older at presentation. They have stiffer and smaller hearts and vessels than men. Symptoms differ significantly from those seen in males. Estrogen has protective effects in premenopausal women. Primary reperfusion therapy is performed less in women and treatment in females is less aggressively in general. In 2011 the American Heart Association updated prevention guidelines for CVD in women. Men suffering from osteoporosis are usually underdiagnosed and undertreated. There are treatment guidelines for men available from several organizations. Diabetes mellitus is a major health burden. The prevalence is similar in both sexes. Estrogen protects women and androgens protect men and both increase insulin sensitivity. Gestational diabetes is associated with adverse pregnancy outcomes and a high risk of progression into type 2 Diabetes Mellitus. Only 1% of breast cancer patients are male. Mutated genes in males differ from those in females. Men receive less breast-conserving therapy and mastectomy is performed more often in males. Additionally, men often face substantial psychological burdens. Discussion: Women face several disadvantages in CVD. They present later and with different symptoms than men with the most common symptom of atypical angina. They are diagnosed later and receive treatment later and less aggressively. To date no specific guideline for treatment of women with CVD are available. No differences exist concerning diabetes mellitus. Men are undertreated in osteoporosis but several guidelines for the treatment of men exist. Breast cancer affects men only rarely and treatment is based mostly on treatment for women. Conclusion: In the chosen frequent diseases, sex differences for both the female and male population exist. With the inclusion of women into clinical trials and drug testing on female animals, treatment options for women have improved. In the era of „personalized medicine“ we would doubtlessly benefit from gender specific research and guidelines to allow optimal treatment for women and men