1. GENDER DIFFERENCES IN PHYSIOLOGY
Refresher Course
sponsored by:
The American Physiological Society Education Committee
EB2006
APS 2006 Refresher Course

2. Martha L. Blair, Ph.D. University of Rochester
What do we know, and what should we teach... about gender differences in physiology?
Martha L. Blair, Ph.D.
University of Rochester
APS 2006 Refresher Course

3. Sex-Based Differences in Heart Disease
Leading cause of death in men and women
Heart disease starts 10 years later in women than men
Stroke more common in women than men
Multiple sex-based differences in co-morbidities, symptoms, progression, outcomes
APS 2006 Refresher Course

4. Diseases that occur more frequently in women than in men:
Osteoporosis
80% of patients with osteoporosis are women
Autoimmune Disease
~3-fold more common in women than men
Depression
2-3 times more common in women than men
Possibly linked to lower production of serotonin in women
Sex-based differences also present in incidence and expression of schizophrenia, post-traumatic stress disorder, panic disorder, other mental illnesses
APS 2006 Refresher Course

5. Sex-Based Differences in Disease: found in most (all?) organ systems
Respiratory
Gastrointestinal
Renal
Skin
Reproductive/GU
and more...
APS 2006 Refresher Course

6. Potential Causes of Sex-Based Differences in Normal Physiology and Disease
Societal
Lifestyle/behavior
Environmental
Healthcare
Genetic
Linked to x- or y-chromosome
Effects of the sex steroids
Androgens, Estrogens, Progestins
All present in both male and female
Estrogens & androgens physiologically important in both males and females
APS 2006 Refresher Course

7. Sex Hormones and Life Stages
Prenatal development
Sexual differentiation
Maturation: child, adolescent, young adult
Variation with menstrual cycle in women
Pregnancy
Abrupt drop in estrogen & progesterone at menopause
Gradual decline in testosterone with aging
Both men and women
APS 2006 Refresher Course

8. Sex-based Differences in Body Composition and Structure
Well-known differences: in comparison with women, males have
Greater bone mass
Greater muscle mass
Lower percent body fat
Males and females also have structural differences in
Heart
Brain
Gastrointestinal system
and more...
APS 2006 Refresher Course

9. Differences in “Normal Values”
Cardiovascular
Blood Pressure
5-10 mmHg higher in men than women
Difference abolished after menopause
Heart rate lower in men than age-matched women
Q-T interval longer in women
Renal
Glomerular filtration rate
Slightly lower in young women than age-matched men
May decline more rapidly with aging in men than women
APS 2006 Refresher Course

10. Sex-Based Differences in Normal Physiological Function
Cardiovascular system
Liver
Lipid metabolism
Drug metabolism
Central nervous system
Other: Gastrointestinal system, immune system, kidney, lung, skin...and more.
APS 2006 Refresher Course

11. Sex-based differences in normal physiological function...
A “Work in Progress”!
APS 2006 Refresher Course

12. Monographs on Sex-Based Differences in Health and Disease
Exploring the biological contributions to human health : does sex matter?
editors, T.M. Wizemann & M-L. Pardue; National Academy Press, 2001
Proceedings of the Institute of Medicine Committee on Understanding the Biology of Sex and Gender Differences 
Principles of gender-specific medicine
editor, Marianne J. Legato; Elsevier Academic Press, 2004  
Principles of sex-based differences in physiology
Advances in Molecular and Cell Biology, vol. 34; editors, V. Miller & M. Hay; Elsevier, 2004
APS 2006 Refresher Course

13. Websites on Sex-Based Differences in Health and Disease
Society for Women’s Health Research:
Overview of sex-based differences
Links to additional sources of information
Centre for Research in Women’s Health
National Center for Gender Physiology at the University of Missouri
Partnership for Gender-Specific Medicine
APS 2006 Refresher Course