Many of us pop a painkiller without a second thought.
But now scientists are warning the efficacy of the medication could not only depend on the dose or the time of day – but your sex.
This is because hormones and genes affect how the body metabolises drugs.
Now, in a new paper, they have revealed women are prescribed drugs that may have never been specifically tested on females.
Women may be prescribed drugs by their doctor that have never been specifically tested on females, scientists have warned (file photo)
They explain females are excluded from clinical trials under the assumption that ‘one size fits all’.
It is believed a new painkiller or antidepressant will be equally effective in either sex.
But a growing number of scientists say hormones and genetic differences affect how medicines behave in the body – meaning drugs might affect women differently to men.
Writing in the journal Cell Metabolism, experts said both men and women must be accounted for in trials to move medical advances forward.
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Previous studies have shown ibuprofen is much more effective in men, while women experience greater pain relief from opioid painkillers.
And other research shows women respond better to SSRI antidepressants, whereas men may fare better on tricyclics.
Professor Deborah Clegg, of Cedars-Sinai Hospital in California, said: ‘Right now, when you go to the doctor and you are given a prescription, it might not ever have been specifically tested in females.
HOW DRUGS AFFECT WOMEN DIFFERENTLY
Women’s different hormones, body composition and metabolism means drugs may affect them differently to men, studies suggest.
For example, ibuprofen is much more effective in men, while women experience greater pain relief from opioid painkillers.
And other research shows women respond better to SSRI antidepressants, whereas men may fare better on tricyclics.
And the US Food and Drug Administration changed its guidelines around doses of certain sleeping tablets for women.
This is because studies revealed higher levels of the drug in women’s systems the day after taking it – which could impact alertness and driving.
‘Almost all basic research – regardless of whether it involves rodent models, dogs, or humans – is predominately done in males.
‘The majority of research is done with the assumption that men and women are biologically the same.’
Professor Clegg said one reason women are excluded from studies is because levels of hormones such as oestrogen and progesterone fluctuate during the menstrual cycle.
This may impact the study – and so researchers often use men instead.
But the sex hormones are implicated in all biological processes, including sensitivity to fatty acids, or the ability to metabolise simple sugars.
Professor Clegg said the differences have implications for all clinical trials, whether they are testing the effects of a drug or a body’s ability to tolerate an organ transplant.
She said chromosomal differences also exist between the sexes.
There is little research examining whether drugs behave differently in the presence of an XX chromosome as opposed to an XY chromosome, she added.
Her laboratory is currently investigating the impact of gender reassignment surgery on cardiovascular disease risk.
Researchers often exclude women from trials because their hormone levels fluctuate across their monthly cycle – skewing results
Women are traditionally protected against cardiovascular diseases when compared to men.
But she said it is unclear whether a transsexual woman – a man who has transitioned to become a woman and usually prescribed female hormones – is at a lower or higher risk for heart disease.
Professor Clegg said: ‘This is an important population of individuals to study, as they will begin to enlighten us about the optimal hormonal profile to protect us from disease.’
The results will have implications for all men and women as well as this specific group of transsexual women.
She continued: ‘It is important to begin to understand if there is a role for hormones, chromosomes, and/or their interactions with respect to disease risk.’
She claimed many researchers don’t know how to properly include sex as a variable in their experiments.
She said that, often, they will include females in their study without addressing if they’re pre- or post-menopause, whether they’re on birth control pills, or if they’re taking hormone blockers.
Women should be included in all trials with studies noting whether they are pre- or post- menopausal, as the changing hormone levels affect how drugs work, experts said (file photo)
Professor Clegg added: ‘Without addressing all of these variables in your analysis, you’re still not accurately reflecting the impact of hormones and chromosomes in your research.
‘It would be great if there were drugs that were specifically tested and dosed based on sex.
‘There are so many variables in medical research that can’t be solved by placing all women, regardless of age, into one category and certainly can’t be solved by excluding us completely.
‘With the goal of personalised medicine, it is important to begin to address and focus on sex as a biological variable.’