Medicine

Female Physiology & The Role of AI in Women’s Health | by Simran Mayra | Nov, 2021

Simran Mayra

The women’s health space is often neglected, as our current health care system treats men and women’s bodies as the same, despite the biological differences.

Until recently, most clinical & basic research was either done in male subjects or male and female subjects where studies didn’t differentiate the sexes in data analysis. This implies that there aren’t significant differences in the physiology of men and women outside the reproductive systems.

Women weren’t as included in trials or research due to the potentially complex nature of controlling the various stages of the female reproductive cycle and different hormonal balances.

These variables would have to be included in experimental design in animal and human studies involving female subjects in some studies. So basically, it was just thought of as a variable that would make data collection more complicated.

Present-day, there is a lot of literature addressing sex-based differences and the effects of sex steroid hormones on the function of multiple organ systems. Research indicates that there are many differences between males and females in normal physiology and the pathophysiology of disease. Unfortunately, these sex-based differences in physiology aren’t systematically addressed in textbooks or the medical physiology curriculum, excluding reproductive physiology.

Potential causes of sex-based differences in normal physiology and disease

  • Genetic differences: females have 2 X chromosomes and no Y chromosome, whereas men have a Y chromosome but only one X chromosome
  • There are genes on the Y chromosome which don’t have a counterpart located on the X chromosome.
  • Some genes located on the X chromosome are more expressed in women than men.
  • Sex steroid hormones such as androgens, estrogens, progestins can alter gene expression. Receptors for sex steroid hormones are in many tissues outside of the reproductive system- some include the heart, bone, skeletal muscle, vasculature, liver, immune, and brain. Circulating androgen levels are higher in males, and circulating estrogen/progestin levels are higher in premenopausal females.
  • Males: typically more muscle mass, bone mass, and a lower % of body fat than women. These differences are primarily a result of gonadal steroid hormones on skeletal muscle and bone metabolism.
  • Sex differences in lungs- men have larger lungs, wider airways, and higher lung diffusion capacity than women. consequence- compared to young men, the maximum exercise capacity may be limited by pulmonary capacity in women
  • Known differences in brain structure result from fetal exposure to gonadal steroid hormones: varying pain threshold and cognitive style, and greater glucocorticoid response to stressors in females than males.
  • Biological basis of these differences are highly complex and not fully understood

The actions of estrogens and androgens control any sex-based differences.

We can take osteoporosis, for example, where 80% of the patients are women. When we look at the causes of osteoporosis, we have genetic characteristics, exercise, dietary history, and the contributions of testosterone and estrogen to bone metabolism. The decline in estrogen production is one of the critical factors that predispose postmenopausal women to the development of osteoporosis.

Another example is an autoimmune disease with 80% of women patients, depicting that sex steroid hormones can significantly alter immune system function. In the cases of autoimmune disease- we can look at dramatic examples of the discrepancy between men and women.


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