Will we ever have ‘his ‘n’ hers’ medicines?
Until recently, men and women were assumed to be identical, pharmacologically speaking: if a drug worked on men, it should be ﬁne for women. Male and female physiologies differ markedly, however, and this can affect both the effectiveness and the side-effects of medications.
Among the known medical sex differences are:
- different responses to certain painkillers (kappa-opioids, such as pentazocine, work better in women)
- women suffer more severe reactions to some anti-HIV drugs
- some lung cancer treatments seem to work better in women (although others work less well)
- the drug alosetron is licensed for severe inﬂammatory bowel disease in women only.
Overall, we simply don’t know enough about sex differences. This is partly because women were explicitly ruled out of drug trials in the 1970s, for fear that medications might harm an unborn child early in pregnancy. That situation is changing; in most cases women are now enrolled, but the data are not always analysed by sex to see whether sex differences exist.
One problem is that to break down a study group like this, greater numbers of participants are needed – increasing the cost and complexity of the trial. Read more in ‘Big Picture: Sex and Gender’.