Sex differences based on the fundamental ways male and females are genetically programed change what we see clinically as types and incidences of diseases prevalence and more importantly how a male vs a female will responds to treatment.
Hormone differences are not the only reason men and women are differeent!
Fundamentally our basic chromosome mix determines much of our physiology. Women have two X chromosomes, one from mom, one from dad. Throughout the body the cells have one or the other inactivated, randomly. So in truth, some women are more genetically similar to mom, others to dad. And in others, not quite half the genetic material inactivates, so they have a bit of extra genetic material.
Males have all of their X chromosome materials from their moms. And yet it’s not ‘exactly’ your mom’s X chromosome, as there are compounds that attach around the chromosomes (in biology this is the epigenetic material) that make a son’s X chromosome material a bit different than his mom’s.
The Y chromosome (what determines male genetic sex) has a region called the SRY gene. This gene does many things, one is to enable the development of testicles. The SRY gene also causes increases testosterone production from the young testicle which permanently alters cells and organs in those born genetic males.
After birth, both the female ovary and male testicle goes very dormant until puberty. But the stage is set for these permanent cell changes, and thus for the life of an individual, whether you are male or female, you will be destined to have different responses to hormones circulating, and differences in the compounds around all the chromosomes in your body, and thus be differently susceptible to various diseases, and respond uniquely to treatments when you do manifest illness.
From this early change many diseases are altered, and beyond the scope of this post to review. For instance, one of the most dramatic differences between males and females in what we see in the most common type of dementia, Alzheimer’s disease, a full two thirds of those with Alzheimer’s disease are women. The types of physiologic changes that lead to this condition differ in men and women, and women who lose their ovaries prematurely are at more risk for these biologic changes.
Women are more likely to be insulin resistant, but in both sexes deficient hormone levels lead to more insulin resistance. For women, this risk is accelerated during the menopause which produces more abrupt hormonal change, than the aging of hormones in the male, which still will occur.
Women are also more likely to catch influenza and viral pandemic diseases, and in fact are more likely to suffer greater morbidity.
None of this is simple, none is set completely by science, nor is the concept of gender completely aligned with the concept of genetic disease risks. Nor do we really know what category of risk one will be if one switches gender . According to Global Health 50/50 they state that “WHO defines gender as the ‘socially constructed characteristics of women and men—such as norms, roles and relationships of and between groups of women and men’.” All of these will affect your health, see your health care provider to understand your personal risks and what you can do to maximize your personal health.