The Menstrual Cycle and Drug Metabolism

Mitchell, Stephen C.; Smith, Richard L.; Waring, R. H.

doi:10.2174/138920009788897966

Cited by 24 publications

(15 citation statements)

References 90 publications

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“…Fluctuations in endogenous sex steroid hormones that occur naturally with the menstrual cycle, pregnancy, and with the transition to menopause have the potential to influence drug efficacy and ADRs. 42…”

Section: Female-s Pecific Cons Ider Ations: Influen Ce S Of Endog Ementioning

confidence: 99%

Individualized medicine: Sex, hormones, genetics, and adverse drug reactions

Moyer

Matey

Miller

2019

Pharmacology Res & Perspec

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Clinically relevant adverse drug reactions differ between men and women. The underlying physiological and pharmacological processes contributing to these differences are infrequently studied or reported. As gene expression, cellular regulatory pathways, and integrated physiological functions differ between females and males, aggregating data from combined groups of men and women obscures the ability to detect these differences. This paper summarizes how genetic sex, that is, the presence of sex chromosomes XY for male or XX for female, and the influence of sex hormones affect transporters, receptors, and enzymes involved in drug metabolism. Changing levels of sex steroids throughout life, including increases at puberty, changes with pregnancy, and decreases with age, may directly and indirectly affect drug absorption, distribution, metabolism, and elimination. The direct and indirect effects of sex steroids in the form of exogenous hormones such as those used in hormonal contraceptives, menopausal hormone treatments, transgender therapy, and over‐the‐counter performance enhancing drugs may interfere with metabolism of other pharmaceuticals, and these interactions may vary by dose, formulation, and mode of delivery (oral, injection, or transdermal) of the steroid hormones. Few drugs have sex‐specific labeling or dosing recommendations. Furthermore, there is limited literature evaluating how the circulating levels of sex steroids impact drug efficacy or adverse reactions. Such research is needed in order to improve the understanding of the impact of sex hormones on pharmacological therapies, particularly as medicine moves toward individualizing treatments.

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Section: Female-s Pecific Cons Ider Ations: Influen Ce S Of Endog Ementioning

confidence: 99%

Individualized medicine: Sex, hormones, genetics, and adverse drug reactions

Moyer

Matey

Miller

2019

Pharmacology Res & Perspec

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“…With regard to sex, differences between male and female will include differences in weight and weight distribution as well as hormonal differences particularly in relation to the menstrual cycle and its absence in prepubescent girls and postmenopausal women [45]. Moreover, physiological differences relating to body composition, gastric motility, liver metabolism, renal function, and glomerular filtration rates all affect differently the disposition of drugs with regard to gender.…”

Section: Pharmacokinetics Related Risk Factors Of Adverse Effectsmentioning

confidence: 99%

Introductory Chapter: Linkages between Pharmacokinetics and Adverse Effects of Drugs

Malangu¹

2018

Pharmacokinetics and Adverse Effects of Drugs - Mechanisms and Risks Factors

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“…In addition, the fluctuating hormone levels also act systemically and modulate functions of nonreproductive organs such as liver and kidney. Together, these interdependencies can lead to female‐specific effects on disease biomarkers, drug metabolism, and poorly understood differences in pharmacokinetics and pharmacodynamics between men and women . Recently, a new multiorgan microphysiological system of was presented that provides a first step toward understanding female‐specific organ interactions and drug effects.…”

Section: Female‐specific Organs‐on‐a‐chipmentioning

confidence: 99%

Organ‐on‐a‐Chip Systems for Women's Health Applications

Nawroth

Rogal

Weiß

et al. 2017

Adv Healthcare Materials

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Biomedical research, for a long time, has paid little attention to the influence of sex in many areas of study, ranging from molecular and cellular biology to animal models and clinical studies on human subjects. Many studies solely rely on male cells/tissues/animals/humans, although there are profound differences in male and female physiology, which can significantly impact disease mechanisms, toxicity of compounds, and efficacy of pharmaceuticals. In vitro systems have been traditionally very limited in their capacity to recapitulate female-specific physiology and anatomy such as dynamic sex-hormone levels and the complex interdependencies of female reproductive tract organs. However, the advent of microphysiological organ-on-a-chip systems, which attempt to recreate the 3D structure and function of human organs, now gives researchers the opportunity to integrate cells and tissues from a variety of individuals. Moreover, adding a dynamic flow environment allows mimicking endocrine signaling during the menstrual cycle and pregnancy, as well as providing a controlled microfluidic environment for pharmacokinetic modeling. This review gives an introduction into preclinical and clinical research on women's health and discusses where organ-on-a-chip systems are already utilized or have the potential to deliver new insights and enable entirely new types of studies.

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The Menstrual Cycle and Drug Metabolism

Cited by 24 publications

References 90 publications

Individualized medicine: Sex, hormones, genetics, and adverse drug reactions

Individualized medicine: Sex, hormones, genetics, and adverse drug reactions

Introductory Chapter: Linkages between Pharmacokinetics and Adverse Effects of Drugs

Organ‐on‐a‐Chip Systems for Women's Health Applications

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