[5][6][3] As of 2021[update], over 10,000 articles had been published addressing sex and gender differences in clinical medicine and related literature.
[citation needed] Sex and gender affect cardiovascular,[7] pulmonary[8] and autoimmune systems,[9][10] gastroenterology,[11][12][13] hepatology,[5] nephrology,[14] endocrinology,[15][16] haematology,[17] neurology,[18][19][20][21] pharmacokinetics, and pharmacodynamics.
Their occurrence may reflect economic and social as well as biological factors, leading to sex differences in the transmission, prevalence, and disease burden of STIs.
The findings of these studies have often been applied across the sexes, and healthcare providers have traditionally assumed a uniform approach in treating both male and female patients.
[25] Females and males exhibit many differences in terms of risk of developing disease, receiving an accurate diagnosis, and responding to treatments.
[28] It is suspected that many differences between the sexes are also influenced by social, environmental, and psychological factors which are difficult to tease apart from biological ones.
Since blood pressure rises in women after menopause,[83] this suggests that the cause of the sex-specific differences lies not only in possible external factors, such as lifestyle, but also in the sex hormones .
This binds to the Ang II type I receptor (A2T1), which causes vasoconstriction and water and sodium reabsorption in the kidneys, and in turn increases blood pressure.
[89] In autoimmune diseases, like Sjögren's syndrome (SS), the body produces hyperreactive autoantibodies against the salivary and lacrimal gland tissue.
Accordingly, it stands to reason that an autoimmune reaction, which is based on a hyperreactive immune sensitivity to autoantigens, can manifest itself much more easily in women.
[91] In this study, low estrogen levels promoted apoptosis and the formation of apoptotic bodies and microparticles containing membrane antigens.
These are recognized as pathogens via TLR (toll-like receptors) of the dendritic and B cells, which then secrete increased levels of INF alpha/ß and cytokines.
Synthesizing this product in women is much more complex and involves several steps that are difficult to ensure when estrogen levels are low (menopause, etc.).
Androgens generally have stimulating effects on the production of the lipid layer in the tear film and oral mucosa.
This means that the lipid layer, which is important for maintaining moisture in the mouth and on the eyes and providing protection against pathogens, is missing.
This suggests an involvement of the double gene expression of the 2nd X chromosome in the pathogenesis of SS,[91] which could also affect XX genotype women.
Another study investigated the influence of a long non coding RNA protein, called XIST, which is a leading factor of the double X chromosome expression.
Furthermore, intestinal microbiome differences, elevated levels of certain miRNAs, and microchimerism during pregnancy are discussed and investigated as possible risk factors in the pathogenesis of SS.