Category: Gender

Older Women Struggle More with Daily Activities

Photo by Bennett Tobias on Unsplash

Older women are more likely to struggle with both regular daily tasks and mobility activities, according to new analysis of longitudinal cohort studies.

However, the researchers say disparities in ability to perform daily tasks have been steadily decreasing as the socioeconomic gap between the sexes has decreased.  

The international study, published in The Lancet Healthy Longevity, uses data from more than 27 000 men and 34 000 women aged 50 to 100, born between 1895 and 1960, to examine sex differences in daily activity and mobility limitations. Researchers at UCL and the National Institute of Health and Medical Research (INSERM) in France drew on four large longitudinal studies, covering 14 countries*.

Women were more found to be more likely than men to be limited in their ‘functional capacity’ (both tasks and mobility) as they get older. From age 75, women were also more likely to have three or more mobility issues (such as going up a flight of stairs) or limitations with more complex daily tasks (eg managing money) compared to men who were more likely to have just one or two. At age 85 years, the prevalence of three or more mobility limitations was 10% higher in women than in men.

Lead author, Mikaela Bloomberg, UCL PhD candidate, explained: “Our study of over 60,000 participants born between 1895 and 1960 provides new insights on functional limitations and sex differences.

“We found that women are more likely to be limited than men in carrying out daily tasks from age 70, while we observed women were more likely to be limited in mobility activities from age 50 onward.

“This is an important observation because mobility limitations can precede other more severe limitations and targeting these gaps at middle age could be one way to reduce sex differences in limitations at older ages.”

Historical socioeconomic differences between men and women in areas such as education and entrance to the labour force may partly explain these differences, as women are disproportionately exposed to associated health risks that can lead to disability.

“It appears that gender inequalities in the ability to carry out daily tasks at older age are decreasing over time and this could be explained by the fact that women have better access to education and are more likely to enter the paid labour force in recent generations,” said Bloomberg.

“And although reductions in socioeconomic inequalities may be associated with smaller disparities in simple daily tasks, we did not see the same reductions in sex disparities for mobility after accounting for socioeconomic factors. This might be partly due to sex differences in body composition such as body mass and skeletal muscle index but more research is needed to identify other factors.”

Co-author Dr Séverine Sabia added: “Developing targeted prevention policies to preserve independent living and quality of life for older adults requires an understanding of drivers of sex differences in functional limitations.

“Our study indicates improvements in socioeconomic conditions for women could play an important role in reducing these sex differences. Findings also highlight the importance of early prevention to tackle sex differences in mobility that may trigger sex differences in disability at older age.”

Source: University College London

Is That A Girl’s Voice or A Boy’s?

Phot by Ben Wicks on Unsplash

Researchers have found that it is possible to distinguish a girl’s voice from a boy’s from as young as five years old, but identification requires the listener to perceive the size of the speaker, providing a clue to their likely age. 

Perceiving gender in children’s voices is of special interest to researchers, because in children, a girl’s voice and a boy’s are very similar before the age of puberty. Adult male and female voices are fairly easy to distinguish due to acoustic differences.

With children, gender perception is much more complicated because gender differences in speech may emerge before sex-related anatomical differences between speakers. This suggests listeners may need to consider speaker age when guessing speaker gender and the perception of gender may depend on acoustic information besides anatomical differences between boys and girls.

In the Journal of the Acoustical Society of America, researchers reported developing a database of speech samples from children ages five to 18 to answer two questions: What types of changes occur in children’s voices as they become adults, and how do listeners adjust to the enormous variability in acoustic patterns across speakers?

Listeners assess a speaker’s gender, age, height, and other physical characteristics based primarily on the speaker’s voice pitch and on the resonance (formant frequencies) of their voice.

“Resonance is related to speaker height — think violin versus cello — and is a reliable indicator of overall body size,” said co-author Santiago Barreda, from the University of California, Davis. “Apart from these basic cues, there are other more subtle cues related to behaviour and the way a person ‘chooses’ to speak, rather than strictly depending on the speaker’s anatomy.”
When co-authors Barreda and Peter Assmann presented listeners with both syllables and sentences from different speakers, gender identification improved for sentences. They said this supports the stylistic elements of speech that highlight gender differences and are better conveyed in sentences.

They made two other important findings. First, listeners can reliably identify the gender of individual children as young as five.

“This is well before there are any anatomical differences between speakers and before there are any reliable differences in pitch or resonance,” said Barreda. “Based on this, we conclude that when the gender of individual children can be readily identified, it is because of differences in their behavior, in their manner of speaking, rather than because of their anatomy.”

Second, they found identification of gender of speakers must take place along with the identification of age and likely physical size.

“Essentially, there is too much uncertainty in the speech signal to treat age, gender, and size as independent decisions,” he said. “One way to resolve this is to consider, for example, what do 11-year-old boys sound like, rather than what do males sound like and what do 11-year-olds sound like, as if these were independent questions.”

Their findings suggest that “perception of gender can depend on subtle cues based on behaviour and not anatomy,” said Barreda. “In other words, gender information in speech can be largely based on performance rather than on physical differences between male and female speakers. If gendered speech followed necessarily from speaker anatomy, there would be no basis to reliably identify the gender of little girls and boys.”

This study supports the notion that gender (as opposed to sex) is largely performative in nature, which has long been argued on theoretical grounds.

Source: American Institute of Physics

Gaps and Gender Differences in Diabetes Management

Photo by Tim Mossholder on Unsplash

A new study from the University of Eastern Finland revealed there are gaps and gender differences in diabetes management. Type 2 diabetes is often accompanied by elevated cholesterol levels, but many patients do not receive appropriate cholesterol-lowering treatment, according to the study, which appears in Scientific Reports.

Type 2 diabetes is a major risk factor of cardiovascular diseases, such as coronary artery disease and heart failure, as well as premature death. To prevent or at least delay complications, regular health care visits and good control of blood glucose, low-density lipoprotein cholesterol (LDL-C) and other risk factors are needed.

The present study shows that LDL-C control and statin prescriptions remain suboptimal in clinical practice – despite guidelines that consistently recommend treating elevated LDL-C with statins at moderate- to high-intensity. The study drew on electronic health records of 8592 type 2 diabetes patients between 2012 and 2017.

Analysing LDL-C values over time, researchers identified four groups with different trajectories. Most patients (86%) had relatively stable LDL-C values at moderate levels and only a few patients showed a significant increase (3%) or decrease (4%) during the follow-up. However, the second-largest group (8%) consisted of patients with alarmingly “high-stable” LDL-C levels at around 3.9 mmol/L.  

The “high-stable” LDL-C group had the lowest proportions of patients on moderate- and high-intensity treatment as well as any statin treatment. The proportion of patients receiving any statin treatment even decreased from 42% to 27% among men, and from 34% to 23% among women between 2012 and 2017.

“We observed significant gender differences in care processes and outcomes,” said Laura Inglin, Early Stage Researcher, University of Eastern Finland. “In all the trajectory groups, women had significantly higher average LDL-C levels and received any statin treatment and high-intensity treatment less frequently than men.”

Significant differences were seen in terms of longitudinal care processes, outcomes, and treatments, pointing out gaps in current diabetes management. Efforts to control LDL-C should be increased – especially in patients with continuously elevated levels – by initiating and intensifying statin treatment earlier and re-initiating the treatment after discontinuation if possible.

Source: University of Eastern Finland

Biological Research Often Incorrectly Reports Sex Differences

Photo by Tim Mossholder on Unsplash

An analysis of published studies from a range of biological specialties shows that when data are reported by sex, critical statistical analyses are often missing and the findings are likely to be reported in misleading ways.

The analysis was published in the journal eLife.

“We found that when researchers report that males and females respond differently to a manipulation such as a drug treatment, 70% of the time the researchers have not actually compared those responses statistically at all,” said senior author Donna Maney, a professor of neuroscience in Emory’s Department of Psychology. “In other words, an alarming percentage of claims of sex differences are not backed by sufficient evidence.”

In the articles lacking the proper evidence, she added, sex-specific effects were claimed almost 90% of the time. In contrast, authors that tested statistically for sex-specific effects only reported them 63% of the time.

”Our results suggest that researchers are predisposed to finding sex differences and that sex-specific effects are likely over-reported in the literature,” Prof Maney said.

The problem is so pervasive not even her own work was safe. “Once I realised how prevalent it is, I went back and checked my own published articles and there it was,” she said. “I myself have claimed a sex difference without comparing males and females statistically.”

Prof Maney stressed that the problem should not be discounted; it is becoming increasingly serious, she said, because of mounting pressure from funding agencies and journals to study both sexes, and interest from the medical community to develop sex-specific treatments.

Better training and oversight are needed to ensure scientific rigor in research on sex differences, the authors wrote: “We call upon funding agencies, journal editors and our colleagues to raise the bar when it comes to testing for and reporting sex differences.”

Historically, biomedical research has often included just one sex, usually biased toward males. In recent decades, laws have been passed requiring US medical research to include females in clinical trials and report the sex of human participants or animal subjects.

“If you’re trying to model anything relevant to a general population, you should include both sexes,” Prof Maney explained. “There are a lot of ways that animals can vary, and sex is one of them. Leaving out half of the population makes a study less rigorous.”

As more studies consider sex-based differences, Maney adds, it is important to ensure that the methods underlying their analyses are sound.

For the analysis, Prof Maney and co-author Yesenia Garcia-Sifuentes, PhD candidate, looked at 147 studies published in 2019 to see what is used for evidence of sex differences. The studies ranged across nine different biological disciplines, including field studies on giraffes and immune responses in humans.

The studies that were analysed all included both males and females and separated the data by sex. Garcia-Sifuentes and Prof Maney found that the sexes were compared, either statistically or by assertion, in 80% of the articles. Of those articles, sex differences were reported in 70% of them and of those treated as a major finding in about half.

Statistical errors were seen in some studies, with a significant difference for one sex but not the other counted as a difference between them.  The problem with that approach is that the statistical tests conducted on each sex can’t give “yes” or “no” answers about whether the treatment had an effect.

“Comparing the outcome of two independent tests is like comparing a ‘maybe so’ with an ‘I don’t know’ or ‘too soon to tell,'” Maney explains. “You’re just guessing. To show actual evidence that the response to treatment differed between females and males, you need to show statistically that the effect of treatment depended on sex. That is, to claim a ‘sex-specific’ effect, you must demonstrate that the effect in one sex was statistically different from the effect in the other.”

Conversely, their analysis also encountered strategies that could mask sex differences, such as pooling data from males and females without testing for a difference.

“At this moment in history, the stakes are high,” Maney says. “Misreported findings may affect health care decisions in dangerous ways. Particularly in cases where sex-based differences may be used to determine what treatment someone gets for a particular condition, we need to proceed cautiously. We need to hold ourselves to a very high standard when it comes to scientific rigor.”

Source: EurekAlert!

Menstrual Cycles May Impact PTSD Symptoms in Women

Photo by Sydney Sims on Unsplash

New research has found that post-traumatic stress disorder symptoms in women may vary over the course of the menstrual cycle, with more symptoms during the cycle’s first few days when the hormone oestradiol is low and fewer symptoms close to ovulation, when oestradiol is high.

The results could have implications for PTSD diagnosis and treatment, said lead author Jenna Rieder, PhD, an assistant professor of psychology at Thomas Jefferson University in Philadelphia. “When in the cycle you assess women might actually affect whether they meet diagnostic criteria for PTSD, especially for people who are right on the border. And that can have real practical implications, say, for someone who is a veteran and entitled to benefits or for health insurance purposes.”

The research was published in the journal Psychological Trauma: Theory, Research, Practice and Policy.

Oestradiol is a form of oestrogen that regulates the menstrual cycle. During the follicular phase, rising oestradiol levels trigger a cascade of events that result in ovulation. Studies have linked low-oestradiol portions of the cycle to greater activation in the limbic areas of the brain, which are related to emotion, and to lower activation in the prefrontal cortex when viewing emotional content. Low oestradiol has also been linked to greater stress and anxiety as well as increased fear responses.

To find out whether those links were related to traua response, researchers studied 40 women, aged 18 to 33, all of whom had experienced or witnessed a traumatic event, such as a serious injury or sexual violence. In the lab, researchers measured the participants’ level of oestradiol in their saliva, then asked them to describe the trauma that had happened to them and the PTSD symptoms they’d experienced in the past month. They found that lower oestradiol was associated with greater self-reported symptom severity in the participants.

The researchers also measured two stress biomarkers in participants’ saliva, the hormone cortisol and the enzyme salivary alpha-amylase, before and after the participants described their trauma. Salivary alpha-amylase is related to the “fight-or-flight” stress response, and cortisol is related to the body’s slower, more sustained stress response.

“In a healthy system we want a moderate, coordinated response of both of these biomarkers,” Prof Rieder said. In the women in the low-oestradiol portions of their menstrual cycles, the researchers instead found low cortisol and high salivary alpha-amylase levels resulting from recounting their trauma stories – a pattern that’s been linked in previous studies with maladaptive stress responses.

The researchers then asked the participants to answer five daily questionnaires for 10 days spanning the high- and low-oestradiol portions of their menstrual cycles. The questionnaires measured how participants were feeling at each time (from “extremely unpleasant” to “extremely pleasant” and “extremely nonstimulated or activated” to “extremely stimulated or activated”). Participants also completed a PTSD symptom checklist each evening.

Participants were found to have greater variability in their daily moods during the low-oestradiol days of their cycle and reported more severe PTSD symptoms on those days.

This could have implications for diagnosis and treatment of PTSD in women, who have long been underrepresented in PTSD research. “PTSD for a long time was mostly studied in men, in part because it was mainly studied in veterans, who were mostly men,” Prof Rieder said.

As well as its relevance to diagnosis, knowing how the menstrual cycle affects PTSD symptoms could be useful for both clinicians and patients, according to Prof Rieder. “I think this is something that clinicians would want to know, so they can impart this knowledge as part of psychoeducation,” she said. “For women who are naturally cycling, it may be useful to understand how the menstrual cycle affects their symptoms. When you can explain what’s happening biologically, it often becomes less threatening.”

Source: American Psychological Association

Men and Women Have the Same Emotional Turbulence

Photo by Monstera from Pexels

Contrary to widely held gender stereotypes, women are not more emotional than men, say researchers of a new study into emotional differences in gender.

Feelings such as enthusiasm, nervousness or strength are often interpreted differently between the two genders. It’s what being ’emotional’ means to men versus women that is part of a new University of Michigan study that dispels these biases.

For example, a man whose emotions fluctuate in a sporting event is described as “passionate” while a woman whose emotions change in any event, even if provoked, is considered “irrational,” said senior author Adriene Beltz, assistant professor of psychology.

Prof Beltz and colleagues followed 142 men and women over 75 days to learn more about their daily emotions, both positive and negative. The women were divided into four groups: one naturally cycling and three others who used different forms of oral contraceptives.

The researchers detected fluctuations in emotions three different ways, and then compared the sexes. Little to no differences were seen between the men and the various groups of women, suggesting that men’s emotions fluctuate to the same extent as women’s, although likely for different reasons.

“We also didn’t find meaningful differences between the groups of women, making clear that emotional highs and lows are due to many influences – not only hormones,” Prof Beltz said.

These findings could have implications for research, which has historically excluded women partly because ovarian hormone fluctuations result in variation, especially in emotion, which cannot be experimentally controlled, the researchers said.

“Our study uniquely provides psychological data to show that the justifications for excluding women in the first place (because fluctuating ovarian hormones, and consequently emotions, confounded experiments) were misguided,” Prof Beltz said.

Source: University of Michigan

Studies Find Females More Susceptible To Addiction

Photo by Tim Mossholder on Unsplash

Several new studies focusing on sex differences in pain and addiction suggest that females could be more susceptible to drug addiction and addiction-like behaviours than males. Researchers also investigated how sleep deprivation affected the likelihood of relapse, partly driven by hormone differences in females and males. The studies will be presented at the American Physiological Society’s seventh conference on New Trends in Sex and Gender Medicine from 19 to 22 October.

This study used a rat model to investigate the connection between opioid abstinence and persistent sleep loss and its impact on the body’s central stress response system. Researchers specifically found persistent sleep disruption may cause or perpetuate abnormalities in their hypothalamic-pituitary adrenal axis. These abnormalities increase the risk of vulnerability to relapse during oxycodone abstinence in some individuals. Scientists are now working to identify susceptibility factors that play a role in boosting the risk of relapse. Adequate sleep may be critical for successful recovery from opioid addiction.

Researchers conducting this study explored how the opioid epidemic in the US continues and evolved during the ongoing COVID pandemic. Women have made up the majority of those prescribed opioids for pain treatment. Prescribed opioids for pain management became the primary conduit to abuse and addiction for women, and the researchers found that mitigations in opioid prescriptions have been followed by increases in the use of other substances, such as heroin and fentanyl, in both men and women. While the rate of opioid use and overdose is higher in men, women have a higher rate of overdose death. Understanding how opioid use and addiction differ in their effect on men and women is key to ending the epidemic.

A rat model was also used to evaluate sex differences in vulnerability to addiction. Their results indicate activation of a specific subset of receptors for oestrogens enhances established cocaine-seeking behaviors in female rats. In male rats, the preference for cocaine under the same circumstances was reduced, involving the area of the brain linked to compulsive behaviours. Females show a greater response than males to stimulants such as amphetamine and cocaine in part due to the gonadal hormone oestradiol, which is one of the three forms of oestrogen. The hope is these results will lead to a better understanding of the mechanisms of addiction-related behaviors and the development of sex-specific treatments for addiction.

Source: American Physiological Society

Not Enough Women in Stroke Clinical Trials

Photo by Loren Joseph on Unsplash

A new study published in Neurology shows that women are underrepresented in stroke clinical trials compared to the proportion who have strokes in the general population. 

“Making sure there are enough women in clinical studies to accurately reflect the proportion of women who have strokes may have implications for future treatment recommendations for women affected by this serious condition,” said study author Cheryl Carcel, MD, of The George Institute for Global Health in Sydney, Australia. “When one sex is underrepresented in clinical trials, it limits the way you can apply the results to the general public and can possibly limit access to new therapies.”

The study analysed 281 stroke trials conducted between 1990 and 2020, with a total of 588 887 participants. Of these, only 37.4 % were women. The average prevalence of stroke in women across the countries included was 48%.

Results were calculated in participation-to-prevalence ratio, a relative measure that weights the percentage of women in a trial compared to their proportion in the total population with that disease. A ratio of one indicates that the percentage of women in the study is the same as the percentage of women with the disease in the general population. An acceptable range for an ideal ratio of female participation is between 0.8 and 1.2.

Overall, women were found to be underrepresented relative to their prevalence in the underlying population, with a consistent ratio of 0.84 over time. They found the greatest differences in trials of intracerebral haemorrhage, with a ratio of 0.73; trials with average participant age under 70, with a ratio of 0.81; non-acute interventions, with a ratio of 0.80; and rehabilitation trials, with a ratio 0.77.

“Our findings have implications for how women with stroke may be treated in the future, as women typically have worse functional outcomes after stroke and require more supportive care,” Dr Carcel said. “We will only achieve more equitable representation of women in clinical trials when researchers look at the barriers that are keeping women from enrolling in studies and actively recruit more women. People who fund the research also need to demand more reliable, sex-balanced evidence.”

Source: American Academy of Neurology

Gender Behavioural Differences Strengthened in Lockdown

Photo by Tim Mossholder on Unsplash

‘Stereotypical’ gender behaviour differences were exaggerated during the COVID lockdown in Austria, according to a recent study published in Scientific Reports

Men and women conducted themselves differently in the wake of the COVD lockdown in Austria, with women spending more time on the phone while men returned to crowded and public areas more quickly.

Using mobile phone data from 1.2 million devices in Austria (representing 15% of the population) across the first phase of the COVID pandemic, researchers quantified gender-specific patterns of communication intensity, mobility, and circadian rhythms. They noted the resilience of behavioural patterns with respect to the shock imposed by a strict nation-wide lock-down that Austria experienced in the beginning of the crisis with severe implications on public and private life. They found significant differences in gender-specific responses during the different phases of the pandemic. They found that following lockdown, gender differences in mobility and communication patterns increased massively, while circadian rhythms tended to synchronise.

In particular, women had fewer but longer phone calls than men during the lock-down. Phone calls involving women lasted significantly longer on average, with big differences depending on who was calling whom. After the first lockdown in Austria was imposed on March 16, calls between women were up to 1.5 times longer than before the crisis (140% increase), while calls from men to women lasted nearly twice as long. Conversely, when women called men, they talked 80 percent longer, while the duration of calls between men rose only by 66 percent.

“Of course, we don’t know the content or purpose of these calls,” says Georg Heiler, a researcher at CSH and TU Wien, who was responsible for data processing. “Yet, literature from the social sciences provides evidence — mostly from small surveys, polls, or interviews — that women tend to choose more active strategies to cope with stress, such as talking with others. Our study would confirm that.”

Mobility declined massively for both genders, however, women tended to restrict their movement stronger than men. Women also showed a stronger tendency to avoid shopping centres and more men frequented recreational areas. 

After the lockdown, males returned back to normal quicker than females; and young and adolescent age-cohorts returned much quicker. An age stratification highlights the role of retirement on behavioural differences. They found that the length of a day for men and women is reduced by one hour. 

Source: Complexity Science Hub Vienna

Study Highlights Role of Sex Hormones in Behavioural Development

Photo by Ben Wicks on Unsplash

A new study shows that sex hormones are important for developing gender role behaviours in boys, such as active play.

In laboratory animals, sex differences in behaviour arise from different hormone levels produced by males and females influence patterns of gene expression in the developing brain. However, the origins of sex differences in human behaviour are not as well understood.

“In the lab, you can do experiments on how these hormones affect animal brains and perform other experimental manipulations. We can’t do those things to people, so we looked to a natural experiment,” explained study leader David Puts, associate professor of anthropology.

Prof Puts and his collaborators made use of a natural experiment called isolated GnRH deficiency (IGD), a rare endocrine disorder. Individuals with IGD lack sex hormones from the second trimester of development right through until they begin hormone replacement therapy to induce puberty. However, as the external genitals develop earlier, during the first trimester, people with IGD are clearly male or female at birth, and are raised according to their sex. 

IGD therefore presents the chance to study the behaviour of those raised as boys but exposed to low testicular hormones, or raised as girls but exposed to low ovarian hormones.

The researchers compared 97 individuals with IGD (a small number due to its rarity) to 1665 individuals with typical hormonal development. Differences in behaviour were investigated; boys being encouraged toward active play, girls pushed to more passive pursuits. The researchers asked subjects to recall behaviours they had as children.

“We asked them, ‘When you read a book, were you the male or female in the story?’, ‘Where your friends boys or girls?’, ‘Did you play with dolls or trucks?’,” said Talia N Shirazi, doctoral recipient in anthropology now working in the reproductive health industry.

These childhood gender role behaviours are among the largest differences in behaviour between sexes, Prof Puts said. Typically, males will say they were the male character, played with other boys and preferred trucks, while females will say they were the female character, played with other girls and preferred dolls.

However, males with IGD reported more gender non-conforming in this regard. The researchers found in that men with IGD recalled a higher level of childhood gender non-conformity than typical men, while women with IGD did not differ from typical women in childhood gender conformity.

‘”We don’t see this effect in the women with IGD,” said Shirazi, indicating that low levels of ovarian hormones does not significantly impact childhood gender role behaviours.

“Our results suggest that in humans, androgens, such as testosterone produced by the testes, influence male brain development directly as they do in other mammals, rather than only indirectly by influencing external appearance and consequently gender socialisation,” said Prof Puts. “Both the direct influence of androgens on the developing brain and gender socialisation probably play important roles in producing sex differences in childhood behaviour.”

Prof Puts and Shirazi agree that despite their modest sample of participants with IGD, they are encouraged that the results were very similar in subjects who came from a clinical setting and those recruited from support groups.

“It would be nice to be able to identify people with IGD when they are younger, before they reach what should be puberty,” said Shirazi. “We need to focus on recruitment for our studies because there is a lot that can be learned about the cause of gender behaviours.”

Source: Penn State