Tag: gender

Categories : COVID Gender GeneticsTags :

Severe COVID and Male Balding Gene Linked

On By ModernMedia
Photo by Brett Sayles from Pexels

While COVID has been long known to be more dangerous in men than women, research which is still in its early stages shows that some of this increased risk could be from having a gene for male balding. 

A team of researchers in the US first suspected the link when they noticed that men with a common form of hormone-sensitive hair loss, known as androgenetic alopecia, were also more likely to be hospitalised with COVID.  They presented their findings May 6 at the virtual spring meeting of the European Academy of Dermatology and Venereology (EADV).

“Among hospitalized men with COVID-19, 79% presented with androgenetic alopecia compared to 31%-53% that would be expected in a similar aged match population,” said researchers led by Dr Andy Goren, chief medical officer at Applied Biology Inc in California. 

The researchers noted that androgenetic alopecia is due to the activity of the androgen receptor (AR) gene, which can lead to balding in some men. An enzyme called TMPRSS2, key to COVID infection, is also androgen-sensitive, and might be affected by the AR gene as well, explained Dr Goren’s group.

One key segment on the AR gene seems to affect both COVID severity and male balding.

In the new study, the Irvine group enrolled 65 men hospitalised with COVID, and conducted a genetic analysis on them. The results showed that participants with certain structural differences in the AR gene were at greater risk of developing severe COVID. Speaking in a meeting press release, Goren said the AR gene anomaly “could be used as a biomarker to help identify male COVID-19 patients most at risk for ICU admissions.”

He added that he believes that “the identification of a biomarker connected with the androgen receptor is another piece of evidence highlighting the important role of androgens [male hormones] in COVID-19 disease severity.”

Dr Teresa Murray Amato  has seen many severe cases of COVID. She is chair of emergency medicine at Long Island Jewish Forest Hills in New York City. Though not connected to the new research, but said it “did show a significant correlation between a higher number of androgen receptors and a higher incidence of ICU admissions for patients infected with COVID-19.”

Dr Amato added that, “While the study is small and the exact association is not completely understood, it may show at least one answer to why men were more likely to be admitted to ICU and have overall higher morality with COVID-19 infections.”

According to Amato, further investigations are necessary to determine whether “medications that block androgen receptors will be useful in treating a subset of [COVID-19] patients.”

Since the findings were presented at a medical meeting, they should be considered preliminary until published in a peer-reviewed journal.

Source: Medical Xpress

Categories : Cardiovascular DiseaseTags :

Earlier, Improved MRI Detects ‘Broken-heart’ Syndrome

On By ModernMedia

A new study from Karolinska Institutet in Sweden suggests that early magnetic resonance imaging (MRI) of the heart can greatly increase the rate of diagnosis of broken-heart syndrome, which can happen when there is no obvious cause in the coronary artery. 

Myocardial infarction is typically caused by a blockage of the coronary artery by a blood clot. However, in up to 10% of all myocardial infarctions, no obvious cause in the coronary artery is found, and so the working diagnosis MINOCA (myocardial infarction with non-obstructive coronary arteries) is given, which can subsequently lead to one of several diagnoses.

Most of these patients are women, many of whom are diagnosed with takotsubo cardiomyopathy (broken-heart syndrome), characterised by reduced heart function that is likely stress-related, presenting the same symptoms as a standard heart attack.

“Around 80 to 90% of broken-heart sufferers are women, and the disease is associated with mental stress,” said principal investigator Per Tornvall, senior physician and professor at the Department of Clinical Science and Education, Stockholm South General Hospital, Karolinska Institutet. “There also seems to be a link to hypersensitivity towards stress caused by low estrogen levels. Unfortunately, research on the investigation and treatment of myocardial infarction is often done on men, while female heart disease is less studied.”

In a prior study with 150 patients, cardiovascular magnetic resonance (CMR) is often done when examining patients with MINOCA. CMR conducted approximately 10 days after onset can result in a diagnosis in under half the patients, normally takotsubo or myocarditis (inflammation of the heart muscle), Now, the same researchers have tested a new, more sensitive CMR technique two to four days after onset on a comparable group of 148 patients. They found that 77% of the patients could be diagnosed: 35% of takotsubo and 17% of myocardial inflammation, compared with 19 and 7%, respectively, in the first study.

“We don’t know how much effect the improved CMR technique has, but the results suggest that with early examination more patients can get a correct diagnosis and therefore the right treatment,” says Professor Tornvall. “The next step is for us to develop the CMR examination with pharmacological stress of the heart. This will enable us to study the smallest of the blood vessels and hopefully find a cause for the 23% who received no diagnosis.”

Source: Medical Xpress

Journal information: Peder Sörensson et al. Early Comprehensive Cardiovascular Magnetic Resonance Imaging in Patients With Myocardial Infarction With Nonobstructive Coronary Arteries, JACC: Cardiovascular Imaging (2021). DOI: 10.1016/j.jcmg.2021.02.021

Categories : Gender Injury & TraumaTags :

Girls at Almost Double The Risk of Concussion in American Football

On By ModernMedia

In high school American football, girls are at nearly double the risk of concussion compared to boys, according to a new study. Girls are also less likely to be removed from play and take longer to recover from the injury than their male counterparts.

Researchers at the University of Pennsylvania and Michigan State University along with Prof Willie Stewart, Honorary Professor at the University of Glasgow reviewed three years of injury data for a population of around 40 000 female high school American footballers in the Michigan High School Athletic Association, comparing them to a similar number of their male counterparts.

They found that, as seen in previous studies, the risk of sports related concussion among female footballers was 1.88 times higher than among males. The researchers also identified several sex-associated differences in sports concussion mechanism and management. This provides new insight into this kind of injury in this demographic. 

Male footballers tended to be injured in collisions with another player and were 1.5 times more likely than females to be removed from play on the day of injury. Female footballers were most often injured from impacts involving equipment, such as the ball or a goalpost, and also took on two days longer on average to recover from injury and return to play. A recent study however showed no differences for concussion recovery time among male and female college athletes, but there could be differences depending on the type of sport.

These sex-associated differences among teenage athletes in mechanism of injury and in management and outcomes of concussion raise the question of whether sports should consider the adoption of sex specific approaches to both participation and concussion management.

Lead author Dr Abigail Bretzin, postdoctoral fellow and certified athletic trainer at the University of Pennsylvania, said: “This is the first study to look in this detail at sex-associated differences in concussion management and outcomes in teenage footballers. Our findings add to research showing that female athletes are at increased concussion risk compared to male athletes, and highlight the importance of sex-specific research in this field.”

Senior author Prof Stewart, said: “Given we know the importance of immediate removal from play for any athlete with suspected concussion, it is notable that “if in doubt, sit them out” appears more likely to happen for boys than girls. This, together with the finding that mechanism of injury appears different between boys and girls, suggests that there might be value in sex-specific approaches to concussion education and management in this age group.”

Source: Medical Xpress

Journal information: Abigail C. Bretzin et al. Association of Sex With Adolescent Soccer Concussion Incidence and Characteristics, JAMA Network Open (2021). DOI: 10.1001/jamanetworkopen.2021.8191

Categories : HIVTags :

People Most in Need of PrEP Don’t Use It

On By ModernMedia

Though sexual minority men and transgender women are aware of pre-exposure prophylaxis (PrEP), a daily pill to prevent HIV infection, few are currently taking it, a New York-based study has found.

The study, published in the journal AIDS and Behavior, surveyed 202 young sexual minority men and transgender women, who are two high-priority populations for HIV prevention, to better understand the factors in their taking PrEP or not.

According to the Centers for Disease Control and Prevention, sexual minority men are the community most impacted by HIV, making up 69% of all new diagnoses in 2018, and transgender populations are disproportionately affected by HIV and prevention challenges. While Black and Hispanic populations are mostly likely to be newly diagnosed with HIV, PrEP users are more likely to be white.

The research team, who is from the Rutgers School of Public Health’s Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), found that while 98 percent of the study’s participants were aware of PrEP, less than 25 percent were currently taking it.

“It was surprising that so few participants were using PrEP, but we were happy to see that there were no racial or ethnic disparities in who was using it,” Caleb LoSchiavo, Study Co-Author and Doctoral Candidate, School of Public Health, Rutgers University. “I think the study results point to the effectiveness of local efforts to increase the use of PrEP for those who need it most.”

While the study PrEP found no differences in use use, it also found racial and ethnic differences in factors associated with taking it. White participants were more likely to use PrEP with increased age, and were less likely to use it if they held concerns about daily medication use. Participants of colour, however, were more likely to use PrEP if they received information about it from a health care provider and if they had more positive beliefs about its use.

“Our study highlights the importance of clinicians in expanding the use of HIV prevention methods like PrEP among those who need it most, both through informing their patients about PrEP and through combating stigmatizing beliefs about PrEP use,” said senior study author Perry N Halkitis, dean of the Rutgers School of Public Health and director of CHIBPS.

The researchers said that the study emphasised the importance of PrEP education in clinical settings.

“Positive public health messaging about PrEP must reframe risk, combat stigma and normalize preventive healthcare,” LoSchiavo said.

Source: News-Medical.Net

Journal information: Jaiswal, J., et al. (2021) Correlates of PrEP Uptake Among Young Sexual Minority Men and Transgender Women in New York City: The Need to Reframe “Risk” Messaging and Normalize Preventative Health. AIDS and Behavior. doi.org/10.1007/s10461-021-03254-4.

Categories : Gender Pain ManagementTags :

Unique Genetic Basis for Chronic Pain in Women Discovered

On By ModernMedia

A meta-analysis of UK genetic data has found a different genetic basis for chronic pain in women compared to men.

While the results are still preliminary, this is one of the largest genetic studies on chronic pain analysing by sexes.

“Our study highlights the importance of considering sex as a biological variable and showed subtle but interesting sex differences in the genetics of chronic pain,” said population geneticist Keira Johnston of the University of Glasgow in Scotland.

Chronic pain conditions are among the most prevalent, disabling, and expensive conditions in public health, and are frequently overlooked for research funding. With 100 million people in chronic pain in the US in 2016, overprescription of opioids for chronic pain has resulted in an epidemic of opioid misuse, with 66% of overdose cases being for opioids. Even very moderate opioid use carries the risk of addiction and abuse.

Even when studies are done, they often overlook underlying sex differences, and that’s a huge and detrimental oversight. Compared to men, women are far more likely to develop multiple chronic pain disorders, and yet historically, 80 percent of all pain studies have been conducted on male mice or male humans. This means we know very little about how and why females are suffering more and what treatments can help them best.

While there are probably multiple biological and psychosocial processes in this sex discrepancy, the current genome-wide study suggests there’s a genetic factor in the mix, too.

The researchers compared gene variants associated with chronic pain in 209 093 women and 178 556 men from the UK Biobank, and found 31 genes associated with chronic pain in women and 37 genes associated with chronic pain in men with barely any overlap. This might be due to the slightly smaller sample size of men but the results are nonetheless intriguing, the researchers maintained.

The vast majority of these genes were active in a cluster of nerves within the spinal cord, known as the dorsal root ganglion, which transmits messages from the body to the brain.
While several genes in the male-only or female-only list were linked with psychiatric disorders or immune function, only one, called DCC, was found in both lists.
DCC encodes for a receptor that binds with a protein crucial for the development of the nervous system, especially the dopaminergic system. The dopaminergic system is the ‘reward centre’ but also has been linked to pain.

DCC is also linked to depression, and DCC mutations appear in those with congenital mirror movement disorder, which results in movements on one side of the body being replicated on the other side.

It’s not how DCC is linked to chronic pain, but the researchers believe their results support several theories “of strong nervous system and immune involvement in chronic pain in both sexes”, which will, they hope, result in the development of better treatments.

Should chronic pain be more closely linked to immune function in women, immune-targeting drugs may have very different side-effects than in men. Opioids negatively impact immune function, indicating that they could in fact worsen the situation for women suffering chronic pain. However, more research is needed to strengthen these findings and understand their impacts.

“All of these lines of evidence, together, suggest putative central and peripheral neuronal roles for some of these genes, many of which have not been historically well studied in the field of chronic pain,” the authors concluded.

Source: Science Alert

Journal information: Johnston KJA, Ward J, Ray PR, Adams MJ, McIntosh AM, Smith BH, et al. (2021) Sex-stratified genome-wide association study of multisite chronic pain in UK Biobank. PLoS Genet 17(3): e1009428. doi.org/10.1371/journal.pgen.1009428

Categories : Diet and NutritionTags :

Low Fat Diets Reduce Testosterone

On By ModernMedia

A new study has found that low fat diets decrease men’s testosterone levels by 10-15%, with important considerations for health.

Optimal testosterone levels are a crucial part of men’s health, with higher risks of heart disease, diabetes, and Alzheimer’s disease resulting from low levels of the hormone. Healthy testosterone levels are also key for men’s athletic performance, mental health, and sexual health. Clinically low testosterone rates are referred to as hypogonadism.

Men’s testosterone levels have been falling since the 1970s but low risk dietary strategies could be a useful treatment for low testosterone.

In a systematic review and meta-analysis, the researchers analysed the results of six well-controlled studies with a total of 206 participants. Men were first put on a high fat diet (40% fat), and then switched to a low fat diet (20% fat), with testosterone levels decreasing by 10-15% on average. Particularly bad were vegetarian low fat diets causing decreases in testosterone up to 26%.

Previous studies conducted in humans and mice found that high intakes of monounsaturated fats found in olive oil, avocados, and nuts may boost testosterone production. However, omega 6 polyunsaturated fats predominantly found in vegetable oils, may in fact damage the cells’ ability to produce testosterone. This is because highly unsaturated fats such as polyunsaturated fats are more prone to oxidation, causing damage to the cells.

“Low testosterone levels are linked to a higher risk of heart disease, diabetes, and Alzheimer’s disease.”

More research needs to be done in this area, said the researchers.

“Ideally, we would like to see a few more studies to confirm our results. However, these studies may never come, normally researchers want to find new results, not replicate old ones. In the meantime, men with low testosterone would be wise to avoid low fat diets.” said lead researcher Joseph Whittaker.

A controversial topic in nutritional science, dietary fibre has proponents of various diets often in stark disagreement over low fat versus low carbohydrates. Low fat diets have benefits such as reduced cholesterol levels, which should be weighed up against the potential downsides, such as decreased testosterone levels.

Traditionally, dietary guidelines have focused on limiting fat intake, with the current UK and US guidelines limiting fat intake to less than 35% of total calories. However, as more research on the benefits of high fat, low carbohydrate diets is done, this traditional view is coming under increasing scrutiny. Recent research has shown that high fat diets can decrease triglycerides, decrease blood pressure, increase HDL cholesterol (aka ‘good cholesterol’), and now it was found that it can increase testosterone levels.

Source: News-Medical.Net

Journal information: Whittaker, J & Wu, K (2021) Low-fat diets and testosterone in men: Systematic review and meta-analysis of intervention studies. The Journal of Steroid Biochemistry and Molecular Biology. doi.org/10.1016/j.jsbmb.2021.105878.

Categories : GenderTags :

Evidence for Puberty Blockers is ‘Very Low’ Says UK Guidance Body

On By ModernMedia

In an official review of studies, the UK’s National Institute of Health and Care Excellence (NICE) said that the evidence for puberty blockers is “very low”.

In an assessment of the evidence for puberty blockers commissioned by NHS England, the guidance body said that existing studies of the drugs were small and “subject to bias and confounding”. The assessment forms part of a review into gender identity services for children and young people.

NHS England said the advice would be considered by the review and it would not be commenting further.

Gonadotrophin-releasing hormone (GnRH) analogues, popularly known as puberty blockers, are prescribed to some young people with gender dysphoria – distress caused by a discrepancy between a person’s gender identity (how they see themselves regarding their gender) and their sex at birth.

The NICE evidence review looked at what impact puberty blockers had on gender dysphoria, mental health – such as depression, anger and anxiety – and quality of life.

NICE, which provides national guidance and advice to improve health and social care, said: “The quality of evidence for these outcomes was assessed as very low certainty.”

The review sought to find out how treatment with GnRH analogues compared in terms of clinical effectiveness with other interventions that may be offered to young people with gender dysphoria. These include psychological support, social transitioning to the desired gender – such as changing pronouns and clothes but without medication – or no intervention at all.

NICE found it was difficult to draw conclusions from existing studies because they were “all small” and lacked control groups. They found other issues with the studies too, such as not describing what other physical and mental health problems a young person may have alongside gender dysphoria.

The review said there was “very little data” on any additional interventions, such as counselling or other drug treatments, that the young people may have received alongside taking puberty blockers, leading to possible bias in results. Impacts of puberty blockers on bone density were another concern.

However without a “comparator group”, it was not known whether bone density changes observed “are associated with GnRH analogues or due to changes over time”.

It is argued by some that it is difficult to withhold support to create a comparator group because it would mean unfairly disadvantaging some. NICE accepted this, but said offering psychological support to compare puberty blockers “may reduce ethical concerns in future trials”.

No evidence of cost-effectiveness of treatment was found by the review.

NICE also reviewed the evidence base for gender-affirming hormones, which can be given to young people with gender dysphoria from age 16 in the NHS. These start the development of the physical sex characteristics of the gender with which they identify with the aim of improving mental health, quality of life and body image.

The review found the evidence of clinical effectiveness and safety of gender-affirming hormones was also of “very low” quality.

“Any potential benefits of gender-affirming hormones must be weighed against the largely unknown long-term safety profile of these treatments in children and adolescents with gender dysphoria,” NICE said.

Source: BBC News

Categories : Cardiovascular Disease GenderTags :

Cardiovascular Diseases in Transgender Youth

On By ModernMedia

Young transgender people face a higher risk of cardiovascular diseases, according to a new study.

Anna Valentine, MD, of the University of Colorado Anschutz Medical Campus in Aurora, presented the findings of her team’s study at the Endocrine Society’s virtual ENDO 2021 meeting. Existing research shows increased cardiovascular risks in adult transgender people.

Researchers found that transgender youths assigned female at birth had a higher risk of obesity compared to cisgender female youths, as well as a nearly doubled chance of polycystic ovary syndrome. However, transgender youth did not have an increased risk of hypertension, dysglycaemia, or liver dysfunction.

These differences could be explained by any number of different mechanisms, Dr Valentine explained. “We know that some youth with gender dysphoria have higher rates of overweight and obesity, and that having overweight and obesity itself increases your risk of having other diagnoses.” It is also known that “youth with gender dysphoria have higher rates of mental health comorbidities … as well as getting less physical activity,” she said.

“And they also may be taking medication that could all influence their cardiometabolic health,” she added.

Adult transwomen taking estradiol are more likely to have higher levels of triglycerides and a higher rate of stroke, blood clots, and myocardial infarction (MI). Adult trans men are at greater risk of elevated triglycerides, low-density lipoprotein cholesterol, and body mass index (BMI), as well as lower high-density lipoprotein cholesterol, and an increased risk of MI.
The data of 4174 paediatric patients (average age of 16) diagnosed with gender dysphoria, were compared with 16 651 cisgender controls. This data came from six large paediatric centres. Participants were matched with four controls.

However, the data did not include information on which participants were receiving hormonal treatment, which is something that Dr Valentine is looking to address in her research.

“We do know that in the adult data, that there is some association with estradiol use and testosterone use with differences in cholesterol parameters, but this is still an emerging field in paediatrics,” Dr Valentine explained. “We have some small single-center studies that sometimes say ‘yes, with hormones we see an increase in BMI,’ but other studies say ‘this section looks very stable on this hormone’.”

“The fact that we have such a large cohort in this multicentre analysis for our next steps, I think it will be really interesting to look at that,” she added.

Source: MedPage Today

Presentation information: Valentine A, et al “Multicenter analysis of cardiometabolic-related diagnoses in transgender adolescents” ENDO 2021.

Categories : Pain ManagementTags :

Dopamine Affects Pain Differently in Female and Male Mice

On By ModernMedia

Researchers have found that dopamine affects the neurons of male and female mice in different ways, a discovery which could have great potential in pain management for women, who suffer pain disproportionately throughout their lives.

Dopamine, popularly known as the brain’s ‘pleasure chemical’, is implicated in many functions, including the reward pathways and also the pain-relieving pathways associated with heroin that the researchers were focussing on. Dopamine is also suggested to be involved in attention, suggesting a link between substance abuse, pain and attention.

“We focused on this neural pathway because our previous work and that of others show that specific neurons release dopamine to regulate pain responses,” explained Thomas Kash, PhD, the John R Andrews Distinguished Professor of Pharmacology, School of Medicine lab, University of North Carolina. “Unfortunately, that research was done only in male mice. So we decided to look at both male and female mice, and what we found was very surprising.”

Previous research from Dr Kash’s lab using male mice showed that dopaminergic neurons were key in how opiates dampen pain, likely through dopamine and glutamate release. The new experiments focussed on a neural pathway starting at the midbrain region called the periaqueductal grey, including part of the dorsal raphe.

This brain region is involved in behavioural adaptation, which is the way animals respond to their environment. The dopamine-producing neurons in this region form a neural pathway with a structure known as the bed nucleus of the stria terminalis (BNST). 

“We found that activating this pathway reduced pain sensitivity in male mice, but made female mice move more, especially in the presence of something capturing their attention,” said first author Waylin Yu, PhD, a former graduate student in the Kash lab and current postdoctoral researcher at UC San Francisco. “We think this is because of the different ways males and females respond to pain.”

This seems to indicate that dopamine helps male mice simply not feel as much pain, while female mice are able to focus their attention elsewhere while experiencing pain.

While further investigation is needed, the results appear to show that the activation of specific neural projections to the BNST reduces acute and persistent inflammatory pain. This adds to the evidence that dopamine signaling can enhance the blocking of pain stimuli, counteracting severe pain.

“We hope to investigate how this pathway can regulate more emotional behaviours associated with chronic pain, and then also look at the dynamics of the system, such as how this pathway works in real time during behaviour measurements,” Dr Kash said. “These neurons are also implicated in the actions of opioids such as morphine, so we plan to investigate that domain, as well.”

Source: News-Medical.Net

Categories : Gender HospitalsTags :

UK Says ‘Strong Evidence’ of Gender Health Gap Exists

On By ModernMedia
Woman in a hospital bed. Photo by Andrea Piacquadio from Pexels.

As an inquiry into the disparity of health service provision to women begins this week, Ministers in the UK say there is “strong evidence” of a gender gap.

The Women’s Health Strategy will speak to women and girls over the next 12 weeks on a variety of issues, ranging from maternity care to mental health.

Nadine Dorries, minister for women’s health, said: “Women’s experiences of healthcare can vary and we want to ensure women are able to access the treatment and services they need.

“It’s crucial women’s voices are at the front and centre of this strategy so we understand their experiences and how to improve their outcomes.”

Patients have told the BBC they have felt overlooked in conditions like endometriosis, or procedures such a pelvic floor mesh.

There is less knowledge on female conditions and their treatment among clinicians. Despite the fact that they make up half of the population, female conditions are often considered a ‘niche’ area. Research shows that a large part of the problem is due to the fact that clinical trials have  failed to take into account gender. Eight out of ten drugs that were withdrawn in the US between 1997 and 2000 were as a result of side effects in women.
While campaigners have welcomed the view, they say that it is still vital to listen to women’s views and act on them.

Gill Walton, chief executive of the Royal College of Midwives, said: “We know that placing women at the centre of their own care not only improves outcomes in pregnancy, but also improves a woman’s experience of birth and maternity care.”

Mika Simmons, co-chair of the Ginsburg Women’s Health Board, filmmaker, and host of The Happy Vagina podcast, said: “Every single woman I speak to, myself included, has experienced either misunderstanding or loss as a direct result of slow or inaccurate diagnosis of their health concerns.

“I am delighted that this – the gender health gap – which grew out of a severe lack of historical research into women’s health issues, is not only finally being acknowledged but that steps are being taken to right size it.”

Source: BBC News