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A new study has uncovered significant hormonal and biochemical differences between men and women with Alcohol Use Disorder (AUD), suggesting the need for sex-specific treatments to improve outcomes. The findings, presented at the 37th European College of Neuropsychopharmacology (ECNP) Congress in Milan, indicate that the biochemical markers associated with alcohol dependence differ between the sexes, which could explain why men and women may respond differently to treatment.
Historically, it has been recognized that men and women exhibit different patterns of alcohol misuse and related health issues. However, the underlying biological mechanisms have been poorly understood. This study, led by Professor Victor Karpyak from the Mayo Clinic in Rochester, Minnesota, marks a significant step forward in understanding how hormones and other biomarkers influence alcohol dependence.
Sex-Specific Biochemical Differences
In their research, the scientists studied 268 men and 132 women diagnosed with AUD. The participants were analyzed for sex-specific blood markers, including sex hormones like testosterone, estrogen, and progesterone, and proteins that affect the bioavailability of these hormones, such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG). These biochemical markers were then correlated with psychological traits like depression, anxiety, and alcohol craving, as well as treatment outcomes.
The researchers found notable differences in the biochemistry of alcohol dependence between men and women. Men with AUD, for example, were more likely to exhibit lower levels of testosterone, estrone, estradiol, and SHBG, especially if they had symptoms of depression or stronger alcohol cravings. Interestingly, no similar associations were observed in women.
On the other hand, women with higher levels of testosterone, SHBG, and albumin were more prone to relapse during the first three months of treatment. This hormonal profile was not linked to relapse risk in men, further supporting the need for sex-specific treatment approaches.
Implications for Treatment
The study’s lead researcher, Professor Karpyak, emphasized the potential for these findings to transform the way AUD is treated. “What works for a man may not work for a woman, and vice versa. This is the first large-scale study to confirm that hormonal and biochemical differences contribute to how alcoholism manifests and how individuals respond to treatment.”
Given the complex relationship between hormones and behavior, Karpyak added that understanding the effects of hormonal fluctuations—such as those occurring during a woman’s menstrual cycle or menopause—could provide new insights into treating alcohol dependence more effectively.
The Path Forward
Dr. Erika Comasco, a molecular psychiatry expert at Uppsala University in Sweden, who was not involved in the study, praised the research as a critical step toward gender equity in medicine. “These findings offer valuable insights into the relationship between sex hormones and alcohol use disorder treatment, highlighting the potential for sex-specific pharmacological interventions.”
While the study brings us closer to understanding the role of sex hormones in alcohol dependence, more research is needed to determine how these differences impact disease progression and long-term treatment strategies. For women, in particular, hormone fluctuations related to the menstrual cycle and menopause may significantly influence treatment responses, warranting further exploration.
As the scientific community continues to uncover the biological differences between men and women in alcohol dependence, these findings pave the way for more personalized, effective treatments that account for gender-specific factors.
Presented at the ECNP Congress
This groundbreaking research was presented at the 37th ECNP Congress, which took place in Milan from September 21 to 24, 2024. For more information, visit www.ecnp.eu/Congress2024/ECNPcongress.
