Autism spectrum disorder involves challenges in social communication and restricted, repetitive behaviors. Historically, males have received autism diagnoses at comparatively high rates, prompting an underrepresentation of females in research and an incomplete understanding of sex-specific symptom presentations and comorbidities. This review examines sex differences in the prevalence of common comorbidities of autism to inform tailored clinical practices. These conditions include attention deficit hyperactivity disorder, anxiety disorders, conduct disorder, depression, epilepsy, intellectual disability, and tic disorders. Attention deficit hyperactivity disorder is prevalent in both sexes; however, females may more frequently exhibit the inattentive subtype. Anxiety disorders display inconsistent sex differences, while conduct disorder more frequently impacts males. Depression becomes more common with age; some studies indicate more pronounced symptoms in adolescent girls, while others suggest greater severity in males. Epilepsy is more prevalent in females, especially those with intellectual disabilities. Despite displaying a male predominance, intellectual disability may exacerbate the severity of autism to a greater degree in females. No clear sex differences have been found regarding tic disorders. Overall, contributors to sex-based differences include biases stemming from male-centric diagnostic tools, compensatory behaviors like camouflaging in females, genetic and neurobiological differences, and the developmental trajectories of comorbidities. Recognizing these factors is crucial for developing sensitive diagnostics and sex-specific interventions. Inconsistencies in the literature highlight the need for longitudinal studies with large, diverse samples to investigate autism comorbidities across the lifespan. Understanding sex differences could facilitate earlier identification, improved care, and personalized interventions, thus enhancing quality of life for individuals with autism.
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Sexually transmitted infections (STIs) continue to pose significant public health
challenges in Korea, with syphilis, gonorrhea, chlamydia,
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, Jieun Jang, Nayoung Kim Citations
, Eunha Kim Neurodevelopmental disorders, which emerge early in development, include a range of neurological phenotypes and exhibit marked differences in prevalence between sexes. A male predominance is particularly pronounced in autism spectrum disorder (ASD). Although the precise cause of ASD is still unknown, certain genetic variations and environmental influences have been implicated as risk factors. Preclinical ASD models have been instrumental in shedding light on the mechanisms behind the sexual dimorphism observed in this disorder. In this review, we explore the potential processes contributing to sex bias by examining both intrinsic differences in neuronal mechanisms and the influence of external factors. We organize these mechanisms into six categories: 1) sexually dimorphic phenotypes in mice with mutations in ASD-associated genes related to synaptic dysfunction; 2) sex-specific microglial activity, which may disrupt neural circuit development by excessively pruning synapses during critical periods; 3) sex steroid hormones, such as testosterone and allopregnanolone, that differentially influence brain structure and function; 4) escape from X chromosome inactivation of the O-linked-N-acetylglucosamine transferase gene in the placenta; 5) sexually dimorphic activation of the integrated stress response pathway following maternal immune activation; and 6) immunological responses that are differentially regulated by sex. Understanding these mechanisms is essential for deciphering the underlying causes of ASD and may offer insights into other disorders with notable sex disparities.
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, Won Kim Understanding the effects of sex and sex differences on liver health and disease is crucial for individualized healthcare and informed decision-making for patients with liver disease. The impact of sex on liver disease varies according to its etiology. Women have a lower prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) than men. However, postmenopausal women face a higher risk of advanced liver fibrosis due to hormonal influences. Sex differences affect the pathogenesis of MASLD, which involves a complex process involving several factors such as hormones, obesity, and the gut microbiome. Furthermore, sex-related differences in the development of MASLDrelated hepatocellular carcinoma have been observed. The sex-specific characteristics of MASLD necessitate an individualized management approach based on scientific evidence. However, research in this area has been lacking. This article reviews the current understanding of sex differences in MASLD.
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, Heisook Lee This review aims to highlight the importance of research on structural, functional, molecular-biological, and disease-specific sex differences in the brain, and to examine current bibliometric indicators related to research on sex differences. The Web of Science Core Collection was searched for related articles from 2010 to 2023. Structural and functional brain differences according to sex, including variations in communication patterns between hemispheres, may play a role in mental disorders. Sex differences in neurotransmitters such as serotonin, dopamine, and γ-aminobutyric acid contribute to disparities in mental health, addiction, and neurodevelopmental conditions. Neurodevelopmental disorders such as autism spectrum disorder and schizophrenia exhibit sex-based differences in prevalence, symptoms, brain changes, and neurotransmitter disruptions under hormonal influence. There is a growing body of research on depression, adolescence, the hippocampus, the amygdala, and cognition, highlighting the importance of considering sex/gender factors. Recent studies on sex differences in brain diseases have identified variations in brain structure, function, and neurophysiological substances, as well as in hormones and genes between the sexes. The incidence of psychiatric disorders such as autism spectrum disorder, depression, anxiety, and Alzheimer’s disease is increasingly being linked to sex differences, and the need for research into the mechanisms underlying these differences is gaining recognition. However, there remains a significant gap in sex-specific neuroscience research related to the diagnosis, treatment, prevention, and management of these conditions. Advancing inclusive research will require comprehensive training, a consensus on methodology, diverse perspectives through collaborative frameworks, governmental/institutional support, and dedicated funding to create suitable research environments and implementation strategies.
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Coronary artery disease (CAD) remains the leading cause of mortality worldwide, driven primarily by atherogenesis. Recent efforts to understand sex differences in CAD have revealed distinct patterns in disease burden, risk factors, and clinical presentations. This review examines these sex differences in CAD, underscoring the importance of customized diagnostic and management strategies. Although men typically have higher rates of CAD prevalence and incidence, women face unique challenges, such as delayed diagnosis, atypical symptoms, and lower rates of medication prescription. Hormonal, genetic, and lifestyle factors all play a role in these disparities, with estrogen notably reducing CAD risk in women. Nontraditional risk factors, including chronic inflammation, psychological stress, socioeconomic status, and reproductive history, also contribute to CAD development and are often neglected in clinical settings. Addressing these differences requires increased awareness, more accurate diagnosis, and equitable healthcare access for both sexes. Furthermore, greater inclusion of women in CAD research is essential to better understand sex-specific mechanisms and optimize treatment outcomes. Personalizing CAD management based on sex-specific knowledge has the potential to improve prognosis and decrease disease incidence for both men and women.
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, Ssirai Kim, Sun Young Lee This study reviewed quantitative research on the health of sexual and gender minorities (SGMs) in Korea and aimed to propose a role for healthcare professionals in improving their health and access to medical care. We searched PubMed through February 29, 2024 for articles published since 2000, using terms related to SGMs and the keyword “Korea.” This process yielded 33 quantitative studies on Korean SGMs. Of these, 17 focused on sexual minorities and 16 on gender minorities. The findings indicate that Korean SGMs experience many symptoms of depression and anxiety, as well as high rates of suicidal ideation, planning, and attempts. They also report diminished health-related quality of life. SGM individuals who have faced discrimination or pressure to change their sexual or gender identity face an elevated risk of mental health issues. To improve the health of Korean SGMs and improve their access to healthcare, we recommend several approaches. First, more research on the health of Korean SGMs is necessary. Second, education and training programs for health professionals are essential to promote their understanding of SGM health issues and their advocacy for SGM health. Third, strategies are required to develop and implement program interventions that improve SGM health, such as increasing the availability of gender-affirming care, which is known to benefit the health of transgender and gender-diverse individuals. Finally, healthcare professionals should actively advocate for SGM health and call for shifts in public perception and institutional change, grounded in a broad understanding of SGMs and their health needs.
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Heart failure (HF) represents a serious public health concern, characterized by substantial morbidity and mortality. Despite advances in pharmacological management, a gap persists in understanding and accounting for sex-related differences in HF treatment. This review was performed to clarify the impact of sex on the clinical outcomes of HF medications. Insights from various clinical trials and studies have highlighted differences between men and women in drug responses and adverse effects, indicating the need for a more nuanced approach to HF management. Promoting greater representation of women in clinical trials and the development of research methodologies that consider sex differences are crucial steps in advancing precision medicine. Such efforts ensure that therapeutic strategies are optimally tailored to the unique biological and genetic profiles of each person. Ultimately, this review emphasizes the vital need for a more inclusive and personalized approach to HF pharmacotherapy, underscoring the critical role of sex-related differences in shaping effective and individualized treatment pathways.
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, Yaiza Del Pozo Martín, Joan Marsh 성별(sex)과 젠더(gender)의 차이를 이해하는 것은 질병 관련 병태생리학 연구, 사회인구학적 건강결정요인, 의학적 또는 사회적 중재의
긍정적 영향 및 위해성 등을 막론하고 엄밀하고 포용적연구에 있어 필수적이다. 다양한 젠더를 포함한 연구가 활발해졌지만 성별과 젠더를 변수로
명시하는 연구는 여전히 부족하다. 2016년에 발표된 성별과 젠더 형평성(Sex and Gender Equity in Research,
SAGER) 지침은 널리 지지되고 있지만, 소수의 과학 학술지와 기관들에서만 이를 공식적인 편집 및 출판 정책에 반영하고 있다.
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, Paola De Castro, Sera Tort, Mirjam Curno Citations
, Yun Ha Hwang, Joong Gyu Ha, In Taek Hwang, Seung Hyun Kim Uterine tumors resembling ovarian sex-cord tumors (UTROSCT) are very rare tumors that occur mainly in the uterine fundus of women in reproductive age. These tumors can be classified into group 1 and group 2 by histological results. In group 1, epithelial-like differentiation is partially observed in the tumors. In group 2, sex-cord elements are predominant in uterine mural mass. We experienced UTROSCT group 1 in a 29-year-old woman who complained of severe abdominal pain that started one week after delivery and UTROSCT group 2 case in a 49-year-old woman who complained of dysfunctional uterine bleeding. We report two different types of UTROSCT cases that we experienced.
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In order to examine the issue of women and health in Korean society, we need to adopt a new approach to consider health and body as a subject of social theory beyond the biomedical model. Health and diseases are not objective entities defined by universal standards that are separate from the patient or physician's life experience, but rather the products of social, cultural, and political processes. From this point of view, this paper explores Korean women and health in two aspects of health and medical field, that is, women as medical service beneficiaries and providers. First, the gender paradox phenomenon—women live longer, but suffer from more illnesses—was confirmed by evaluating the physical and mental health status of women. The life expectancy of Korean women is longer, but their morbidity rate of physical and mental health and subjective health evaluation is worse than men. Second, as medical service providers, the present status of female doctors showed the horizontal and vertical segregation in the medical labor market despite of the increase of female doctors and medical students. We pointed out the problems of gender inequality in health care sector and discuss policy implications of ‘gender specific medicine’ to improve women's health and medical education.
The purpose of this study is to investigate the dissociative levels and histories of reported abuse among women psychiatric outpatients.
The author observed the dissociative levels and histories of reported abuse of the 66 women outpatients who visited psychiatric clinics, and compare dissociative symptoms of women who reported the history of physical and sexual abuse and symptoms of the others who did not have such history.
Results are as follows :
1) 54.5% of the other 66 outpatients of psychiatric clinic reported the history of abuse, including 13.6%, 24.2% and 16.7% of them reporting sexual abuse, physical abuse and physical and sexual abuse respectively.
2) Scores on the DES of abuse group was 18.6±16.3 which was significantly higher than DES of the non-abuse group(7.09±7.10).
3) Scores on the DES was highest in sexual abuse group, followed by physical abuse group and then physical and sexual abuse group. The percentile of score on the DES above 25 which was considered the score of dissociative disorder 44.4% of sexual abuse group, 18.8% of physical abuse group, 18.2% of physical and sexual abuse group, and 3.3% of non-abuse group.
4) Scores on the DES was variable according to the age of first abuse. It was highest in 7-11 years old group, followed by 12-16years old group, and then above 16years old group.
Sexual and physical abuse, especially sexual abuse, appears to be responsible for dissociation, or at least to ve a precipitating factor of dissociative experience.
The purpose of this study is to investigate the psychiatric problems of rape victims.
The author observed the psychiatric symptoms of the 10 women patients who visited psychiatric clinics immediately after rape after trauma, and made a related survey of 61 other 61 female outpatients in order to compare psychiatric symptoms of those of them who reported the history of rape trauma and those of the others who did not have such history.
Results are given as follows :
1) The most frequent psychiatric diagnosis of the victims of rather recent day's rape was posttraumatic stress disorder(4/10), followed by depression(2/10) and Schizoaffective disorder(2/10). The most frequent perpetrator was unknown person(8/10).
2) 49.2% of the other 61 patients of psychiatric clinic reported the history of abuse, including 26.2% and 36.1% of them reporting sexual abuse and physical abuse, respectively.
3) Sexual dysfunction was reported in 58.3% of the rape victims, who generally showed a tendency toward the high level of anxiety, hostility and paranoid symptoms.
4) The high scored dissociation was observed in rape victims but not in non-abuse group.
The rape trauma appears to be responsible for some psychiatric symptoms, or at least to be a precipitating factor of psychiatric disorders. The author also confirmed that aftermath of the rape trauma can continue rather perennially, for years after trauma or even for life ling.
, Haing Won Woo This study investigated the correlations between childhood sexual abuse and the severity of psychopathology symptoms in adulthood and the usefulness of adult psychiatric symptoms, diagnoses, and medications as factors in the identification of patients who have been sexually abused in childhood.
The subject of this study were 21 childhood sexually abused female inpatients and 22 nonabused female inpatients(psychiatric control group). All subjects were interviewed and completed self report instruments that focused of childhood sexual histoy of trauma, and current general psychiatric symptoms, dissociative symptoms.
Sexually abused broup showed significantly higher rates of divorce than psychiatric control group. Relative to psychiatric control group, sexually abused group have more hospitalization, higher proportion of more suicidal symptoms and more often major pharmacological tratment. Sexually abused group manifested significantly higher levels of dissociative symptoms and general psychiatric symptoms, including interpersonal sensitivity, psychoticism, obsessive compulsive and global severity index.
Findings suggest that childhood sexual abuse is associated with adult psychiatric symptoms, especially dissociative symptoms and work as etiology of psychopathology of boderline personalitiy disorder.
, Woo Sik Chung, Hana Yoon Androgen plays an important role in female sexual function, and its insufficiency causes a clinically significant sexual dysfunction. This study examines the association between sex hormones and the clinical effect of testosterone replacement therapy in female sexual dysfunction.
This study examined 75 female patients who visited our hospital from March 2002 to June 2008 to treat sexual dysfunction. For the rest of the patients, we performed primary treatment and physiotherapy in accordance with the main cause of their sexual dysfunction. We also performed combination treatment of androgen replacement therapy for the patients who did not make medical progress after two months of primary treatment and for the patients whose free testosterone level is in the bottom group out of three normal range groups.
The mean age of target patients was 39.6±8.7 years (range, 35~66 years) old. 10 patients out of 75 patients were postmenopausal women, and estrogen replacement therapy had been performed without androgen replacement therapy. We performed a combination treatment of androgen replacement therapy for the patients with sexual desire disorder, and 60% of them answered that they had an increased sexual response after they were given combination treatment of androgen replacement therapy.
The results support the concepts that sex hormones significantly affect sexual response in women with sexual dysfunction. Clinically, it is effective and safe to perform a combination treatment of androgen replacement therapy in treating sexual dysfunction if medication is administered properly and carefully.
, Woo Sik Chung, Bong Suk Shim, Deok Hee Kang Chronic kidney disease(CKD) and Sexual dysfunction are important public health problems in older man as a part of life. We investigated the relationship between two groups.
We examined sixty-five CKD patients on glomerular filtration rate (GFR), serum creatinine (sCr), Prevalence period and causative disease. Sexual function was evaluated by International Index of Erectile Function(IIEF-5), libido(2 items), ejaculation(4 items), frequency of sex in a month and serum testosterone. A control group composed of eighteen male adults who had visited to the general medical testing center in the hospital. They didn't have any combined disease and they were similar age range to the group of the CKD. We analyzed correlations between components of the CKD and sexual function.
The study revealed that all sexual components of the CKD group(mean age 51.8±2.6) were significantly worse than the control group; 12.3±3.9 of IIEF-5, 5.4±1.8 of libido and 10.1±2.2 of ejaculation, 1.4±0.7times of sex in a month in the CKD group and 18.3±3.5 of IIEF-5, 7.2±2.1 of libido and 15.3±2.9 of ejaculation, 2.9±1.1 times of sex in a month in the control group. The patients whose prevalence period of CKD was over than 3 years or whose sCr was over than 2.0ng/ml, had all sexual components worse significantly. Comparing by the causative disease of the CKD, there was no any significant difference. Analyzing by correlation, erectile function is related with serum glucose, sCr, Prevalence periods and libido is related with prevalence periods, and ejaculation is related with diabetes.
The patients with CKD may have a sexual dysfunction that make erection, libido and ejaculation and the number of their sex seemed to decrease. Therefore we need to have more attention to their sexual function as an important part of life.
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