Previous research has already suggested different levels of risk of alcohol abuse and associated problems and response to treatment in women versus men. However, the biological mechanisms underlying these differences remain poorly understood.
The research, called by its lead author, Dr. Victor Karpyak, professor of psychiatry at the Mayo Clinic, is “the first large-scale to confirm that some of the variability in alcohol use disorder and associated problems is associated with particular combinations of hormones and chemical biomarkers in men and women. Sex-specific treatments could thus help improve the responses of men and women suffering from alcohol dependence.
The study is part of a larger research program into the alcohol dependence drug acamprosate and is examining hormone and protein markers in 400 participants, including 268 men and 132 women, with alcohol use disorders. Once measured, the biological markers were compared to psychological markers, such as depressed mood, anxiety, “craving” including the desire to smoke, consume alcohol as well as the results of treatment during of the first 3 months. At baseline, several sex-specific blood markers, including sex hormones (testosterone, estrogen, progesterone) as well as proteins known to have an impact on reproduction and the bioavailability of these hormones in the blood were evaluated. The analysis reveals that:
- At the start of the study, male participants with alcohol use disorders, symptoms of depression, and increased cravings for alcohol also had lower levels of the hormones testosterone, estrone, estradiol , as well as globulin protein binding sex hormones;
- no association of the same type is observed in the participants;
- however, women with higher levels of testosterone, sex hormone-binding globulin, and albumin were found to be more likely to relapse during the first 3 months of treatment vs. their counterparts with lower levels of these biochemical markers. No such relationship was found in men.
However, these different hormones and proteins are already known to have an influence on the behavior and associations observed in alcohol use disorder, so these data suggest treating women and men differently.
If more research remains necessary to decipher the mechanisms underlying these differences, the study calls for better taking into account, in treatments, the differences linked to sex hormones and even “the dramatic hormonal change that women experience during the menstrual cycle and at menopause”
which could also affect the biochemistry of “alcoholism”.
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