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Advances in Physiology Education is dedicated to the improvement of teaching and learning physiology, both in specialized
courses and in the broader context of general biology education. It is published four times a year in March, June, September and
December by the American Physiological Society, 9650 Rockville Pike, Bethesda MD 20814-3991. Copyright © 2007 by the
American Physiological Society. ISSN: 1043-4046, ESSN: 1522-1229. Visit our website at http://www.the-aps.org/.
Adv Physiol Educ 31: 23–25, 2007;
doi:10.1152/advan.00118.2006. Refresher Course
Blair ML. Sex-based differences in physiology: what should we minimal differences in the physiology and pathophysiology of
teach in the medical curriculum? Adv Physiol Educ 31: 23–25, 2007; males and females other than those that specifically involve the
doi:10.1152/advan.00118.2006.—An abundance of recent research reproductive system. The potential complexities of controlling
indicates that there are multiple differences between males and fe- for the various phases of female reproductive cycle served as
males both in normal physiology and in the pathophysiology of
an additional deterrent for the inclusion of females in experi-
disease. The Refresher Course on Gender Differences in Physiology,
sponsored by the American Physiological Society Education Com- mental design for both animal and human studies. During the
mittee at the 2006 Experimental Biology Meeting in San Franciso, period of 1977–1993, furthermore, women of reproductive age
were required to be excluded from phase I clinical trials
to’s thyroiditis, which has a 10-fold greater incidence in logical actions of circulating androgens, such as those on bone
women than in men; for Grave’s hyperthyroidism, which has a metabolism, are proposed to be mediated by the conversion of
7-fold greater incidence in women than in men; and for testosterone to estrogen in males by aromatase (20). The
systemic lupus erythematosus, which has a 6-fold greater effects of testosterone on vascular tone also may be mediated
incidence in women than in men (2, 4, 5). There also are in part by aromatase conversion to estrogen (13, 20).
prominent sex-based differences in the incidence and expres- One of the complexities of unraveling the contribution of
sion of a wide range of mental illnesses, including depression, steroid hormones to either normal physiology or disease is the
schizophrenia, posttraumatic stress disorder, and panic disor- changing role of these hormones across development. In utero,
der. For example, depression is diagnosed two to three times the sex hormones are critical for sex determination and differ-
more frequently in women than in men (8). entiation, and gonadal steroid hormone levels and their contri-
Conversely, heart disease has traditionally been thought to butions to physiological function undergo marked changes in
be predominantly a disease of men. In reality, this is not the the transitions from childhood to adolescence to adulthood. In
case: heart disease is the leading cause of death in both women women, there are the additional variables of the menstrual
and men. However, the age of onset of coronary artery disease cycle, pregnancy, and menopause, and, in both women and
is, on average, roughly a decade later in women than in men. men, testosterone levels decline with aging.
The incidence of heart disease in women increases markedly In addition to the contribution of genetic and gonadal steroid
after menopause. While this strongly implies a cardioprotective hormone effects to the pathophysiology of disease, it must also
role for estrogen, the role of estrogen in cardiovascular health be recognized that societal factors can play a marked role in the
is clearly not straightforward, as shown by the outcome of the incidence and expression of disease. Gender differences in
volved in autonomic regulation and thus have the potential to 2006 Refresher Course presentations, we present key concepts
influence a wide range of homeostatic regulatory processes that we propose should be included in a medical physiology
(18). curriculum.
There are multiple differences between women and men in
terms of their normal cardiovascular function. For example, REFERENCES
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