Principles of Gender-Specific Medicine

Sex and Gender-Specific Biology in the Postgenomic Era

4th Edition - April 3, 2023

Editor: Marianne Legato J

Hardback ISBN:

9 7 8 - 0 - 3 2 3 - 8 8 5 3 4 - 8

eBook ISBN:

9 7 8 - 0 - 3 2 3 - 9 5 8 2 7 - 1

Awarded with the 2018 Prose Award in Clinical Medicine, the third edition of Principles of Gender-Specific Medicine explored and described exciting new areas in biomedicine that… Read more

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Awarded with the 2018 Prose Award in Clinical Medicine, the third edition of Principles of Gender-Specific Medicine explored and described exciting new areas in biomedicine that integrated technology into the treatment of disease and the augmentation of human function. Novel topics such as the sex-specific aspects of space medicine, the development and the use of genderized robots and a discussion of cyborgs were included in the third edition, providing a preview of the expanding world of sex-specific physiology and therapeutics. This Fourth Edition is a continuation of the mission to trace the relevance of biological sex to normal function and to the experience of disease in humans.We are now twenty years into the postgenomic era. The investigation of how the genome produces the phenome has led to fascinating insights as well as yet unanswered questions. Principles of Gender-Specific Medicine, Fourth Edition, has a central theme: discuss advances in understanding the role of epigenetics in regulating gene expression in a dynamic, sex-specific way during human life. It explores the protean role of epigenetics in human physiology, the relevance of environmental experience to human function, the therapeutic promise of cutting-edge methodologies like gene manipulation, the preparation of humans for space travel, the use of artificial intelligence in detection and therapeutic decisions concerning disease states, the possibilities for technological support of not only compromised individuals but of the augmentation of human function, and an analysis of the benefits, limitations and issues that surround our current expectations of personalized medicine.

Cover image
Title page
Table of Contents
Copyright
Dedication
Contributors
Foreword
1: Gender- and sex-conscious medicine vs. precision medicine
2: Precision medicine, sex, and gender
References
Preface
Chapter 1: Is there a role for natural selection in sex differences?
Abstract
Acknowledgments
1.1: Introduction
1.2: The study of sex steroid activity may provide insights on the origin of sex differences in organs not directly associated with reproduction
1.3: Liver sexual dimorphism: A resultant of evolutionary pressure?
1.4: A potential role of liver in the sexually dimorphic predisposition to disease
1.5: Do sex specific metabolic responses explain all differences in male and female predisposition to disease?
1.6: Concluding remarks
References
Chapter 2: Spermatozoa selection in the female reproductive tract: The initiation of the battle of the sexes
Abstract
2.1: Introduction: The adaptive control of offspring gender
2.2: Offspring gender bias in nonmammals
2.3: Offspring gender bias in mammals
2.4: What is the advantage of skewed sex ratio?
2.5: Evidence that parents are able to influence the sex ratio of offspring
2.6: Can the female reproductive tract influence offspring gender bias?
2.7: Differential molecular expression in X chromosome and Y chromosome-bearing spermatozoa
2.8: Spermatozoa induce sex-specific gene expression in the oviduct
2.9: Sex-specific sperm recognition systems in the female reproductive tract: Potential mechanisms of action
2.10: Concluding remarks
References
Chapter 3: Gender/sex: Shaping identity in infancy and early childhood
Abstract
3.1: A little history
3.2: Clarifying terminology
3.3: Theoretical challenges
3.4: Gender/sex identity in young children: What is it? How does it develop?
3.5: Toward a theory of gender/sex identity development
3.6: Supporting empirical research
3.7: Conclusion: Gender/sex identity formation and challenges for future research and educational policy
References
Chapter 4: A gendered brain perspective from structure to brain interactions
Abstract
Acknowledgments
4.1: Introduction
4.2: Brain imaging in vivo: Structural and functional connectivity techniques
4.3: Structural brain contributions to the understanding of gender identities
4.4: Brain network interactions in the construction of a gendered self
4.5: Future directions and concluding remarks
References
Chapter 5: Sex-specific implications of exposure to an adverse intrauterine environment
Abstract
5.1: Introduction
5.2: Sex-specific differences in normal intrauterine development
5.3: Sexual dimorphism in the placenta
5.4: Interaction of maternal physiology and fetal sex
5.5: Defining a sex-specific response in developmental programming – Methodological analysis
5.6: Sex-specific implications of adverse environmental stimuli in human early development
5.7: Sex-specific implications of adverse environmental stimuli in animal models
5.8: Developmental programming of the reproductive tract: A special case
5.9: Sex-specific transgenerational developmental programming
5.10: Conclusions
References
Chapter 6: Mate choice and the genetic imprint of the battle of the sexes
Abstract
6.1: Introduction
6.2: Imprinting of mate choice behavior
6.3: The role of Peg13 in regulating behavioral phenotypes
6.4: Conclusions
References
Chapter 7: Using the exposome to understand the role of the environment in gender- and sex-specific medicine
Abstract
7.1: The environment as a modifier of health and disease
7.2: Sex-specific responses to environmental exposures
7.3: Examples of sex-specific household and personal care exposures
7.4: Intersectionality
7.5: The exposome as a tool to measure environmental contribution to health and disease
7.6: Introduction to the concept and benefits of the exposome
7.7: Analytical techniques
7.8: Incorporating the exposome as a variable in sex-specific medicine
7.9: What is the male exposome versus the female exposome
7.10: Nonbinary medicine
7.11: How we can use the exposome framework to study sex differences
References
Chapter 8: Regulation of gene expression in the brain by sex hormones
Abstract
8.1: Introduction
8.2: Gene regulation by gonadal sex hormones
8.3: Sex variability in the brain
8.4: Sex variable gene expression in the brain
8.5: The future of organization and activation: More to it than two
References
Chapter 9: Sex-specific differences in mitochondrial function and its role in health disparities
Abstract
Funding sources
9.1: Introduction
9.2: The potential origin of sex differences in mitochondrial biology
9.3: A role for mitonuclear crosstalk as a driver of sex differences
9.4: Expanding the mitochondrial genetic repertoire
9.5: Mitochondria-derived peptides and their potential link to sex differences in mitochondrial function
9.6: Mitochondria localized micro-RNA encoded by nuclear DNA
9.7: Sex-based numtogenesis
9.8: Sex differences in the mtDNA-mediated epigenetic regulation
9.9: Sex steroids in mitochondrial biology
9.10: Sex differences in mitochondrial respiratory function, metabolism, and oxidative stress
9.11: X-chromosome encoded mitochondrial proteins in sex-specific function
9.12: Mitochondria and hormones
9.13: Sex differences in the expression of mitochondrial genes
9.14: Mitochondrial genome-mediated sex-specific phenotypes
9.15: Evidence for mitochondrial genetic control of autosomal gene expression
9.16: Future perspectives
References
Chapter 10: Sex differences in fetal programming: Antenatal origins of health and disease (AOHD)
Abstract
10.1: Fetal origin hypothesis
10.2: Genetic, environmental and hormonal aspects of fetal sex determination
10.3: The placenta
10.4: The effects of fetal testosterone on the growing fetus
10.5: “Female” brain and “male” brain
10.6: Antenatal origin of health and disease (AOHD)
10.7: Prenatal maternal stress and the developing embryo and fetus
10.8: The pregnant women as a mediator to the outside world
References
Chapter 11: Sex differences in the brain: Focus on developmental mechanisms
Abstract
11.1: Introduction
11.2: Historical perspective and current status
11.3: Conceptualizing sex differences
11.4: Steroid hormones program the developing brain
11.5: Mechanisms of steroid-induced masculinization
11.6: Elucidating mechanisms of normal brain development in males and females provides clues to sources of vulnerability and resilience
References
Chapter 12: Genes, environments, and epigenetics
Abstract
12.1: Introduction
12.2: Moving from the nature–nurture dichotomy to gene–environment interplay
12.3: Epigenetics and gene regulation
12.4: Biological embedding of experience
12.5: Epigenetics, sex, and gender
12.6: Epigenetics and sex differences in health and well-being
12.7: Epigenetics and gender
12.8: Summary and anticipating the future
References
Chapter 13: Epigenetics: Mechanisms, theory, and social implications
Abstract
Acknowledgments
13.1: Evolution and development: A new synthesis?
13.2: Genes in the postgenomic age
13.3: Postgenomic genomes as genomes-in-context
13.4: Enter epigenetics
13.5: Summary and potential social implications
13.6: Gender and epigenetics
References
Chapter 14: Adipose-derived stem cells: Use in clinical medicine
Abstract
14.1: Orthopedics
14.2: Regenerative medicine using adipose-derived stem cells in surgery
14.3: Cardiovascular surgery
14.4: Periodontal surgery
References
Chapter 15: All cells have a sex: Sex chromosome function at the cellular level
Abstract
15.1: Introduction
15.2: Cell physiology at the heart of biomedical science
15.3: Hormone-independent effects of sex chromosomes and the “sexome”
15.4: The sex chromosomes
15.5: Sex and autoimmune disease – It depends where your X came from
15.6: X-rated microRNAs
15.7: Zinc finger proteins
15.8: Sex at the heart of protein synthesis
15.9: Sex and the cytochromes
15.10: Sex in the time of covid
15.11: Sex and the brain
15.12: Y some male cells are not!
15.13: Conclusion
References
Chapter 16: Best-laid plans: The establishment of biological sex and its susceptibility to genetic and environmental disruption
Abstract
Acknowledgments
16.1: Introduction
16.2: Sry does not provide a robust sex-determining mechanism
16.3: Gonadal development is highly dependent on intercellular signaling mechanisms
16.4: For each sex there is an alternative pathway that is engaged if the intended pathway is compromised
16.5: Concluding remarks
References
Chapter 17: CRISPR technology and its potential role in treating rare imprinting diseases
Abstract
17.1: Introduction to imprinting and imprinting diseases
17.2: Angelman syndrome and Prader–Willi syndrome
17.3: Prader–Willi syndrome epidemiology, clinical manifestation and disease genetics
17.4: Bridging IDs with current advances in genome editing
17.5: CRISPR-based systems in the context of Angelman and Prader–Willi syndromes
17.6: Concerns regarding CRISPR based genome editing
References
Chapter 18: Parental genome and brain functions: The case of genomic imprinting
Abstract
18.1: Genomic imprinting: An overview
18.2: Timing of imprinting establishment
18.3: Imprinting disorders
18.4: Imprinting in the brain and sleep regulation
18.5: Concluding remarks
References
Chapter 19: Microbiome: Impact of sex on function and characteristics of gut microbiome
Abstract
Acknowledgments
19.1: Introduction
19.2: Host microbiome and immune system
19.3: Sex bias in the immune system
19.4: Microbiome and sex bias
19.5: Sex hormones and microbiome
19.6: Microbiome in sex-biased autoimmunity
19.7: Lupus and microbiome
19.8: Rheumatoid arthritis and microbiome
19.9: Diet, sex, and microbiome
References
Chapter 20: Geoepidemiology and the key role of sex chromosomes on autoimmune diseases
Abstract
20.1: Introduction
20.2: Geoepidemiology of autoimmune diseases: “Where” can help to explain “why”
20.3: Sex prevalence: Why is autoimmunity more common in women?
20.4: The influence of gender
20.5: Sex prevalence in autoimmune diseases: Is there a prognostic role for sex?
20.6: Concluding remarks and future directions
References
Chapter 21: Molecular mechanisms of sex differences in epilepsy
Abstract
21.1: Introduction
21.2: Sex differences in the epilepsies
21.3: Potential molecular and network mechanisms of sex differences in epilepsy
21.4: Neurobiological mechanisms in catamenial epilepsy
21.5: Sex differences in antiseizure medication treatments
21.6: Conclusions and future directions
References
Chapter 22: Consideration of biological sex in stem cell therapies
Abstract
22.1: Introduction
22.2: Embryonic stem cells
22.3: Induced pluripotent stem cells
22.4: Mesenchymal stem cells
22.5: Hematopoietic stem cells
22.6: Muscle derived stem cells
22.7: Endothelial progenitor cells
22.8: Neural stem cells
22.9: Current challenges and future prospects
References
Chapter 23: Sex and the human brain: Moving beyond the binary
Abstract
23.1: Introduction
23.2: Sex and the brain
23.3: Concluding remarks
References
Chapter 24: Genomic and epigenomic signature at the branch-point among genome, phenome, and sexome in health and disease: A multiomics approach
Abstract
24.1: Introduction
24.2: Routes toward an integrative approach in the omics era: Genome first, phenome first, and environment first
24.3: Epigenetic approaches: From the womb to adulthood
24.4: The impact of sex and gender on genomics and epigenomics
24.5: Current challenges and perspectives
References
Chapter 25: The importance of gender-specific medicine in the pharmaceutical industry, clinical practice, and global health care
Abstract
25.1: Introduction
25.2: Biological sex differences and pharmacology
25.3: The pharmaceutical industry business model
25.4: The pharmaceutical industry and gender-specific medicine
25.5: General obstacles for the development of gender-specific drugs
25.6: But how to change this situation?47
25.7: Gender-specific low-hanging fruits
25.8: Conclusion: Gender medicine, pharmaceuticals and global health care
References
Chapter 26: The neurobiology of gender identity and gender dysphoria
Abstract
Acknowledgments
26.1: Definitions
26.2: Gender identity
26.3: Gender dysphoria due to gender incongruence
26.4: Treatment strategies
26.5: Conclusion
References
Further reading
Chapter 27: Nutritional genomics and biological sex
Abstract
27.1: Introduction
27.2: Precision nutrition and sex/gender differences
27.3: Difference between sex and gender
27.4: Sex and gender identification in studies on nutritional genomics/precision nutrition
27.5: Reported sex/gender gene–diet interactions
27.6: Improvement in diet measurement and other related variables using gender perspective in nutritional genomics
27.7: Polygenic risk scores and the sex/gender perspective
27.8: Recommendations on the design, analysis, and presentation of results in nutritional genomics/precision nutrition studies with a gender perspective
27.9: Conclusions
References
Chapter 28: The invaluable contribution of animal models in understanding sex-dependent differences in neuropsychiatric disorders
Abstract
28.1: Why use an animal model to study a neuropsychiatric disorder?
28.2: Sex differences in animal models of mood disorders
28.3: Sex differences in animal models of eating disorders
28.4: Sex differences in animal models of schizophrenia, autism and ADHD
28.5: Sex differences in animal models of drug addiction
28.6: Summary and conclusions
References
Chapter 29: Sexual dimorphism in molecular biology of cancer
Abstract
29.1: Introduction
29.2: Gender, sex, and the genome
29.3: Sexual dimorphism in cancer
29.4: Sexual dimorphism in the development of specific cancers
29.5: Sex and cancer treatment
References
Chapter 30: The importance of expeditionary fitness in optimizing the human commercial spaceflight experience
Abstract
30.1: Introduction
30.2: What is expeditionary fitness?
30.3: Why expeditionary fitness matters: The case of viral reactivation in space
30.4: Expeditionary fitness and the physiological phenotype
30.5: Expeditionary fitness and the morphological phenotype
30.6: Expeditionary fitness and the behavioral phenotype: Expeditionary behavior
30.7: Training fitness: The importance of preparedness and exposure
30.8: The unique civilian spaceflight cohort
30.9: The emergence of entertainment in space
30.10: Human research program for civilian spaceflight
30.11: The role of precision medicine in expeditionary fitness
30.12: Conclusions
References
Chapter 31: Brain morphological changes associated with sexual orientation
Abstract
31.1: Introduction
31.2: Methodology
31.3: Morphology and sexual orientation
31.4: White matter findings
31.5: Conclusions
31.6: Avenues for future research
References
Further reading
Chapter 32: The operationalization of gender in medicine
Abstract
32.1: Introduction
32.2: Gender identity
32.3: Identity/dysphoria
32.4: Gender expression
32.5: Gender norms and roles
32.6: Measures of masculinity OR femininity
32.7: Gender relations
32.8: Composite scores
32.9: Disease-specific examples
32.10: Considerations for applicability and future steps
References
Chapter 33: Precision medicine: Overview and challenges to clinical implementation
Abstract
33.1: Introduction
33.2: Genome sciences
33.3: Clinical applications
33.4: Challenges to clinical implementation
33.5: Conclusion
References
Chapter 34: Assessment of fall risks in older females and males using an automated smartphone mobility suite
Abstract
34.1: Introduction
34.2: Automated assessment of mobility
34.3: A smartwatch s30SCST implementation
34.4: Experimental studies
34.5: Conclusion
References
Chapter 35: Statin therapy and sex hormones
Abstract
Competing interests
35.1: Statin therapy for patients with coronary heart disease
35.2: Statin therapy for patients with ischemic stroke
35.3: Statin therapy for patients with peripheral artery disease
35.4: Effects of statins on endogenous steroid hormone synthesis (via three interconnected pathways)
35.5: A review of studies on the effects of statins on testosterone levels in men
35.6: The effect of statins on spermatogenesis
35.7: An overview of studies associating statins with erectile dysfunction
35.8: Role of statin treatment on estradiol and LH/FSH ratio in women
35.9: Potential benefits and risks of statins in polycystic ovary syndrome
35.10: Conclusions
References
Chapter 36: Exercise physiology in women and men
Abstract
36.1: Introduction
36.2: Body composition
36.3: Cardiovascular differences and maximal oxygen uptake
36.4: Muscle fiber type composition
36.5: Anaerobic and aerobic exercise
36.6: Aerobic carbohydrate and lipid oxidation during exercise
36.7: ATP resynthesis in skeletal muscle
36.8: Estrogen and its impact on metabolism
36.9: Gender differences in metabolism during recovery from exercise
36.10: Concluding highlights
References
Chapter 37: Cerebral effects of gender-affirming hormone treatments in transgender persons
Abstract
Acknowledgments
37.1: Introduction
37.2: Effects of affirming hormone treatment on the brain of transgender individuals
37.3: Explanatory hypotheses to explain brain changes in transgender persons receiving hormone treatment
37.4: Concluding remarks
References
Chapter 38: Artificial intelligence in healthcare
Abstract
38.1: Artificial intelligence, overview
38.2: Definitions
38.3: Benefits brought by artificial intelligence
38.4: Current challenges and limitations
38.5: Continuous learning and model retraining
38.6: From prediction to decision and action
38.7: Machine-learning overview
38.8: Data preparation
38.9: Model training: Learning and generalization
38.10: Neural networks
38.11: Neural networks shortcomings
38.12: Tree-based algorithms
38.13: Decision tree shortcomings
38.14: Application to healthcare
38.15: Conclusion
References
Chapter 39: Trauma and gender in primary care
Abstract
39.1: Introduction
39.2: Acute psychological trauma in a medical setting
39.3: Gender differences in trauma exposure
39.4: Gender differences in the acute response to trauma
39.5: Gender differences in trauma-related symptoms and disorders
39.6: Gender differences in a clinical context
39.7: Gender differences in in treatment of trauma-related disorders
39.8: Discussion
39.9: Conclusion
References
Chapter 40: Fertility treatment and preservation in transgender men and women
Abstract
40.1: Introduction
40.2: Definition of transgender people
40.3: Standards of care for the health of transsexual, transgender, and gender-nonconforming people
40.4: Epidemiology of gender identity disorder
40.5: Reproductive options for trans people
40.6: The ethical/legal status of medically assisted reproduction in transsexual people
40.7: ART treatment for transgender men and women
40.8: Reproductive wish in transgender men
40.9: Fertility and achievement of pregnancy in transgender men
40.10: Reproductive wish in transgender women
40.11: Fertility and achievement of pregnancy in transgender women
40.12: Conclusion
References
Chapter 41: Atrial fibrillation in women
Abstract
41.1: Prevalence of atrial fibrillation
41.2: Electrophysiology of AF
41.3: Cellular electrophysiology and ionic basis for sex differences
41.4: Sex-based differences in presentation and treatment in women with AF
41.5: Drug therapy for AF
41.6: Antiarrhythmic therapy for AF
41.7: Catheter ablation for AF
41.8: Pregnancy in AF
41.9: Sex based differences in outcomes in women with AF
References
Chapter 42: Sex differences in COVID-19 susceptibility – Reductionistic and holistic perspectives
Abstract
42.1: Introduction
42.2: Reductionism and holism
42.3: COVID-19 pandemic and the impact of sex on clinical outcomes
42.4: Reductionistic approaches
42.5: Holistic approaches
42.6: Conclusions – An integrated view
References
Chapter 43: Sex and gender differences in sleep disorders: An overview
Abstract
43.1: Introduction
43.2: Insomnia
43.3: Sleep disordered breathing
43.4: Obesity hypoventilation syndrome
43.5: Restless legs syndrome or Willis-Ekbom disorder
43.6: Circadian rhythm sleep disorders
43.7: Parasomnias
43.8: Conclusions
References
Chapter 44: Estrogen: Impact on cardiomyocytes and the heart
Abstract
Disclosures
44.1: Introduction
44.2: Estrogen on the heart: Clinical considerations
44.3: Estrogen on cardiomyocytes: Scientific data
44.4: Conclusion
References
Chapter 45: Beyond sex and gender differences: The case for women's health research
Abstract
45.1: Introduction
45.2: Why the mandates don’t necessarily further women's health
45.3: Misconceptions in sex differences research
45.4: By focusing on studying sex differences have we missed the point?
45.5: History of women's health research
45.6: Beyond sex/gender differences: What is women's health?
45.7: What does it cost us when we ignore women's health?
45.8: Conclusions
References
Chapter 46: Measurement and meaning of gender/sex from bench to bedside – And the mutuality of equity and precision in medicine
Abstract
Acknowledgments
46.1: Introduction
46.2: Social categories in biomedical science
46.3: Operationalizing gender/sex
46.4: Conclusions
References
Chapter 47: Person-centered cancer genetic counseling for transgender and gender diverse patients
Abstract
47.1: Background
47.2: Family history questionnaires
47.3: Pedigrees
47.4: Language and terminology
47.5: Psychosocial and sociocultural factors
47.6: Impact of gender-affirming treatments
47.7: Training and education
47.8: Conclusion
References
Chapter 48: Musculoskeletal complaints in male and female instrumental musicians
Abstract
48.1: A historical perspective
48.2: Musculoskeletal complaints in the general population
48.3: Gender differences
48.4: Other determinants of musculoskeletal complaints in musicians
48.5: Instrument
48.6: Prevention
48.7: Therapeutic management – A practical approach
48.8: Conclusion
References
Chapter 49: Sex, gender, and pain
Abstract
49.1: Introduction
49.2: Conceptual issues
49.3: Sex differences in clinical pain
49.4: Sex differences in experimental pain responses
49.5: Mechanisms contributing to sex differences in pain
49.6: Sex differences in pain treatment
49.7: Conclusions and future directions
References
Chapter 50: Influence of gender on the pathophysiology and treatment of urological malignancies
Abstract
50.1: Bladder cancer
50.2: Kidney cancer
References
Chapter 51: Beyond the mask: The role of camouflaging in managing an autistic identity for girls and women
Abstract
51.1: Introduction
51.2: Terminology
51.3: Managing an autistic identity in early life through masking or camouflaging
51.4: New research findings relating to autism, sex/gender differences and camouflaging
51.5: Outcomes of camouflaging
51.6: Implications
51.7: Conclusion
References
Chapter 52: There is no stronger sex: Evolutionary Anthropology's conclusion based on the sex-typical susceptibility to stress factors during prenatal development
Abstract
52.1: Introduction
52.2: Sex and gender
52.3: The biology of sex
52.4: The importance of sex in the prenatal phase
52.5: Sex-typical differences in the prenatal phase
52.6: Sex ratio
52.7: Sex differences in fetal growth
52.8: Sex differences in preterm birth rate
52.9: Sex differences in birth outcomes
52.10: Sex differences in newborn size
52.11: Sex differences in pre- and perinatal vulnerability
52.12: Discussion
52.13: Ultimate explanations
52.14: Conclusion
References
Chapter 53: Robots and gender
Abstract
Acknowledgments
53.1: Introduction
53.2: Robot gender
53.3: Human gender
53.4: Interaction effects
53.5: Future directions of gender issues in HRI
53.6: Summary
References
Chapter 54: Sex specificity in neonatal diseases
Abstract
54.1: Introduction
54.2: Fetal sex and adverse pregnancy outcomes
54.3: Neonatal lung disease
54.4: Brain injury and neurodevelopmental outcomes
54.5: Growth, nutritional interventions, and neurodevelopment
54.6: Endocrine adaptation
54.7: Immune response and infection
54.8: Cardiovascular adaptation and heart disease
54.9: Gut microbiome and necrotizing enterocolitis
54.10: Blood donor sex and neonatal outcomes
54.11: Miscellaneous
54.12: Conclusions
References
Chapter 55: Human male and female phenotypes depend on lifestyle (smoking and hormonal contraceptives): Implications for prevention and care
Abstract
55.1: Introduction
55.2: Evolution of oral contraceptives
55.3: Exposure to exogenous sexual hormones
55.4: Combined oral contraceptives induce physiological alterations in women
55.5: Interactions among combined oral contraceptives and drugs
55.6: Some sex and gender differences in tobacco smoking
55.7: Conclusions
References
Index