Gender differences in methamphetamine use and responses: A review

Background: Men and women differ markedly with regard to their use of, and responses to, methamphetamine (MA) and related amphetamines. However, these gender differences oftentimes are given only a cursory consideration in the analyses of these MA effects. Objective: In this brief review, we summarize the data on gender differences in various parameters of MA use and responses. Such information on the pattern of male versus female differences in the use and responses to this psychostimulant can aid in tailoring gender-dependent treatment strategies. Methods: English-language articles were identified from MEDLINE as well as from reference lists of identified articles for the years 1966 to 2007. Search terms included various combinations of men/male, women/female, methamphetamine, and gender/sex differences. Only studies with human subjects were reviewed. Results: Women tend to begin MA use at earlier ages, appear more dependent on MA, but also respond better to treatment than do men. MA use appears to be associated with depression in women, and women seem more committed to MA, whereas men are more likely to use other drugs in the absence of access to MA. Female MA abusers had both larger volumes within the corpus callosum and more hyperperfused regions in the parietal and occipital areas of the brain, along with more genetic alterations but less MA-induced toxicity. Amphetamine-stimulated dopamine release was greater in men. Conclusions: When considered in total, women seem more dependent on and committed to MA but show diminished (amphetamine-stimulated) dopamine responses and a decreased degree of toxicity, as indicated by a lower incidence of emergency department-related deaths involving MA. A pervasive comorbidity of depression or depression-related characteristics were present in women MA users, suggesting that MA may serve as a type of self-medication for their depression. These findings not only highlight the need for consideration of gender when assessing MA use, but also can serve to direct efforts at prevention and treatment programs that address the specific needs of men and women.