Hormonal Differences Between Women and Men, Their Consequences on Addiction to Substances and Considerations on the Therapeutic Approach

Purpose of the review A search of scientific papers has been carried out to investigate sex differences in drug abuse and to understand the underlying biological and psychosocial causes of these differences. Based on the anatomical and neurochemical differences of the male and female brain, the difference in skills, and the possible importance of evolutionary factors, the reasons for the differential characteristics of addictions in men and women as well as the sex bias in the concurrent neuropsychiatric disorders are reviewed. The importance of sex hormones in these differences is also reviewed, as well as the influence of psychosocial conditioning factors associated with gender in addiction. Finally, the main features that differentiate the treatment of drug abuse in men and women are reviewed. Recent findings The results obtained indicate that there is a close link between the differential biological characteristics of the male and female brain and sex hormones, which explain the specific characteristics of drug abuse according to sex. These differences exist in the reward circuit, in metabolism, and in the different phases of the addictive process-acquisition, escalation of consumption, abstinence, and relapse-as well as in the associated neuropsychiatric disorders; all of them are modulated by psychosocial gender particularities. Finally, the need for separate sex-specific treatments, especially indicated in the presence of coexisting psychological or psychiatric disorders, is assessed.