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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Suggested Citation:"Index." Institute of Medicine. 2001. Exploring the Biological Contributions to Human Health: Does Sex Matter?. Washington, DC: The National Academies Press. doi: 10.17226/10028.
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Index A Acetylsalicylic acid, 74 Adipose tissue/fat, 66, 72, 124, 131-139 (passim) obesity, 21, 49, 70, 132-137, 159 Adolescence, see Puberty Adrenal gland, 54, 68-70, 128 congenital adrenal hyperplasia, 90-93 immune response, 145 obesity, 136 Adulthood, 72-77 androgen, 72, 73 autoimmunity, 153, 157 calcium requirements, 139 energy requirements, 132 menopause, 72-73, 98-99, 102-103, 136, 139, 140 coronary heart disease, 162, 163, 164 melanoma, 130, 140-142 osteoporosis, 20, 73, 130, 138-140 pain perception, 108 African Americans, 65-66, 128, 134, 135 coronary heart disease, 161, 162, 163, 165, 170 Age factors, 231, 237 see also Adulthood; Developmental factors; Early childhood development; Menopause; Puberty 255 coronary heart disease, 158, 159, 160- 162,164,167,168,171,172 Food and drug Administration, drug applications, 175 gastric processes, 121, 122 immune response, 153-154, 155 infancy, 64, 70 melanoma, 141 Agenda for Research on Women's Health for the 21st Century, 15, 229, 231 AIDS, 147, 148 Alcohol, 124, 128, 140 Alosetron, 129 Alzheimer's disease, 238 American Indians, 135 American Medical Association Manual of Style, 17-18 Analgesics, 105-109, 110 Androgen, 178-179, 231, 234 adulthood, 72, 73 andropause, bone effects, 73 behavioral effects, 80, 90-94 brain development, 93-94 congenital adrenal hyperplasia, 63, 90- 93 deficiency, 73 idiopathic hypogonadotropic hydropogonadism, 91 immune response, 144 prenatal, 52, 55, 60, 89, 90-94

256 psychosexual differentiation, 80 puberty, 63, 68-69 Animal models, 5, 6, 8, 14-15, 16, 181 behavioral factors, 92-93, 95, 96 brain, 81, 82-83, 109, 111, 112-114 cerebrovascular and cardiovascular diseases, 112-115 cognitive abilities, 95, 99 developmental biology, 45, 48, 51, 54, 55, 59, 78 ethical/regulatory issues, 6, 78, 181 immune response, 147, 148, 149, 152, 154-159 pain, 109, 111 pregnancy/prenatal period, 48 psychosexual differentiation, 80-81 sex and gender, use of terminology, 175, 176 sex determination/differentiation, 46, 4748, 51, 54, 59, 80-81 transgenic, 43, 51, 54, 78, 82, 114, 154, 156-159 Antigens, 34, 146, 149, 155, 157, 239 Biotechnology Antimullerian hormone, 54, 55-56, 60 cloning, 43 Aromatase, 63, 68 Arthritis, 23, 106, 123, 146, 150-154 (passim) Articulatory skills, 87-88 Attention deficit hyperactivity disorder, 128 Attitudes coronary heart disease, 169 discrimination, 9-10, 11, 24-25, 168, 183- 184 Autoimmune diseases, 20, 142-143, 147-159 see specific diseases defined, 142, 149-150, 239 Autosomes, 31, 35, 40, 42, 56 defined, 239 sex determination, 50, 51, 54 B Bacterial infections, 148 mycobacteria, 148-149 Behavioral factors, ix, 2, 6, 14, 15, 20, 28, 41, 79-84, 115-116 see also Sociological factors alcohol intake, 124, 128, 140 androgen, 80, 90-94 animal models, 92-93, 95, 96 environmental factors and, 79, 80, 94-95, 124, 128, 140 INDEX estrogen, 94 gender identity, 6, 18 genetic factors, 79-116 health-related behaviors, 75, 77, 84, 124, 128, 134, 139, 140 hormones, 79-81, 89-97 obesity, 134 osteoporosis, 139 pregnancy/prenatal period, 79-80, 89-90 puberty, 45, 70-72 sleep, 144, 236 smoking, 140, 143, 162-163, 236 stress, 75, 77, 107, 145, 161, 165 testosterone, 93 toxins, exposure to, 143 Bioavailability, 118, 239 Biochemistry, 28, 29, 37, 179 see also Calcium; Cholesterol; Enzymatic processes; Gonadotropin; Hormonal processes; Molecular biology; Proteins; Serotonin; Toxic agents transgenic animals, 43, 51, 54, 78, 82, 114, 154, 156-159 Biotransformation, 118, 119, 125 defined, 239 Birth weight, 49, 70 Black persons, see African Americans Blood pressure, see Hypertension Body composition, 124, 130, 131-139 adipose tissue/fat, 66, 72, 124, 131-139 (passim) Body size, 130, 132, 134, 135, 138 height, 20-21, 132, 133 obesity, 21, 49, 70, 132-137, 139, 159 osteoporosis, 139 Body weight, 18, 49, 72, 132, 137-138, 239 coronary heart disease, 159, 162 birth weight, 49, 70 bone, 131 drug metabolism, 124 muscle mass, 72 obesity, 21, 49, 70, 132-137, 139, 159 osteoporosis, 139, 140 pregnancy, 131 Bone, 178, 231 andropause, 73 menopause, 72, 73 osteoporosis, 20, 73, 130, 138-140 pubertal growth spurt, 68

INDEX skeletal dysplasia, 54 weight of, 131 Bowels and bowel diseases, 106, 112, 121, 129, 150, 236 Brain, 6-7, 11, 23, 81-83, 96,102-104,115- 116, 130 see also Cerebrovascular and cardiovascular diseases; Cognitive factors adulthood, 72 Alzheimer's disease, 238 androgen, 93-94 animal models, 81, 82-83, 109, 111, 112- 114 cerebellum, 82, 111 hippocampus, 82, 111 hormonal processes, 81-83, 92, 96, 97, 102-104, 112-115 hypothalamus, 62, 64-65, 72, 82-83,145 imaging studies, 102-103,111 neurons, 81-83, 99,107,108,113 pain, 111 psychosexual differentiation, 80 puberty, 71 synapses, 81, 83 testosterone, 82 Breasts, 66, 79 cancer, 180 lactation, 139 menopause, 72 Bridging Disciplines in the Brain, Behavioral, and Clinical Sciences, 182 C Calcium, 73, 139 see also Osteoporosis Cancer, 19, 75,118,119 breast, 180 melanoma, 130, 140-142 National Cancer Institute, 177-178 Cardiovascular disease, see Cerebrovascular and cardiovascular diseases Caucasians, 65-66, 135 coronary heart disease, 161, 162, 163, 165-166, 170 osteoporosis, 138 Cell cultures, 38 Cellular biology, ix, 1, 2, 3, 4, 8, 10, 11, 13, 14-15, 16, 21, 28-44, 96, 178-179 see also Genetics; Genomics 257 immune response, 143,144,145,149, 153, 178-179 leukocytes, 114,144,146, 152 Leydig cells, 58, 60, 64, 66, 68 meiosis, 28, 34, 4142, 46, 56, 241 mitosis, 37, 241 mosaicism, 36, 37, 3940 neurons, 81-83, 99,107,108,113 psychosexual differentiation, 80-81 puberty, 64 Sertoli cells, 51, 52, 56, 60 somatic cells, 4, 31, 37, 38, 44 stem cells, 41, 56 testicular organogenesis, 34, 35, 55-56 Central nervous system, 81-82 see also Brain multiple sclerosis, 20, 152 pain perception, 107 Cerebellum, 82, 111 Cerebrovascular and cardiovascular diseases, 19-20, 23, 49, 70, 74-75, 128-129, 158-172, 178-179, 231 age factors, 158,159,160-162,164,167, 168, 171, 172 animal models, 112-115 body weight, 159, 162 Chagas's disease, 148,149 diabetes and, 159,166-167,168 drugs, 158,170, 171 environmental factors, 159-160,170,171 estrogen, 107-108,114,164,165, 166 genetic factors, 158,159,170,171 hormones, 114,164,165,166,170, 171, 238 hypertension, 49, 70, 72, 74, 160, 162, 165-166 infectious diseases and, 159,170,171 longitudinal studies, 161-162 menopause, 72, 73,162,163,164 nutrition, 161, 170 pregnancy/prenatal period, 158, 161, 166, 167, 171 race/ethnicity, 161,162,163, 165-166, 170 smoking, 162-163 stress, 161, 165 treatment of, 168-170 Chagas's disease, 148,149 Chemical processes, see Biochemistry; Toxic agents Cholesterol, 49, 114, 145, 158-165 (passim), 237

258 Chorionic gonadrotropin-luteinizing hormone (LH), 56, 58, 64, 65, 68 Cigarette smoking, see Smoking Clinical studies, 24-25, 26 analgesics, 108 drugs, other, 127, 130 Cloacal exostrophy, 63, 84 Cloning, 43 Collaborative research, see Interdisciplinary research Cognitive factors, 6, 41, 79, 80, 81, 84, 85- 104 see also Brain animal models, 95, 99 dyslexia, 71, 100, 101-102 hormonal effects on, 79-82, 96-104 language, 19, 71 dyslexia, 71, 100, 101-102 reading ability, 99-104 memory, 87, 95, 99, 104 menstrual cycle, 97-98 pregnancy/prenatal period, 79 puberty, 71 quantitative abilities, 86, 88-89, 104 spatial abilities, 88, 92, 95, 104 Congenital adrenal hyperplasia, 63, 90-93 Coronary heart disease, see Cerebrovascular and cardiovascular diseases Cost factors brain research, 115 funding, 8, 79 Creatinine, 126 Cultural factors, 80, 84 infectious diseases, 147 Cytochromes P450, 108, 125 D Definitional issues autoimmunity, 142, 149-150, 239 biology, 13(n.1), 17 glossary, 239-242 obesity, 133-134 pharmaceutical terminology, 118, 242 sex and gender, 7-8, 10, 11, 13(n.2), 17- 19, 173, 174-176, 231, 240, 242 sex determination and differentiation, 50 Dehydroepiandrosterone, 68-69, 70 Dental asymmetry, 48 INDEX Department of Health and Human Services, 14(n.3~. 24, 25 Depression, 80, 130 immune response, 145 Developmental factors, ix, 1-2, 14, 15, 45-78, 96-97 see also Adulthood; Age factors; Early childhood development; Menopause; Pregnancy/prenatal period; Puberty; Secondary sex characteristics animal models, 45, 48, 51, 54, 55, 59, 78 infancy, 64, 70 Diabetes mellitus, 70, 122, 166-167 coronary heart disease and, 159, 166- 167, 168 obesity and, 132-133 Digestion, 120-122, 136 Discrimination based on sex/gender, 9-10, 11, 24-25, 168, 183-184 Diseases and disorders, xix, 2, 34, 6, 7, 10, 14, 16, 40, 44, 117-172, 183 see also Cancer; Cerebrovascular and cardiovascular diseases; Infectious diseases; Mental illness; Pharmaceuticals AIDS, 147, 148 Alzheimer's disease, 238 arthritis, 23, 106, 123, 146, 150-154 (passim) autoimmune diseases, 20, 142-143, 147- 159, 239; see also specific diseases infra and supra body composition and, 130 bowel, 106, 112, 121, 129, 150, 236 congenital adrenal hyperplasia, 63, 90- 93 defined, 240 dental asymmetry, 48 diabetes, 4849 dyslexia, 71, 100, 101-102 dyslipidemia, 70 dysmenorrhea, 111-112 fibromyalgia, 72, 112 filariasis, 149 fungal, 148-149 gonadal dysgenesis, 54 hepatitis, 146 herpes, 147, 148 idiopathic hypogonadotropic hydropogonadism, 91 life expectancy, 7, 74-75, 76

INDEX lupus, 22, 106, 149-159 (passim) Lyme disease, 148, 151, 152 malaria, 149 measles, 146, 148 meningitis, 146 menopause-related, 72-73 multiple sclerosis, 20 mutations and, 32-33 obesity, 21, 49, 70, 132-137, 139, 159 osteoporosis, 20, 73, 130, 138-140 pain, 23, 46, 74, 79, 105-112 parasitic diseases, 148-149 pertussis, 146 polycystic ovary syndrome, 70 preeclampsia, 166 pregnancy/prenatal environment, 48- 49, 79-80 coronary heart disease, 158, 161, 166, 167, 171 rheumatic diseases, 106, 123, 142, 148, 150-154 (passim) scleroderma, 147, 151 sex determination/differentiation, 54, 63, 83-84, 115 spine bifida, 49 trypanosomiasis, 149 Turner syndrome, 63 X-chromosome inactivation, 39 X-chromosome-linked, 28 DNA, 34, 41 arrays, 32 defined, 240 genomics, 29-35, 39, 40, 43, 44, 240 sex determination and differentiation, 51 transgenics, 43 Dopamine, 82, 128, 233, 238 Dose-response, 118, 119 defined, 240 Drug metabolism, 118, 119, 124, 125, 242 Drugs, see Pharmaceuticals Dyslexia, 71, 100, 101-102 Dyslipidemia, 70 Dysmenorrhea, 111-112 E Early childhood development, 50-62, 64-65, 77, 94-95 see also Pregnancy/prenatal period; Puberty body composition, 131 259 brain, 81 calcium requirements, 139 energy requirements, 132 environmental and genetic factors, 50 infancy, 64, 70 Economic factors, xx, 2, 3, 15 cost of brain research, 115 funding, 8, 79 socioeconomic status, 16 Education, see Public education Educational attainment, obesity, 135 Embryos, 22, 37, 41, 42, 47, 50, 55, 96 Endocrine system, see Hormonal processes Energy storage and metabolism, 7, 117, 118, 120, 130, 131-132, 134, 136, 137, 170 Environmental factors, ix, 3, 6, 14, 20, 46, 117, 174 see also Behavioral factors; Nutrition; Physical activity; Sociological factors; Toxic agents autoimmunity, 150-151 behavioral effects, 79, 80, 94-95, 124, 128, 140 cognitive effects, 79 coronary heart disease, 159-160, 170, 171 early development, 50 height, 21 immune response, 143, 150-151, 155 obesity, 134 osteoporosis, 140 prenatal, 45, 48, 49, 70 sex and gender defined, 18 sex determination and differentiation, 50 toxic agents, xix, 3, 7, 23, 150-151, 159, 170 Enzymatic processes, 62, 176, 233-238 adulthood, 72 coronary heart disease, 165-166 genomics, 31 pain perception, 108 Epidemiology, 15, 182 see also Longitudinal studies coronary heart disease, 161-162 obesity, 134, 135 reading disabilities, 101 Estradiol pregnancy, 146 psychosexual differentiation, 81 puberty, 65, 67-68

260 Estriol, 126, 146 Estrogen, 31, 54, 72, 73, 82-83, 93, 94, 97, 98, 99, 140, 235 behavioral effects, 94 brain effects, 82-83, 113-115 cardiovascular effects, 107-108, 114, 164, 165, 166 cognitive effects, 97, 98-104 diabetes, 166 dopamine binding, 238 immune response, 145, 152, 157 osteoporosis, 140 pain perception, 107-108 puberty, 64, 65, 68, 71, 72 replacement therapy, 73, 103, 152, 157, 165 Ethical issues, xx, 2, 3, 7, 15, 172, 181 animal studies, 6, 78, 181 clinical studies, 24 discrimination, 9-10, 11, 24-25, 168, 183- 184 Ethnicity, see Race/ethnicity Exercise, see Physical activity F Family planning, 16 Family relations, 71 parental factors, 2-3, 16 Fat/adipose tissue, 66, 72, 124, 131-139 (passim) obesity, 21, 49, 70, 132-137, 139, 159 Federal government see also Regulatory issues Department of Health and Human Services, 14(n.3), 24, 25 Food and Drug Administration, 25-26, 129-130, 175 General Accounting Office (GAO), 25, 26,175,177,178 National Cancer Institute, 177-178 National Institutes of Health (NIH), 15- 16, 25, 26, 127-128, 175, 177, 182, 183-184 Fertility, 34, 64 menarche, 65-66, 70 menopause, 72-73, 98-99, 102-103, 136, 139, 140 cerebrovascular and coronary disease, 72, 73, 162, 163, 164 pain and reproductive status, 105 Fibromyalgia, 72, 112 INDEX Filariasis, 149 Follicle-stimulating hormone (FSH), 58, 64, 65, 68, 70 Food and Drug Administration, 25-26, 129- 130, 175 Foreign countries, see Life expectancy Funding, 8, 78 Fungi, 148-149 G Gastrointestinal tract, 120-122, 136 Gender, defined, 7-8, 10, 11, 13(n.2), 17-19, 173, 174-176, 231, 240, 242 Gender identity, 6, 7, 8, 13(n.2), 15, 17-18, 79, 83-84, 90-91, 92-93, 94, 95, 97, 174-176 General Accounting Office (GAO), 25, 26, 175, 177, 178 Genetics, 2, 3, 4, 6, 14, 15, 21, 22, 2846, 183 see also Sex determination and differentiation autosomes, 31, 35, 40, 42, 50, 51, 54, 56, 239 behavior and, 79-116 brain, 82 coronary heart disease, 158, 159, 170, 171 definitions, 240 early development, 50 gender identity, 83, 84 hemizygosity, 40 immune response, 143, 144, 153, 155 imprinting, 28, 40, 44 melanoma, 140-141 mosaicism, 36-40 (passim), 44, 240, 242 mutations, 31, 32, 36, 38, 40, 42, 43, 51 pubertal growth spurt, 68 transgenics, 43, 51, 54, 78, 82, 114, 154, 156-159 osteoporosis, 140 pain perception, 106-107 protein encoding, 29, 35 pseudoautosomal region, 33, 34, 35, 42 sex and gender defined, 17-18 SRY gene, 34, 50-51, 53, 54, 55, 56-57 transgenic techniques, 43, 51, 54, 78, 82, 114, 154, 156-159 X-chromosome inactivation, 28, 31, 33, 36, 37-39, 44 Genomics, 29-35, 39, 40, 43, 44 defined, 240

INDEX Germ cells, 4142, 44, 55, 56, 58 oocytes and ova, 37, 40, 41, 42, 47, 55 spermatogenesis, 33, 34, 35, 37, 40, 41, 42 Gonadotropin, 54, 58, 62, 64, 65, 66, 91 Government role, see Federal government Growth see also Body size fetal, 70 height, 20-21, 132, 133 hormones, 66-67, 139, 238 osteoporosis, 139 pregnancy/prenatal environment, 49 pubertal growth spurt, 62, 66, 67-68, 69 race/ethnicity and, 66 Guide for the Care and Use of Laboratory Animals, 6, 78 H Headache, 106, 112 Health factors, 16, 20, 117-172 behavioral, 75, 77, 84, 124, 128, 134, 139, 140 discrimination based on sex/gender, 9- 10, 11, 24-25, 168, 183-184 life expectancy, 7, 74-75, 76, 183 see also Diseases and disorders; Life expectancy; Pain; Toxic agents Heart disease, see Cerebrovascular and cardiovascular diseases Height, 20-21, 132, 133 Hemizygosity, 40 Hepatic system, 72, 121, 122, 123, 125, 126, 142 Hepatitis, 146 Herpes, 147, 148 Hippocampus, 82, 111 Hispanics, 135 Historical perspectives, 1, 21-22 clinical studies, 24 discrimination, 9-10, 24 life expectancy, 7, 74-75, 76, 183 sex and gender defined, 7, 174-175 HIV, see AIDS Hormonal processes, 4, 6, 7, 9, 14, 20, 32, 46,47,72-73,75,173,178,181, 231 see also Adrenal gland; Androgen; Estrogen; Testosterone antimullerian hormone, 54, 55-56, 60 behavioral effects, 79-81, 89-97 261 body composition, 131 brain, 81-83, 92, 96, 97, 102-104, 112-115 cardiovascular effects, 114, 164, 165, 166, 170, 171, 238 chorionic gonadrotropin-luteinizing hormone (LH), 56, 58, 64, 65, 68 cognitive effects, 79-82, 96-104 defined, 241 estradiol, 65, 67-68, 81, 146 follicle-stimulating hormone (FSH), 58, 64,65,68,70 gender identity, 18, 90-91 gene expression, 29-32 (passim), 44 growth, 66-67, 139, 238 hormone treatment, 16, 73, 103, 152, 157, 165 hypothalamic luteinizing hormone- releasing hormone (LHRH), 64- 65 immune response, 143, 144-145, 152, 155, 156-159 insulin, 67, 70, 238 leptin, 66-67, 137 melanoma, 141 menopause, 72-73; see also "hormone treatment" supra obesity, 136, 137 osteoporosis, 130, 139, 140 pain, 107-108, 109 pituitary, 59, 62, 64, 145 pregnancy/prenatal period, 48, 49, 50, 51, 52, 54, 55-56, 58-59, 60, 79-80, 89-95, 146, 152 progesterone, 113-114, 121-122, 136, 235 progestins, 72 prostate gland, 62 psychosexual differentiation, 80-81 puberty, 45, 62, 63, 64, 65, 66-71, 72 sex determination/differentiation, 50, 51, 54, 55-59 social factors, 93 steroids, pain, 107-108 prenatal period, 50, 51, 54, 55, 56, 58- 59 stress, 75, 77 testes, organogenesis, 55-56 thyroid gland, 22, 123, 140, 142, 149, 150, 154-155, 156-157, 158 Hyperactivity disorder, 128 Hypertension, 49, 70, 72, 74, 160, 162, 165- 166

262 Hypothalamic luteinizing hormone- releasing hormone (LHRH), 64- 65 Hypothalamus, 62, 64-65, 82-83 immune response, 145 menopause, 72 I Idiopathic hypogonadotropic hydropogonadism, 91 Imaging technology, brain, 102-103, 111 Immune system, 15, 22-23, 142, 143-147 see also Infectious diseases age factors, 153-154, 155, 157 androgen, 144 animal models, 147, 148, 149, 152, 154- 159 antigens, 34, 146, 149, 155, 157, 239 autoimmune diseases, 20, 142-143, 147- 159, 239 cellular processes, 143, 144, 145, 149, 153, 178-179 definitions, 239, 241 environmental factors, 143, 150-151, 155 estrogen, 145, 152, 157 genetic factors, 143, 144, 153, 155 hormones, 143, 144-145, 152, 155, 156-159 inflammation, 142, 143, 144, 152 leukocytes, 114, 144, 146, 152 melanoma, 141 menstrual cycle, 143, 144-145 pregnancy, 143, 144, 147, 152 social factors, 143, 144 Immunization, 23, 145-146, 148, 154-155 Infancy, 64, 70 Infectious diseases, 46, 142-149 coronary heart disease and, 159, 170, 171 cultural factors, 147 defined, 241 immunization, 23, 145-146, 148, 154-155 Inflammation, 142, 143, 144, 152 Influenza, 146 In Her Lifetime: Female Morbidity and Mortality in Sub-Saharan Africa, 16 In Her Own Right: The Institute of Medicine's Guide to Women's Health Issues, 16 Insulin, 67, 70, 238 Interdisciplinary research, 8, 9, 10, 11, 15, 173, 175-176, 177, 181-183 committee approach, ix, 2 INDEX International perspectives coronary heart disease, 161-162, 166 life expectancy, 76 World Health Organization, 18 K Kidney, see Renal system L Lactation, 139 Language factors, 19, 86-87, 97, 98, 99-104 puberty, 71 reading abilities, 71, 99-104 Legislation see also Regulatory issues National Institutes of Health Revitalization Act, 25 Leprosy, 148, 149 Leptin, 66-67, 137 Leukocytes, 114, 144, 146, 152 Leydig cells, 58, 60, 64, 66, 68 Life expectancy, 7, 74-75, 76, 183 Lipoproteins, 114, 123-124, 136, 160, 162, 163, 164, 178, 238 Liver, see Hepatic system Longitudinal studies, 7-8, 9, 10, 11, 127, 176, 180 coronary heart disease, 161-162 Lupus, 22, 106, 149-159 (passim) Lyme disease, 148, 151, 152 M Malaria, 149 Mathematical abilities, see Quantitative abilities Measles, 146, 148 Meiosis, 28, 34, 4142, 46 defined, 241 testicular organogenesis, 56 Melanoma, 130, 140-142 Memory, 87, 95, 99, 104 Meningitis, 146 Menstrual cycle, 115, 120, 128, 180, 235 calcium requirements, 139 cognitive effects, 97-98 dysmenorrhea, 111-112 food intake, 131 hypertension, 165

INDEX immune response, 143, 144-145 menarche, 65-66, 70 menopause, 72-73, 98-99, 102-103, 136, 139, 140 cerebrovascular and coronary disease, 72, 73, 162, 163, 164 pain, 109-112 toxins, exposure to, 142-143 Mental illness, 84 see also Stress depression, 80, 130, 145 hyperactivity disorder, 128 obsessive-compulsive disorder, 237 posttraumatic stress disorder, 130 Metabolic processes, 7, 131-133, 231, 234, 237 see also Diabetes mellitus, Enzymatic processes carcinogens, 119 drugs, 118, 119, 124, 125, 242 energy storage and, 7, 117, 118, 120, 130, 131-132, 134, 136, 137, 170 obesity, 134, 136 pregnancy/prenatal environment, 49 X-chromosome inactivation, 38 Military personnel, 137-138 Minority groups, see Race/ethnicity Mitosis, 37, 241 Molecular biology, 1, 4, 13, 15, 21, 179 see also Enzymatic processes; Genetics; Genomics; Hormonal processes; Proteins coronary heart disease, 171 infection and inflammation, 143 osteoporosis, 130 Mosaicism, 36-40 (passim), 44 defined, 240, 242 Motor skills, 86, 87-88, 128 Mullerian ducts, 55, 60, 61, 62 Multidisciplinary research, see Interdisciplinary research Multiple sclerosis, 20, 152 Mumps, 146 Muscle, 126, 128(n.1), 131, 134, 137, 231 mass, 72 pain, 106, 110, 111 Mutation, 31, 32, 36, 38, 40, 42, 43, 51 pubertal growth spurt, 68 transgenics, 43, 51 Mycobacteria, 148-149 263 N National Cancer Institute, 177-178 National Health and Nutrition Examination survey, 162 National Institutes of Health (NIH), 15-16, 25, 26, 127-128, 175, 177, 182, 183- 184 National Institutes of Health Revitalization Act, 25 Native Americans, see American Indians Neurological factors, 15, 127, 128 see also Brain; Central nervous system; Pain Neurons, 81-83, 99, 107, 108, 113 Nitric oxide, 82 Nociception, 105-108 Nuremberg Code of Ethics, 24 Nutrition see also Body weight; Obesity coronary heart disease, 161, 170 energy storage and metabolism, 7, 117, 118, 120, 130, 131-132, 134, 136, 137, 170 height, 21 menstrual cycle, 131 pain perception and, 107 pregnancy/prenatal environment, 49, 70 o Obesity, 21, 49, 70, 132-137 coronary heart disease, 159 diabetes, 132-133 osteoporosis, 139 Obsessive-compulsive disorder, 237 Oocytes and ova, 37, 40, 41, 42, 55 animal models, sex determination/ differentiation, 47 Opioids, 109 Osteoporosis, 20, 73, 130, 138-140 Ovaries menopause, 72, 98 polycystic ovary syndrome, 70 prenatal development, 51, 54, 55, 58-59 puberty, 68, 70 Oxytocin, 75

264 p Pain, 23, 46, 74, 79, 105-112 analgesics, 105-109, 110 animal models, 109, 111 estrogen, 107-108 headache, 106, 112 Parasitic diseases, 148-149 Parental factors, 2-3,16 Perception, 79, 86 see also Pain pregnancy/prenatal period, 48 spatial abilities, 88, 92, 95,104 visual perception, other, 96 Performance, see Physical performance Pertussis, 146 Pharmaceuticals, 25-26,117, 118-130, 231- 238 see also Drug metabolism; Food and Drug Administration analgesics, 105-109, 110 antihypertensive therapies, 74 bone loss, 140-141 clinical studies, 108, 127,130 coronary heart disease, 158, 170, 171 definitional issues, 118, 242 estrogen replacement therapy, 73, 103, 152, 157, 165 hormone treatment, general, 16 infectious diseases, 148 Pharmacodynamics, 118,119,127, 231 defined, 242 Pharmacokinetics, 118,119,124,125, 127, 231, 237 defined, 242 Phenotypes, 6, 17, 19, 21, 28, 32, 42, 43, 44, 46, 80 see also Sex determination and differentiation behavior and perception, 79-116 defined, 242 inflammation and immunity, 143,144 radios, 29 Physical activity, 132,137-138 immune response, 145 obesity, 134 osteoporosis, 130 Physical performance, 130, 137-138 motor skills, 86, 87-88,128 strength, gross motor, 86,130 Physiological factors, 1, 2, 7,14, 15,19, 233- 238 INDEX see also Metabolism sex and gender defined, 18 Pituitary gland immune response, 145 prenatal period, 59, 62 puberty, 64 Placenta, 49, 58, 131 Platelets, 74,168, 236 Pneumococcal infection, 146 Polycystic ovary syndrome, 70 Posttraumatic stress disorder, 130 Preeclampsia, 166 Pregnancy/prenatal period, 2-3, 5-6, 16, 24, 25, 45-46, 48-62, 77, 78, 181 androgen, 52, 55, 60, 89, 90-94 animal models, 48 autoimmune diseases, 152 behavioral effects, 79-80, 89-90 body weight, 131 calcium diversion from mother, 139 cognitive development, 79 coronary heart disease, 158, 161, 166, 167, 171 diabetes of, 167 disease and disorders, general, 4849, 79-80 embryos, 22, 37, 41, 42, 47, 50, 55, 96 environmental factors, 45, 48, 49, 70 hormones, 48, 49, 50, 51, 52, 54, 55-56, 58-59, 60, 79-80, 89-95, 146, 152 hypertension, 166 immune response, 143,144,147,152 melanoma, 141 metabolism, 49 nutrition, 49, 70 ovaries, organogenesis, 51, 54, 55, 58-59 pituitary gland, 59, 62 placenta, 49, 58, 131 postnatal stress, 107 protein binding, 123-124 sex determination/differentiation, 45, 46, 51-55, 95 steroids, 50, 51, 54, 55, 56, 58-59 testes, organogenesis, 34, 35, 45-46, 50- 51, 54, 55-58, 60 testosterone, 48, 52, 56, 58, 59, 60-61, 62, 91-92 Professional education, interdisciplinary, 182 Progesterone, 113-114, 121-122,136, 235 Progestins, 72 Prostate gland, 62

INDEX Proteins binding, 123-124,127, 128 digestion, 122 energy storage and metabolism, 131 genetic encoding, 29, 35 inflammation and immunity, 143 lipoproteins, 114,123-124,136,160, 162, 163, 164, 178, 238 prepubertal period, 65 sex determination, 53 Pseudoautosomal region, 33, 34, 35, 42 Psychological factors, see Behavioral factors; Cognitive factors; Mental illness Psychomotor skills, see Motor skills Puberty, 45, 62, 64-72, 77 androgen, 63, 68-69 behavior, 45, 70-72 brain/cognition, 71 energy requirements, 132 estradiol, 65, 67-68 estrogen, 64, 65, 68, 71, 72 growth spurt, 62, 66, 67-68, 69 hormones, 45, 62, 63, 64, 65, 66-71, 72 language development, 71 ovaries, 68, 70 pituitary gland, 64 race/ethnicity, 65-66 secondary sex characteristics, 62, 65, 66, 67, 69, 71 social factors, 71-72 testes, 66, 67, 68 testosterone, 65, 66, 68, 71 Public education, 2,15 Public Health Service, 24, 25 Pulmonary tract, 122-123 Q Quantitative abilities, 86, 88-89,104 R Race/ethnicity, 20, 23, 25,128,184 see also specific groups body composition, military standards 138 coronary heart disease, 161, 162, 163, 165-166, 170 Food and drug Administration, drug applications, 175 265 obesity, 134, 135 osteoporosis, 138 puberty, 65-66 Reading ability, 99-104 dyslexia, 71,100, 101-102 Regulatory issues, 24-26,181 see also Food and Drug Administration animal research, 6, 78,181 institutional review boards, 181 Renal system, 60,123,125-127, 128, 140, 235 Reproductive system, ix, 1,15,19 see also Embryos; Fertility; Menstrual cycle; Oocytes; Ovaries; Pregnancy/prenatal period; Testes body size and composition, 130 coronary heart disease and, 172 pain and reproductive status, 105,107, 108 Research recommendations, 2-11, 21-26, 44, 78, 104, 115-116, 127-128, 172, 173-184 Rheumatic diseases, 106,123,142,148,150- 154 (passim) Ribosomes, 35 Rubella, 146, 148 S Scleroderma, 147, 151 Secondary sex characteristics, 45, 50 breasts, 66, 72, 79,180 menopause, 72 puberty, 62, 65, 66, 67, 69, 71 Serotonin, 83,130, 137, 235, 237 Sertoli cells, 51, 52, 56, 60 Setraline, 130 Sex, defined, 7-8, 10, 11, 13(n.2), 17-19,173, 174-176, 231, 240, 242 Sex determination and differentiation, 2, 5, 15, 34, 44, 4647, 50-62, 63, 93, 97, 115, 174, 233-238 see also Secondary sex characteristics abnormal, 50 androgen, 52, 55, 60, 80 animal models, 46, 4748, 51, 54, 59, 80- 81 autosomes, 50, 51, 54 behavioral factors, 6, 18 body composition, 131 defined, 50 diseases related to, 54, 63, 83-84,115

266 gender identity, 6, 7, 8, 13(n.2), 15, 17- 18, 79, 83-84 hormones, 50, 51, 54, 55-59 prenatal period, 45, 46, 51-55, 95 psychosexual differentiation, 80-83; see also "gender identity" supra secondary sex characteristics, 45, 50, 62, 65,66,67,70,71 SRY gene, 34, 50-51, 53, 54, 55, 56-57 testicular organogenesis, 34, 35, 4546, 55-58 transcription, 51, 53, 55 Sexual activity, exposure to toxins, 142-143 Skeletal system, see Bone Skin, 231 melanoma, 130, 140-142 menopause, 72 pharmaceuticals, 122 scleroderma, 147, 151 toxins, exposure to, 142-143 Sleep, 144, 236 Smoking, 140, 143, 236 coronary heart disease, 162-163 menopause, early, 162 Socioeconomic status, 16 Sociological factors, xx, 2, 3, 14, 15, 21 adulthood, 72 body composition, 130 cultural factors, 80, 84, 147 family relations, 71 parental factors, 2-3, 16 gender identity, 8, 17-18, 94 hormones and, 93 infectious diseases, 147, 148 inflammation and immunity, 143, 144 melanoma, 141 obesity, 134 puberty, 71-72 toxins, exposure to, 143 Somatic cells, 4, 31, 37, 38, 44 Spatial abilities, 88, 92, 95, 104 Spermatogenesis, 33, 34, 35, 37, 40, 41, 42 animal models, sex determination/ differentiation, 47 Spina bifida, 49 SRY gene, 34, 50-51, 53, 54, 55, 56-57 Stem cells, 41, 56 Steroids pain, 107-108 prenatal period, 50, 51, 54, 55, 56, 58-59 Strength, gross motor, 86, 130 Stress, 75, 77, 107 INDEX coronary heart disease, 161, 165 immune response, 145 Synapses, 81, 83 T Testes organogenesis, 34, 35, 4546, 50-51, 54, 55-58, 60 psychosexual differentiation, 80-81 puberty, 66, 67, 68 spermatogenesis, 33, 34, 35, 37, 40, 41, 42,47 Testosterone, 46, 234, 238 adulthood, 73 behavioral effects, 93 brain, 82 pain perception, 107 prenatal period, 48, 52, 56, 58, 59, 60-61, 62, 91-92 puberty, 65, 66, 68, 71 Therapeutic index, 118, 242 Thyroid gland, 22, 123, 140, 142, 149, 150, 154-155, 156-157, 158 Tobacco use, see Smoking Toxic agents, xix, 3, 7, 23, 143, 150-151, 170 coronary heart disease, 159 Transcription, 38 sex determination, 51, 53, 55 X-chromosome inactivation, 28, 31, 33, 36, 37-39, 44 Transgenic animals, 43, 51, 54, 78, 82, 114, 154, 156-159 Transmission ratio distortion, 42 Triiodothyronine, 67 Trypanosomiasis, 149 Tuberculosis, 149 Turner syndrome, 63 Twins, 48 V Vaccines, see Immunization Verbal abilities, see Language factors Viral infections, 146, 147, 148 immunization, 23, 145-146, 148, 154-155 Visual perception, 96 spatial abilities, 88, 92, 95, 104 Vitamins, 170 vitamin A, 148 vitamin D, 139

INDEX W Weight, see Body weight; Obesity White persons, see Caucasians Wolffian ducts, 55, 60, 61 Women and Health Research, 182 267 Women's Health: NIH Has Increased Its Efforts to Include Women in Research, 175,177, 178 World Health Organization, 18 X X-chromosome inactivation, 28, 31, 33, 36, 37-39, 44

Exploring the Biological Contributions to Human Health: Does Sex Matter? Get This Book
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It's obvious why only men develop prostate cancer and why only women get ovarian cancer. But it is not obvious why women are more likely to recover language ability after a stroke than men or why women are more apt to develop autoimmune diseases such as lupus.

Sex differences in health throughout the lifespan have been documented. Exploring the Biological Contributions to Human Health begins to snap the pieces of the puzzle into place so that this knowledge can be used to improve health for both sexes. From behavior and cognition to metabolism and response to chemicals and infectious organisms, this book explores the health impact of sex (being male or female, according to reproductive organs and chromosomes) and gender (one's sense of self as male or female in society).

Exploring the Biological Contributions to Human Health discusses basic biochemical differences in the cells of males and females and health variability between the sexes from conception throughout life. The book identifies key research needs and opportunities and addresses barriers to research.

Exploring the Biological Contributions to Human Health will be important to health policy makers, basic, applied, and clinical researchers, educators, providers, and journalists-while being very accessible to interested lay readers.

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