Men vs. Women Still Matters in Modern Medicine
By Jenny Peterson
There are many different healthcare recommendations for men and women, from ideal body fat percentage to how many alcoholic drinks each can safely have in a day.
Historically, healthcare has been male-focused. Clinical trials have often relied heavily on male participants, even for medications used by both sexes. For decades, this meant that data informing treatment decisions was not always fully representative of the populations actually taking those medications.
It wasn’t until 1991 that the National Institutes of Health created the Office of Research on Women’s Health and launched large studies on postmenopausal hormone therapy, diet and supplements like calcium and vitamin D to help address heart disease, fractures and cancer. That research marked a turning point in recognizing that sex-based differences in health outcomes are important.
Since then, research has continued to reinforce what clinicians now see in practice: men and women don’t respond the same way to disease, medication or treatment.
Differences in hormones, metabolism, body composition, fat distribution and immune response all influence how care works in the real world. Even in patients of the same gender, nuanced differences like stress response and sleep regulation can vary person to person, creating uneven results and different side effects across many treatments.
Those differences are becoming more visible as newer treatments enter the mainstream.
From GLP-1 weight-loss medications to hormone therapies and metabolic interventions, providers say understanding a person’s unique biology is helping them better predict side effects, fine-tune dosing and personalize treatment plans rather than relying on one-size-fits-all protocols.
Weight Loss Drugs
For popular metabolic weight loss treatments, doctors say hormones meaningfully influence how the medications work and how side effects present in patients.
“There is a huge hormonal influence on GLP-1 dosing,” said Dr. Chris Michaelis, owner of Luminus Aesthetic & Wellness.
“Estrogen increases the GLP-1 receptors, so women tend to have a higher concentration of the GLP-1 medication in their body and side effects can be a little bit higher. That means that for women, you have to start at a lower dose and be a little bit more gradual as you increase that dose.”
Dosing and tolerance can vary significantly between patients. While GLP-1 drugs are designed to regulate appetite and blood sugar by acting on gut-brain signaling pathways, individual hormonal environments appear to affect how strongly those signals are received.
Men typically respond more quickly to weight loss injections, Dr. Michaelis said, in part due to differences in body composition and baseline muscle mass.
“For men, their metabolism is usually already high, so they’ll get one dose and already start losing weight because of their fat-to-muscle ratio and start burning fat right off the bat,” Dr. Michaelis said.
Muscle mass, insulin sensitivity and hormone levels all interact with medication in ways that can accelerate or slow outcomes.
Fluctuating estrogen levels for women throughout every month can also make dosing more complex, with additional considerations for women who are menopausal.
“Menopausal women have lower estrogen levels, so they see less side effects from the GLP-1 doses than younger women with higher estrogen levels,” Dr. Michaelis said. “As a clinician, we often have to change dosages on a dime based on reactions. We may even change diet, what times of the day someone is eating and even change their exercise regimen so they can start metabolizing a little bit quicker.”
This kind of individualized adjustment reflects a broader trend in metabolic medicine. Responsible providers are constantly adjusting doses based on ongoing response, side effects and lifestyle factors.
These nuances are also why providers emphasize medical supervision when starting weight loss drug therapies.
“You see so many people buying needles on Amazon and they haven’t been taught how to properly give themselves a shot. And there are all these complications that can come from blindly going down those roads and not seeking actual medical guidance,” Dr. Michaelis said.
Beyond safety concerns, clinicians say unsupervised use can obscure important biological signals that help determine whether a dose is appropriate or whether side effects are being managed.
Testosterone, Estrogen and the Individualized Model
While men and women have differing health frameworks, there are still many overlapping hormones.
Both men and women produce estrogen and testosterone, for example, just in different ratios. Those differences influence energy, mood, muscle maintenance, sleep and recovery.
“We’re all working with the same hormones — just in very different amounts,” said Dr. Sherri Jacobs, a Naturopathic Doctor and certified nutrition specialist and co-owner of Remedy Wellness, a primary care and wellness collective on Johns Island.
At Remedy, providers rely on lab tracking and hormone-based adjustments across treatments for both men and women.
While there have been many conversations around perimenopause and menopause, Dr. Jacobs said hormone imbalance is not only a women’s health issue.
“Low estrogen in males is not great either,” said Dr. Jacobs. “Sometimes we’ll use small doses of progesterone in men to increase respiratory drive for issues like sleep apnea.”
Treatment in functional medicine is moving away from rigid “male vs. female” dosing frameworks and toward a more fluid understanding of how hormones actually behave in the body.
“We believe in following hormones closely,” said Misti Borgestad, a family nurse practitioner at Remedy. “We look at hormone precursors and peptides that increase hormone production in different ways. We’re really looking at how everything is working together.”
A 70-year-old patient in excellent shape who exercises regularly will not be treated the same way as a sedentary patient of the same age, even if their diagnoses are identical, Dr. Jacobs said. Lifestyle, activity level and metabolic health can shift how aggressively or conservatively treatment is approached.
Remedy uses a membership-based healthcare model and offers a “HER” program for women focused on hormone health across perimenopause, menopause and beyond.
While much of hormone-focused care has traditionally centered on women, particularly during midlife transitions, providers say interest is expanding across demographics.
“Men come in for not just decreased sex drive, but decreased drive in general,” Dr. Jacobs said. “We’re seeing more interest in personalized medicine. Especially with younger patients, more people are more open to understanding how their hormones affect how they feel. It’s not as common for men to come in and want this level of care – although they need it.”
This more targeted and data-driven model tracking individual patient responses over categorical assumptions makes treatment more precise, adaptive and effective.
