Gender medicine emphases on the patho-physiological, clinical, prevention and treatment differences in diseases that are similarly presented in both men and women. The chief objective of gender medicine includes offering receives the best treatment possible based on scientific evidence for each individual man and woman. Moreover, the concept of gender not only focusses on the sexual characteristics of individuals but also physiological and psychological attributes of men and women, comprising of risk factors, protective or aggravating effects of sexual hormones and variances associated with genetics and corporal structures of men and women. 

Gender differences can have a role in autoimmune diseases such as primary biliary cirrhosis (PBC) which is typified as a chronic cholestatic liver disease characterized by immune-mediated inflammatory destruction of the small intrahepatic bile ducts, and fibrosis. It usually occurs in females, aged 40-60 years. The incidence rates in women and men range from 3:1 to 22:1, with an average incidence rate in women of 10:1. The underlying cause of these gender differences is the immune system, as estrogen can modulate the immune system. Women have a significantly higher number of CD4+ T lymphocytes and a higher CD4+/CD8+ ratio than men. Furthermore, the secretion of interferon-γ and interleukin-10 was increased after the supplementation of estrogen in T-cell clones isolated from women.

The severe forms of liver diseases such as hepatitis, cirrhosis are interlinked with ingestion of 160 g/die of alcohol in 10-20 years. It has been estimated that the incidence of alcoholic liver disease increases proportionally with the consumption of alcohol. However, mounting evidences suggest that hepatic damage develops faster in women in contrast to men. It has been revealed that the relative risk of developing cirrhosis was equal to 7 in men and 17 in women, in heavy drinkers with a weekly consumption of 336-492 g. Additionally, the relative risk of developing alcoholic liver disease was 3.7 in men and 7.3 in women. The reasons contributed to these gender differences involve differences in corporal structures, different enzymatic activity and hormonal differences.

Source: Durazzo M, Belci P, Collo A, et al. Gender specific medicine in liver diseases: a point of view. World J Gastroenterol. 2014;20(9):2127-2135.