title: Sex Differences in Alcohol Use Disorder.
abstract: BACKGROUND
  Alcohol use disorder (AUD) is a common and disabling mental disorder associated with a significant burden of medical consequences and high socioeconomic costs. Although a growing number of studies support the existence of sex differences in several aspects of alcohol consumption and AUD, the majority of investigations have been conducted in men.
  
  
  OBJECTIVE
  This article was aimed at reviewing sex differences in AUD, focusing on epidemiology, neurobiology, pharmacokinetics, susceptibility to medical consequences, and treatment.
  
  
  RESULTS
  Although AUD is more prevalent in men, the number of women with AUD is rapidly increasing, especially in adolescents. Women show a higher vulnerability to medical consequences induced by alcohol consumption, including alcohol-related liver disease, cardiomyopathy, and breast cancer. This observation is only partly explained by the sex differences observed in the pharmacokinetics of alcohol. Women also show an accelerated progression from the first use of alcohol to the onset of AUD and appear to be at higher risk of alcohol- medication interactions. Although AUD women are less likely to seek treatment than men, they achieve better results through dedicated programs taking into account the special needs of female patients. However, findings on the efficacy and safety of medications used to treat AUD mostly come from studies in which women were largely underrepresented.
  
  
  CONCLUSIONS
  The sex differences observed suggest the urgent need to conduct studies recruiting adequate numbers of female subjects, to increase knowledge of sex differences in AUD, and to develop personalized and evidence-based approaches of prevention and treatment of AUD in women.
authors.affiliation: Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cittadella Universitaria, S.S. 554, km. 4.500, I-09042 Monserrato (CA). Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Agabio
authors.affiliation: Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari. Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Pisanu
authors.affiliation: Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari. Italy.
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Gessa
authors.affiliation: National Laboratory of Gender Medicine of the National Institute of Biostructures and Biosystems, Osilo, Sassari. Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Franconi
mesh_terms: D000428:Alcohol Drinking / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D019973:Alcohol-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D000818:Animals; D006801:Humans; D012727:Sex Characteristics
keywords: Alcohol use disorder; alcohol; alcohol-related consequences; sex differences; treatment; women