Let's address this person who thinks that the only difference between men and women are levels of sex hormones. https://t.co/vp3minSrGv
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Females have two x chromosomes. They deactivate one of them in each cell (although a not insignificant % escape - it's fascinating). Men have one x chromosome and one Y. We already know that these chromosomes are activated in much more than the gonads and pituitary.
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The Sry locus of the Y chromosome regulates tyrosine hydroxylase, a critical enzyme in the synthesis of norepinephrine. This changes how the body develops and deals with high blood pressure.
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Genetic variants in alpha and beta adrenergic receptors affect vascular tone. In females with atherosclerosis, these genetic differences can increase their risk of stroke, heart attack, and cardiomyopathy.
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We already know women respond differently to drugs, due to not only size etc but sex chromosome differences in the liver and in these adrenergic receptors. Sadly, research is woefully behind on this and we still don't have appropriate sex-specific treatment guidelines.
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Genes on the X affect inflammatory risk factors, including apoptosis, lipid oxidation, and generation of oxygen-derived free radicals produced by mitochondria. After stroke, females show greater and differential up regulation of genes on mosaic Xs compared to males with one X.
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Let's talk cholesterol. Sex hormones matter a lot here, but so do genes. Various loci have been identified that contribute to cholesterol synthesis which differ for males and females. This can affect statin efficacy, especially in women on T accelerating lipid metabolism.
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There are differences for males and females at the genetic level in prostaglandin signaling (affecting stroke), coronary calcium development (affecting stroke and MI), heritability of traits like carotid artery strength, and neurovascular changes.
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I have work to do so I will stop now but I think you get my drift here- women are not men with low testosterone, and taking testosterone doesn't turn them into men. They remain women with female-specific risks that may be accelerated by taking wrong-sex drugs for a LIFETIME.
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Saying "oh well they just came up to male risk" is embarrassingly ignorant, and shows an utter disregard for women and their bodies.
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And for anyone confused about why sex differences at the genetic level are in the entire body instead of just the genitals, get a clue. Pregnancy affects the WHOLE BODY. The female body has evolved for this.
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(And all of this is in addition to the fact that exogenous testosterone is also worsening diabetes risk in women, which will most certainly continue to INCREASE their risk of heart attack over time.)
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End of conversation
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