Study calls for tailoring treatment for alcohol use disorders in men, women

While it has been previously known that men and women have different risks related to alcohol misuse and related problems, the biological mechanisms underlying those differences are not well understood. "This is the first large study to confirm that some of the variability in alcohol use disorder (AUD) and related problems is associated with particular combinations of hormones and chemical biomarkers in men and women," said lead researcher Victor Karpyak, Professor of Psychiatry at Mayo Clinic in Rochester, Minnesota (US). Karpyak said this means that "sex-specific treatments can be tailored to improve responses for men and women with alcohol problems". The researchers focussed on hormonal and protein markers of 268 men and 132 women with AUD; and correlated them with psychological markers, such as depressed mood, anxiety, craving, alcohol consumption, and treatment outcomes during the first 3 months of treatment. At the beginning of the trial -- before anyone had taken any medication -- the researchers tested men and women for several sex-specific blood markers, including sex hormones (testosterone, oestrogens, progesterone) as well as proteins known to impact their reproduction (such as follicle-stimulating hormone, and luteinizing hormone) or bioavailability of these hormones in the blood (albumin and sex hormone-binding globulin). They found that men with alcohol use disorder, symptoms of depression, and higher craving for alcohol, also had lower levels of the hormones testosterone, oestrone, oestradiol, as well as the protein sex hormone binding globulin. However, no such associations were found in women with AUD. Further, women who had higher levels of testosterone, sex hormone-binding globulin, and albumin were also more likely to relapse during the first three months of treatment compared to women with lower levels of those biochemical markers. But "no such relationships were found in men," Karpyak said. Karpyak said this implies that what works for a man may not work for a woman, and vice versa. The researcher also called for further studies to understand the differences between men and women with AUD to tailor treatment options. The study was presented at the ongoing European College of Neuropsychopharmacology (ECNP) Conference in Milan, Italy.