Sex and Gender Aspects in Vestibular Disorders: Current Knowledge and Emerging Perspectives-A Systematic Review.

Area of Science:

• Audiology and Otolaryngology
• Neuroscience
• Reproductive Biology

Background:

• Precision medicine emphasizes sex and gender determinants, yet knowledge in audio-vestibular disorders is limited.
• Existing research often overlooks sex and gender influences on vestibular conditions.
• This review addresses the gap by analyzing gender medicine evidence in vestibular disorders.

Purpose of the Study:

• To review sex- and gender-related evidence in vestibular disorders.
• To analyze pathophysiology, clinical presentation, and biological mechanisms.
• To examine prognostic variables, treatment response, and outcomes.
• To explore sex- and gender-specific diagnostic and therapeutic approaches.

Main Methods:

• Systematic literature search of PubMed, Scopus, and Web of Science databases.
• Protocol registered on PROSPERO (CRD42025641292).
• Analysis of 67 included studies after applying inclusion/exclusion criteria.

Main Results:

• Higher incidence of vestibular dysfunctions reported in females.
• Potential mechanisms include hormonal fluctuations, calcium metabolism, vitamin D, and estrogen receptors.
• Lifestyle, comorbidities, and health-seeking behaviors may influence disease expression and course.

Conclusions:

• Sex-related differences in vestibular disorder epidemiology and clinical presentation are suggested.
• Substantial gaps exist in understanding mechanisms, outcomes, and clinical implications.
• Future research requires sex- and gender-sensitive prospective studies with standardized reporting.