Peripheral effects of sex steroids: implications for patient management

Sex steroids--estrogens, progesterone, and testosterone and other androgens--have effects on the anatomy and physiology of many nonreproductive organ systems. These changes can influence the sex ratio of certain diseases. They also affect the "normal range" for certain parameters, and data from men often do not apply to normal female physiology. Sex steroids also affect the response to certain toxins, pharmacologic agents, and other therapies. Replacement sex steroid therapy and oral contraceptives may affect these processes differently than natural hormones do. The normal monthly changes of female hormones can also affect the severity of many conditions and may change the response to therapy in certain conditions, such as asthma or control of diabetes. This paper reviews the data on the effects of sex hormones on normal and pathologic human physiology and examines the therapeutic implications of these findings.