Gender Differences With Low-Dose Minoxidil Side Effects

TOPLINE:

A series of retrospective studies reported that women treated with low-dose oral minoxidil (LDOM) experience orthostatic symptoms more frequently than men, despite normal blood pressure (BP) readings.

METHODOLOGY:

• Researchers reported findings from multiple retrospective studies, which included patients with androgenetic alopecia (AGA) who received LDOM.
• Researchers also conducted a pooled analysis of five studies.
• Studies analyzed doses, changes in BP, and adverse events (AEs) in men and women.

TAKEAWAY:

• In a retrospective cohort study of 151 patients (59% women), LDOM was well-tolerated across age and sex groups; average doses for women and men were similar between women (1.9 mg/d for women and 2.1 mg/d for men; P = .32), with no clinically significant changes in BP.
• In another study of 128 patients (71.1% women), researchers noted no significant BP changes overall, except a minor diastolic BP reduction in men (-3.1 mm Hg; P = .01); women received lower doses than men (average, 1.265 mg/d vs 2.179 mg/d).
• In the pooled analysis that included the four other studies (n = 2409; 93.7% women), women were two to three times more likely than men to report AEs despite receiving a dose of < 1 mg/d and often with no measurable BP changes, suggesting BP monitoring may not fully reflect sex-specific tolerability differences.
• In a study of 310 patients with AGA (53.2% women), women were prescribed lower average doses than men (1.8 vs 2.2 mg/d; P < .001) but reported dizziness/lightheadedness more frequently (22.4% vs 5.5%; P < .001).

IN PRACTICE:

“Presence of hypotensive symptoms without measurable hypotension raises the possibility that symptom perception or anxiety-related responses to cardiovascular sensations may influence tolerability, especially in women,” the study authors wrote. “Further research is warranted to explore the physiologic and psychologic mechanisms underlying these sex-based differences, which could inform more personalized dosing and monitoring strategies,” they added.

SOURCE:

The study was conducted by Michael M. Ong, BS, Weill Cornell Medicine, and Shari Lipner, MD, Department of Dermatology, Weill Cornell Medicine, New York City, and was published online on June 26 in the Journal of the American Academy of Dermatology.

LIMITATIONS:

The reliance solely on BP measurements may not fully capture the range of vascular sensitivity experienced by patients.

DISCLOSURES:

The study received no funding. Lipner disclosed serving as a consultant for Moberg Pharma and BelleTorus Corporation.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.