Understanding pharmacokinetic variability in women across different life stages

Introduction: The historical exclusion of adult women, including pre- and post-menopausal women, pregnant and breastfeeding women, from clinical trials has contributed to gaps in pharmacological knowledge and suboptimal care in these populations. To address this, it is mandatory to address absorption, distribution, metabolism, and elimination in adult women. Understanding these factors is critical for achieving appropriate dosing and effective pharmacotherapy. Area covered: This review summarizes pharmacokinetic variability in adult women across different life stages, highlighting the effects of age, the menstrual cycle, pregnancy, lactation, oral contraceptives, life style and hormone replacement therapy, providing some specific examples. Moreover, examples of sex differences in pharmacokinetic of protein-based therapeutics and physiologically based pharmacokinetic modeling are provided. Expert opinion: Emphasizing the urgent need of new pharmacological trials which including adult women considering the phase of their life, and life styles with the aim that current and future research will reduce disparities in patient care related to age, life stage, and sex conducted by investigators expert in pharmacokinetic and sex and gender research.