Ethanol, its metabolism and gonadal effects: does sex make a difference?

The role of gender as a variable that might affect the metabolism of ethanol and thus the consequences of ethanol metabolism is reviewed. First, the pharmacodynamics of ethanol are reviewed. Specific differences between males and females relative to ethanol pharmacokinetic parameters are discussed including gender differences in the volume of distribution and putative hormonal effects on achieved blood alcohol levels. In addition, attention is directed toward the metabolic capacity of alcohol dehydrogenase and the microsomal ethanol oxidizing system with respect to effects of both sex differences and hormonal manipulations on the activities of these ethanol metabolizing enzymes. Finally, the data upon which the concept of sex-related differences in susceptibility to alcohol induced end organ failure are presented.