Gastroparesis: Pathophysiology, Clinical Presentation, Diagnosis and Treatment: Chapter 37: Female Predominance in Gastroparesis

Elsevier, Gastroparesis, 2021, Pages 494-505
M. Showkat Ali, Zorisadday Gonzalez, and Richard W.McCallum

Gastroparesis is a disorder with slowed or inhibited movement of stomach contents into the small intestine. It has long been recognized that the female gender is more prone to gastroparesis, though the significance of this remains a mystery and has not been completely elucidated. Several hypotheses have been proposed over the years including elevated levels of sex steroid hormones, loss of neuronal nitric oxide (nNOS) expression, elevated oxidative stress, altered serotonergic signaling, and slower transit time in females. Targeting of these pathogenic mechanisms may point towards future therapeutic options to alleviate or prevent gastroparesis. Furthermore, factoring in gender when considering different treatment options for patients with gastroparesis will become increasingly important. This chapter will attempt to explain the epidemiology and pathogenesis of female predominance in gastroparesis. We will also discuss several potential explanations as to why females may be significantly more susceptible to developing gastroparesis compared to men.