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Cited by 463Erythropoietin and Anemia TreatmentIron Metabolism and DisordersHemoglobin structure and function

The sex difference in haemoglobin levels in adults—mechanisms, causes, and consequences

Murphy, William G.·2014·Blood Reviews
DOI 10.1016/j.blre.2013.12.003
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Abstract

Men and women have different mean haemoglobin levels in health in venous blood - women have mean levels approximately 12% lower than men. A similar sex-related difference in haemoglobin levels in adult animals is found in many species of mammals, birds and reptiles, indicating that it is an important physiological phenomenon. It is probably a direct effect of sex hormones, both oestrogen and androgens, on erythropoiesis. However, since there is no difference in erythropoietin levels between the sexes, this effect most likely takes place in the kidney, rather than in the bone marrow. Oestrogens dilate and androgens constrict the renal microvasculature: dilation and vasoconstriction in vessels below 300 μm in diameter respectively increase and decrease the haematocrit in blood in arterioles, capillaries and venules, altering the oxygen delivery per unit red cell mass, and providing a mechanism for varying the red cell mass without compensatory changes in erythropoiesis.

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Crossref · 10.1016/j.blre.2013.12.003

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  • An 11% increase in circulating hemoglobin translates to a 10% difference in maximal oxygen transfer, which may account for virtually all the 12% sex difference in male and female circulating hemoglobin.

    “An 11% increase in circulating hemoglobin translates to a 10% difference in maximal oxygen transfer (124), which may account for virtually all the 12% sex difference in male and female circulating hemoglobin (125).”

    From Circulating Testosterone as the Hormonal Basis of Sex Differences in Athletic Performance (2018) · cites this paper as [125]

  • Circulating hemoglobin levels are higher in men than in women by 12% on average.

    “It is well known that levels of circulating hemoglobin are androgen-dependent and consequently higher in men than in women by 12% on average; however, the physiological mechanism by which androgens such as testosterone boosts circulating hemoglobin is not fully understood (121).”

    From Circulating Testosterone as the Hormonal Basis of Sex Differences in Athletic Performance (2018) · cites this paper as [125]

  • When circulating testosterone was suppressed to <10 nmol/L, the levels of circulating hemoglobin were 12% lower and comparable with nondoped, non-DSD females, corresponding to the 12% magnitude of the sex difference in hemoglobin between men and women.

    “However, when circulating testosterone was suppressed to <10 nmol/L the levels of circulating hemoglobin were 12% lower and again comparable with nondoped, non-DSD females, corresponding to the 12% magnitude of the sex difference in hemoglobin between men and women (125).”

    From Circulating Testosterone as the Hormonal Basis of Sex Differences in Athletic Performance (2018) · cites this paper as [125]

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Authors
Murphy, W. G.
Affiliations
University College Dublin (IE)
Corresponding author
Murphy, William G.
ORCID
Murphy, William G.
Venue
Blood Reviews
Publisher
Elsevier BV
Published
2014-03
Volume
28
Issue
2
Pages
41-47
ISSN
0268-960X (ISSN-L)
DOI
10.1016/j.blre.2013.12.003
OpenAlex
W2155094895
Cited by
463
References
90
Citations by year
2026: 59 · 2025: 56 · 2024: 55 · 2023: 57 · 2022: 52 · 2021: 60 · 2020: 36 · 2019: 30 · 2018: 17 · 2017: 25 · 2016: 7 · 2015: 7 · 2014: 2
FWCI
2.09
Type
journal article
Language
en
Open access
closed
Locations
  • Blood Reviews (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Hematology › Erythropoietin and Anemia Treatment
  • Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Hemoglobin structure and function
Keywords
sex differences, hemoglobin levels, sex hormones, estrogen, androgens, erythropoiesis, erythropoietin, renal vasoconstriction, renal microvasculature, hematocrit, oxygen delivery, red cell mass, venous blood
MeSH terms
Adult, Animals, Erythropoiesis, Female, Hemoglobins, Humans, Male, Sex Factors

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