A future of personalized medicine for astronauts: Considering genetic variability and biologic sex-based differences in space medicine

The spaceflight environment affects nearly every physiological system in the human body. Spaceflight impacts human biology through genetic, epigenetic, and biologic sex-based responses to microgravity and radiation. Additionally, space medicine has historically been male-focused, resulting in a large disparity in available data related to the differences in understanding female and individual variability in space physiology. It is important to explore the longitudinal effects of space travel and microgravity on the female as well as male human body. Ultimately, understanding the different biologic differences amongst astronauts may be significant to optimize human health in space. We discuss the need for personalized medicine that considers genetic diversity, epigenetic adaptation, and biologic sex-specific factors to optimize astronaut health across demographics.