Sex- and age-specific trends in prescription medication use, 2005–2025: a nationwide repeated cross-sectional study

Background Previous studies have documented higher medication consumption among females than males; however contemporary sex-based differences across age and therapeutic classes remain poorly characterized. Methods We used the Danish National Prescription Registry to identify all prescriptions redeemed by Danish adults in 2005, 2015 and 2025, assessing overall medication use by sex and age. For the 30 most prescribed therapeutic classes, age-adjusted rate ratios (aRRs) with 95% confidence intervals (CI) were estimated to compare use between sexes. Polypharmacy (≥ five medications redeemed within a calendar year) was also assessed by sex and age groups. Findings In 2025, females accounted for 52% of total medication consumption (1.98 billion Defined Daily Doses (DDDs) among females vs. 3.82 billion DDDs overall), down from 60% (1.17 billion vs. 1.96 billion DDDs) in 2005. This female excess was confined to early adulthood; from age 55 onward, male consumption exceeded that of females. While some of the higher medication use reflected a higher prevalence of certain conditions among females (e.g., thyroid disorders, osteoporosis, depression), females also exhibited a higher use of mental health medications, including antipsychotics, and, newly in 2025, ADHD medications (aRR 1.25; 95%CI 1.16–1.34). Males more frequently used cardiovascular therapies (antithrombotic agents (0.64; 0.62–0.66), insulins (0.67; 0.65–0.69)). However, the historical male cardiovascular predominance was challenged in 2025: thiazide diuretics (1.19; 1.16–1.22) and non-insulin glucose-lowering drugs were more prescribed to females (1.08; 1.01–1.16). Polypharmacy was more common among females in early adulthood but converged after age 65. Interpretation Sex-based differences in overall medication use have narrowed over time. There is a need for continued monitoring of persistent and emerging sex differences in prescribing.