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Gender and Medicine

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"Gender medicine is not feminist. It's about real science...later the patient will reap the benefit"  Dr Alyson McGregor, Brown University. 

 

As someone who relies on medication to keep my health conditions under control (Lupus) this is a topic that I'm very interested and it catches my eye if I see it in a magazine/paper.  I also run a business that caters for women, as well as women with specific health needs such as having had a mastectomy, and issues around gender with women transitioning from a male body to a female one.  Health, medication and gender are around me in my professional and personal life every day.

My Dad subscribes to the BBC magazine "Science Focus" (formally just BBC Focus) and an article in there recently about gender and medicine was fascinating. If you'd like to read it, I can scan and send you a copy, but to summarise the writer Simon Crompton wrote:

  • Only in the past decade has mainstream medicine started to realise that different drug doses may be needed for men and women
  • This was accelerated by the findings that a sleeping and jet lag treatment caused women to act bizarrely with no recollection of what they have done. After the US drug regulators investigated, it was found that women needed half the amount than men do, as women metabolise it slower than men, meaning it stays in their system longer. 
  • The old medical view of a woman with regard to medicine was that they are essential men with "boobs and tubes". 
  • Since changing ideas, it has found that women experience heart attacks differently.  For men, look out for a tight pain in the chest, shooting pains down the arm and dizziness. With women, look for shortness of breath, fatigue, nausea and pain in the lower jaw or back. 
  • We have found that women have faster and stronger immune responses than men, as testosterone dampens men's responses. 
  • This results in men being more likely to die of infectious diseases
  • Women are more likely to have autoimmune diseases (like lupus, which is a "woman's disease"). The believe percentage of autoimmune diseases is 78% women. 
  • Women and men have different metabolisms and different experiences of pain.
  • Biological sex and gender with characteristics and identity shapes by society and the environment and now both being studied on their influence over medicine.
  • Women and men tend to experience Alzheimer's differently. Look for behavioural changes and aggression in women, and physical impairment and aggression in men.
  • Gut function really seems to vary, with women taking twice as long to digest food and medication, being more likely to get gall stones have IBS. 
  • The main reason behind the assumption, until now, that medicine works the same for men and women, is that all medical trials were carried out on men.  It was believed that women of childbearing years etc should be protected from harmful testing.  As a result, the differences in medication influence were not seen in a lab environment and when women are involved the results tend to be combined so the differences between them are never discovered in the same way as separate testing for men and women. 
  • Gender medicine has been slow to grow due to cost. Trials on women are more expensive. Hormone fluctuations mean as woman needs checking more often, depending on where they are in their menstrual cycle. 
  • Despite the costs, Dr Alyson McGregor states that it is important for the evolution in excellence in health care. Afterall, currently mixed trials are potentially making the results inaccurate for men too.  

Clearly, we are experiencing a change in the medical and pharmaceutical industries, but this change will take time. I await with interest the day that I see the first change on a medication packaging, detailing the dose for men and the dose for women. 

For more information about Dr Alyson McGregor, you can read her TED page here and watch her TED talk on the subject at the bottom. 

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The article I read was written by Simon Crompton, a science journalist, and you can read some of his other articles for free on The Times website here.

 

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