The first decade of the XXI century has already brought us several revolutionary medical discoveries: the bionic eye, a cure for hepatitis C, 3D printers of biological material and many others. The question is what's next. Judging by the medical journals, it's time for gender-oriented medicine.
Although scientists have been dealing with this topic for decades, a turning point in practice was made by the US Food and Drug Administration when it approved an initiative to prescribe different doses of the popular sleep medicine Ambien to men and women, making it the only drug on the US market whose dose depends from half the consumer.
The decision followed research that confirmed that women need more time to metabolically process the drug, which means that when they wake up, they still have more of it in their bodies than is recommended, which can lead to a number of unwanted consequences. . One of them is sleepiness behind the wheel when they go to work in the morning, for example. In men who drink the same medicine in the same dose, this was mostly not the case. In other words, women who drank Ambien, approved twenty years ago and prescribed in 40 million cases last year alone, were overdosed on this drug practically every day.
BIKINI MEDICINE: As things stand, many other drugs could join Ambien on this list in the near future. That this future is certain is perhaps best evidenced by the increasing number of articles on the legitimacy of universal drug trials, which are mainly conducted on men. Hence, at the beginning of September, the question was again raised in the American media whether in the 21st century women should also fight for equality in drug trials, which would ensure more adequate therapies for the diseases they face.
Namely, it is increasingly being said that low doses of "aspirin" are a good prevention of heart attacks in healthy men, but not in women. It was concluded that women are much more susceptible to neurological damage due to alcohol consumption than men. It has been found that women have a higher chance of getting lung cancer, regardless of whether they are smokers or exposed to secondhand smoke, and so on. Statistics have shown that multiple sclerosis is two to three times more common in women, that they are twice as prone to depression than men, and that they make up the overwhelming majority of lupus sufferers (as much as 90 percent). Women also wake up faster from anesthesia, and have been reported to experience more side effects from antihistamines, antibiotics, steroids, and antidepressants than men.
It turned out, therefore, that gender and how it plays an important role in which disease a man or a woman can get, what will be its course, treatment and treatment results, and that list of differences is growing day by day. And yet, most diagnoses, therapies, and drug dosages today are based on the symptoms, responses, and test results of adult white males, and those results are simply generalized and applied to female patients.
Scientists who wholeheartedly support the principle of equality in drug testing claim that this practice should be changed as soon as possible. One of them is Dr. Sara L. Berga, professor of medicine and specialist in the field of gynecology and obstetrics at Wake Forest Baptist Medical Academic Medical Center (Wake Forest Baptist Medical Center) in North Carolina. Berga recalls that until three decades ago, "women's medicine" was considered dealing with cancer of the breast, ovaries, uterus, pregnancy and the menstrual cycle, which some mockingly called "bikini medicine", while diseases of the organs of both men and women were treated universally .
Therefore, the research conducted on drugs and therapies for "universal" diseases did not significantly take into account the sex of the respondents. "If, for example, women did not respond to a drug in the same way as men, it was attributed to the fact that they are physically smaller, or lighter, than men," explains Berga. With new times, came new conclusions.
GENDER DOES MATTER: Last year, for example, in the journal "Clinical chemistry and laboratory medicine" (Clinical Chemistry and Laboratory Medicine) published an article that refutes the gender equality advocated by classical medicine in five domains: cardiovascular disease, cancer, liver disease, osteoporosis, and pharmacology.
The article, signed by Dr. Giovanella Baggio from the University of Padua and her expert team, states that cardiovascular diseases, although considered typically "male", often manifest differently in women: while chest pain and tingling in the left arm are a sign of heart disease attack in men, in women, it turns out, manifests itself as nausea and pain in the abdomen. Therefore, according to the authors of the research, women who come to the doctor and complain about these symptoms are often denied examination procedures related to the diagnosis of heart attacks, because doctors simply do not recognize them as indicators of a heart attack.
Researchers from the University of Padova further determined that colon cancer in women occurs later in life, but that they respond better to therapy than men. They also reported that primary biliary cirrhosis of the liver affects women more often, and they also addressed osteoporosis, which is perceived mainly as a "female disease" and concluded that mortality from bone fractures caused by the effects of osteoporosis is higher in men.
Differences in gender, the scientists concluded, also affect the absorption of drugs and their effect. "Men and women differ in virtually every aspect of the body's functioning, so it's no wonder they respond differently to medications," says Dr. Marianne Legato, who founded the Partnership for Gender-Based Medicine at Columbia University. Women's hearts beat faster, they have more fatty tissue and "moody" hormones. For example, women who have epilepsy are more likely to have a seizure when they are menstruating, as the increased hormone levels make the medications they take less effective.
DISCRIMINATION FROM THE BEST INTENTIONS: It turns out that exactly the dictation of hormones is one of the main reasons why scientists give men an advantage during testing. Namely, working with women requires an additional division of research groups: women are divided into those before and after menopause and must also be tested before and after menstruation. Furthermore, in certain groups of women there is a risk of an unrecognized pregnancy, which is why it is possible to harm the embryo with the tested preparation. Taking these factors into account not only makes the research more expensive, but also increases the risk that something could go wrong (especially if the subject is in a different state).
If we go a step further, we will see that the situation is no different even when tests are carried out on animals. The latest research done at Northwestern University in Chicago included 2300 medical studies published in medical journals. It turned out that in more than 20 percent of those studies, the sex of the animals on which the experiments were performed was not mentioned, and among those who diligently stated this information, in as many as 80 percent of the cases, it was about male subjects. Scientists give the same explanation here. Just like in human beings, in the animal world, the female sex has "wayward" hormones that can complicate things.
Because of these circumstances, researchers are forced to balance the need to urgently respond to the constant need for an effective solution that implies a one-size-fits-all drug and the possibility of failure that occurs when the principle of universality suffers a debacle, just like in the case of Ambien.
However, the rules of the game are slowly changing. In the last few years, in some developed countries, it has been prescribed by law that clinical research of new drugs must take into account different modes of action in men and women. Not only do new studies express the need for women to be more involved in medical research, now it is required that if a drug has not been tested on women, this should be clearly indicated in the instructions, so that they know that they are taking something that has not been tested on women.
Now, someone will say that at the moment medicine has a bigger job and that this is just another search for a hair in the egg, but from another point of view no one can be denied the right to expect (and receive) the treatment they deserve. As far as advocates of gender-oriented medicine are concerned, the day when whether you are male or female will determine the code your doctor writes on your prescription is not far off.
