Gender Medicine: Why We Need To Focus On How Women vs. Men Get Sick

Why Don't Doctors Know More About How Women Get Sick?

We live in a world where robots help perform surgery and a baby born with AIDS has been functionally cured, but doctors still have a lot to learn about the fundamentally different ways in which men and women get sick and respond to treatment, according to a new article written by researchers in Italy.

There are significant gender-based discrepancies in the signs, prognosis and treatment of cardiovascular disease, cancer, liver disease and osteoporosis. The new article, published in the journal Clinical Chemistry and Laboratory Medicine this week, charges that those variations are not widely understood because many clinical trials in the past 30 years haven't included women.

"Studies on these diseases [have been] done almost exclusively in men," said co-author Dr. Giovannella Baggio, director of the internal medicine unit at Padova University Hospital in Italy, in an email to HuffPost. "But women have really different characteristics when sick."

Take heart disease, which is the number one killer of women in the U.S. The authors contend it is still largely thought of as a man's health problem, and many women do not take preventive measures until it is too late. Furthermore, because women having a heart attack often experience different symptoms than men -- nausea and lower abdominal pain, rather than chest constriction and left arm pain -- doctors regularly fail to recognize the signs and run necessary tests.

The article also highlights the different ways in which men and women develop and respond to treatment for certain cancers, particularly colon cancer, which is the second-leading cause of cancer death among Americans. On average, women develop the disease five years later in life than men, and it is more advanced by the time they're diagnosed. Women also tend to get tumors on the right side of the colon, versus the left side for men.

"In terms of cancer, the questions about the differences between the sexes just don't end," said Dr. Marianne Legato, a professor of clinical medicine at New York's Columbia University and director of the Foundation for Gender-Specific Medicine, who did not work on the new article. "Why do women's colon cancers tend to concentrate on the right side compared to men? We just don't know."

Certain types of liver disease, primarily biliary cirrhosis, disproportionately affect women for reasons that are not entirely understood. And because osteoporosis is generally thought of as a women's issue, men often are not diagnosed with the bone disease until they have had a fracture.

The Italian review focuses as well on gender-based differences in how the body responds to common drugs, including aspirin. Studies have shown that aspirin is metabolized differently in women than in men. Men who take aspirin preventatively may reduce their risk of heart attack but not stroke. Women, on the other hand, may reduce their risk of stroke but not heart attack. Women are also advised to wait until they are older to consider a daily aspirin regimen.

What all of this signals, the authors conclude, is a clear and pressing need for physicians and researchers to become better versed in gender differences when it comes to common diseases, their prevention and treatment. For now, women should be very clear with their doctors about any symptoms they are experiencing, Baggio said, and ask their doctors to bear in mind the differences between men and women.

"The most important thing that we should be aware of is that our genes, our very DNA, [are] expressed differently in all of the tissues of the body as a function of whether we're male or female," echoed Legato. She argued for specific training in gender-based differences in medical school.

"Patients are calling for this," Legato said. "But many doctors don't want to hear about it, because it's more work."

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