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Advancing Women’s Health Requires Better Evidence

by Karun Bholewasi |

The old, beaten-up path of the medical industry always led to the betterment of men’s health, at least for the 80s and 90s decades. It was certainly not done in a way to undermine women or as a conspiracy to provide less for the populace. The reason behind testing on men was simply that the male body could handle the pressure of a new substance better, which is not the case for the complex physiology of women. 

There is a delicate balance of hormones in the female body, which makes it riskier for tests and to try out new pharmaceutical drugs. However, for a long time, it has been the convention that the formulae applied to the male body (at least for common illnesses like dengue) will work for the female body as well.

It was the general idea for medicine formulating or surgery practicing doctors that the male and female bodies are similar enough to cause much difference in the effect of medicines. Nonetheless, it is now known to the highest of medical lobbies that it is incorrect and unethical.

The male and female bodies have significant biological differences, translating constantly to the cellular level. The mechanisms of cardiovascular health and other diseases differ vastly in men and women. Some of the conditions that occur are mainly self-healing for men, which means they get taken care of by the body’s defense mechanism itself. In similar situations, however, women’s bodies fail to defend themselves. 

For a common illness like cold and flu-induced cough, men tend to bounce back to normalcy in a few days without medical intervention. In contrast, very few women can control the condition without the use of cough syrups, hot baths, or flu pills. So, the biological process that tends to worsen the symptoms of diseases in the male body can have opposite effects in women or vice versa. 

This sheds new light on creating medical care procedures and drugs for men and women differently.
The difficulty in the treatment of women increases when you notice that women are more prone to chronic diseases like Alzheimer’s and rheumatoid arthritis. Since the studies are done with results being produced as an average, the effects of one disease meddling with the established solution of another are highly probable.

Even when developing multiple diseases in the same patient, the combination of conditions that will show up in the average man will be completely different from that of a woman. As seen generally, women tend to experience more autoimmune diseases, and men tend to contract more infectious or nutrition-related diseases. 

This complicates the case as both genders will have different troubles when the treatments for their multiple disorders conflict with each other.

But how did we end up here? A place where women’s health is kept only on second thought when going through pharmaceutical and medical studies?

There was once a time when women were indeed included in pharmaceutical studies and had a perfect position to be studied for medical advancement. However, there are two different tragedies with two other drugs- Diethylstilbesterol (DES) and thalidomide. DES was a synthetic hormone drug first used to treat estrogen deficiencies in mothers, including the reduction of lactation. Then, it was used to prevent miscarriages and premature deliveries in Europe and the USA. Thalidomide, first used as a sedative, was used to treat certain seasonal conditions such as headaches, flu, and cold. But its most extensive use later was to help with morning sickness and nausea that pregnant women experience.

The trouble with DES began when it was later found that it was acting as a carcinogen in women and could cause cervical and vaginal cancer along with breast cancer in women. Many of these carcinogenic properties were also able to cross over to the child. As with thalidomide, the problem was much more severe. It was found that the drug meddled with the genetic code of the fetuses, and in adults, it caused nerve damage to the hands and feet. If it was taken during early pregnancy, it was confident that the child might have limb impairments and sight loss, hearing loss, facial paralysis, and other such physiological deformities. Many children were affected, and even grandchildren of women who were never directly exposed to thalidomide were born with differently shaped limbs or no limbs at all.

Studies for both these medicines were done on pregnant women, and the result was curing the condition but at a much higher cost to the woman and the next generation that she was to nurture. These tragedies caused the medical industry to make decisions to exclude women from the studies to protect the existing fetuses and future pregnancies. While the problem might have been seen as a protective decision back in the 1900s, it is sad to know the problem exists today where biological gender differences are not assessed for proper research.

The medical studies performed to date have allowed researchers to find out the solutions to the health issues faced only by men. In contrast, the differences between male and female biology have been wholly ignored. Over the years, differences in lifestyle, social roles, daily activity, and longevity have been ignored between men and women. Due to this ignorance of biological and social factors, the system of research has made it challenging to access correct results that suit both genders and has also made it impossible to get a precise understanding of the underlying causes of multiple diseases that affect both genders separately. This keeps away information about certain co-existent disorders in the female body, which reduces the effectiveness of treatment for various conditions that might interfere with each other. So, the medical system working more on guesses rather than solid data requires a reform that provides concrete evidence that supports complex treatments for women in the future.




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