You are here: MEDICA Portal. Part III: Gender in Medicine. Health Care Politics.
The Slight Difference (Part 1)
The prejudices that surround the male and female sex in our society are omnipresent. Simple guidebooks fill the shelves telling why women are so different from men and vice versa with the result that editors become rich and the misunderstanding between the sexes grows. However, there is an area that could actually profit from a thorough investigation into the small difference – in favour of health. Still: In biomedical research, doctors, pharmaceutical companies and researchers keep pretending that women are a kind of smaller man.
This kind of thinking is ignoring the fact that proof already exists for some drugs reacting differently in men and women. „That is so with Asprin, a few drugs preventing blood coagulation and Digitalis, a drug for the treatment of cardiac insufficiency“, Vera Regitz-Zagrosek says. A recent big study showed that women taking Digitalis had an increased death rate. The professor from the Centre of Gender Studies at the Charité in Berlin explains this observation with the metabolisation of drugs. In case of Digitalis the solution lies within the kidneys. „It seems that they function in women at a lower degree than the kidneys of men the same age.“ Due to proteins that work in the kidneys and differ between the sexes.
In reality, the neutral object is a man
Over- and underdosage in medication may also be due to the fact that women normally weigh less, the the fat and water distribution in the body and metabolising enzymes and hormones differ. In spite of this knowledge, drugs appear on the market that may do harm to women. The reason: The whole area of basic research uses young male mice thus causing bias in study results. „If you work with female mice you in fact get different results“, the cardiologist explains. But why does research then concentrate solely on male mice? Regitz-Zagrosek`s answer is pragmatic: „They are cheaper. On top of that, medicine is being dominated by men which causes a neutral research object that is the in the centre of attention. But in truth, it is a man.“
Indeed, pharmaceutical studies concentrate on young men. It is more complicated and thus more expensive to include women and elderly. „Women have menstrual cycles, may take the antibaby pill and this has to be considered“, according to Regitz-Zagrosek. „But everybody would profit from an inclusion of women. Men, too.“ An example would be the sudden cardiac death. This fatal event occurs much more often in men and women seem to have some kind of biological advantage considering cardiac diseases. „What they are and how we could use the knowledge for men – this could be a promising start in drug development.“
- Part 1: The Slight Difference
- Part 2: Gender always takes part