If there is one thing most of the
population of this planet can agree on, its that there are definitely some
differences between male and female anatomy, both on a physiological and
endocrine level. Why is it then, that
for so many years and even up to the present day, that the impact of sex on
illnesses and their treatments was often overlooked or flat out ignored? For decades, most research has been conducted
using male subjects, the predominant rationalization for this being that since males
lack a menstrual cycle, their hormones don’t fluctuate over time, making them a
“more homogenous study population” (Moyer).
This would be completely fine, if not for the
fact that those pesky little hormones that researchers want to avoid can have a
huge impact on how susceptible women are to certain illnesses, much as
autoimmune diseases and depression, and on how they metabolize medication (Harreys). Women of childbearing age were even
completely banned from early-stage clinical trials in 1977, including those who
used contraception or were gay (NIH). In
1993, the NIH Revitalization Act updated their guidelines for the inclusion of
women and minorities in clinical research in an attempt to make their health a
priority, the gap between the number of men used for research compared to women
is still quite large (Moyer).
A study published in Neuroscience
and Biobehavioral Reviews in 2009 found that was a bias for male animals in
eight out of ten disciplines, including neuroscience, pharmacology, and physiology
(Harreys). Another study published in the Journal of Women’s Health found that in
a sample of 69 papers, women comprised on average 37% of each sample group and 87%
of the papers did not publish any outcomes by sex, showing an inadequate adherence
to the NIH guidelines these studies were required to abide by (Geller). The only drug on the market for which the FDA
recommends different doses for men and women is Ambien, after research clearly
showed that women metabolize the drug in a way that allows it to remain in the
bloodstream much longer.
Change must occur in order for us
to fully understand the interactions between sex and disease. Federal agencies
must be held accountable for the research they fund, efforts must be made to
examine correlations between results and the sex of the experiment’s
participants, and new training curricula must be implemented to ensure that the
next generation of researchers does not make the same mistakes as the last if
we hope to properly cater to women’s health concerns. Even if we don't want to risk the health of women who could become pregnant or deal with possible complications arising from the use of female subjects, that doesn't change the fact that these women will at some point be taking medication and seeking treatment for disease. If we don't find potential issues in the clinical stage, then the entire female population has their health left up to chance. A report for women’s
health from Brigham and Women’s Hospital goes in depth into how cardiovascular disease,
lung cancer, depression, and Alzheimer’s affects women differently than men and
outlines a full list of actions and policies that should be taken and created improve
current sex-related problems in research, and you should read it fully if you
have the time. If you are a woman who cares about her health, a person who has
cares about the health of the women in their life, or just someone who thinks
that all people deserve to receive adequate and equal medical care regardless
of gender, then this issue is one you cannot ignore.
Bibliography
Harreys, Alexandra. "Women's Health Summit Policy
Report." Brigham and Women's Hospital.
Brigham and Women's Hospital, 4 Dec.
2014. Web. 18 Feb. 2016.
Moyer, Melinda Wenner. "Drug Problem." Slate.
The Slate Group, 29 July 2010. Web. 18 Feb. 2016.
NIH. "NIH Guidelines on the Inclusion of
Women and Minorities as Subjects in Clinical Research."
National
Institutes of Health. NIH, 1 Oct. 2001. Web. 18 Feb. 2016.
Stacie E. Geller, Marci Goldstein Adams, and
Molly Carnes. Journal of Women's Health. January
2007,
15(10): 1123-1131. doi:10.1089/jwh.2006.15.1123.
Westervelt, Amy. "The Medical Research
Gender Gap: How excluding Women from Clinical Trials Is
Hurting
Our Health." The Guardian. Guardian News and Media, 30 Apr.
2015. Web. 18 Feb. 2016.
