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Gender Specific Medicine

What's good for the goose is not always good for the gander, as science has begun to see. For years, women were treated like small men and received the same medical treatment as their male counterparts. Now there is conclusive evidence that the female and male bodies are different in almost every way imaginable. These findings have thus led to a new specialization called gender specific medicine, and CBS This Morning's medical correspondent Dr. Emily Senay has the story.

For years, men were used as the model for every clinical study around. It was assumed the results and suggested treatment should and would be the same for women. In the early 1990s new laws passed demanded that women must be included in all relevant clinical trials receiving federal funds. This inclusion led to the discovery that women's bodies respond quite differently from the male body in just about every fashion. Now there are doctors who believe that physicians should specialize in both male and female medicine so not only women, but men too could receive more dedicated gender specific care.

Now there are doctors who believe that their colleagues in the medical profession should specialize in both male and female medicine so not only women, but men too could receive more dedicated gender specific medical care.

Gender specific medicine is aimed at respecting the individual characteristics of male and female biology. It's built on the premise that every medicine taken, or treatment given can have a different effect, depending on whether a person is a woman or a man.

Before the early 90's these critical differences were never explored - the assumption being the male body was the universal human norm so men were the only sex used in clinical trials. We now know this was a big mistake.

Female-oriented trials like the Framingham study in Massachusetts have revealed women can benefit from new treatment options tailored to the female body, as in new medications to help women with heart disease. Concentrating on women's medicine or gender specific biology could explain why, although women develop more debilitating diseases than men do, they actually live seven years longer.

The bottom line: concentrating on women's medical issues and developing better female specific treatments for conditions like heart disease, Alzheimer's disease and certain cancers for instance, could in the long run, help doctors refine and better service the medical needs of men and maybe even help men live longer.

The Brain

Both men and women get migraine headaches, depression, and Alzheimer's disease. But gender studies now show women get five times more migraines, suffer three-times more depression and overall get more Alzheimer's.

In general men respond better to medication for headaches and antidepressants. In women, those responses can differ dramatically. Researchers now believthe female brain responds much differently to hormones and brain chemicals. Couple that premise with stress and lifestyle factors, and the effect of traditional anti-headache or depression medication changes even more.

What gender science has found is that women are sensitive to fluctuations in serotonin - the mood regulating chemical - and actually respond better than men to drugs like prozac which raises and stabilizes serotonin levels. Understanding hormonal differences in the sexes is leading to the development of new tailor-made drugs for women that may very well treat other headache conditions or hormone imbalances.

In the same vane, gender science is showing that supplemental estrogen can improve short-term memory in normal postmenopausal women. So if gender study results are strong enough, it may be that one day post menopausal women who had not considered estrogen replacement may be encouraged to do so to prevent or even retard Alzheimer's disease.

The Heart

Men have larger hearts and get heart disease earlier. Women's hearts are smaller, and pump faster. They get heart disease ten years later and heart attacks are often misdiagnosed.

Although the number one killer of both men and women, more women die of cardiovascular disease each year.

Doctors often misdiagnose heart attacks in women because the symptoms in women are not as easily recognized, like the crushing chest pain characteristically seen in men. The risk of cardiovascular disease quadruples once women reach menopause - estrogen levels drop, levels of HDL - the good cholesterol - drop so heart vessels have less protection.

When a heart attack happens symptoms in women manifest as shortness of breath, fatigue, pain in the upper abdomen and nausea. Sounds like a stomachache or an anxiety attack right? Well sometimes it isn't. Cardiovascular disease kills a half-million women each year and until recently doctors largely ignored cardiovascular disease as a threat to women's lives.

Also, women who have had heart attacks are more likely to die of sudden death when they take the same anti-arrhythmia medications that work so well in men. Discoveries like these are now, for the first time leading to the development of experimental heart medications specifically designed for women.

Digestive System and Metabolism

We're finding women have more constipation than men do in part because food moves much more slowly through the female intestinal tract. Recurrent constipation can lead to irritable bowels, which could then lead to other problems.

Enzymes in the female body can differ from men's and affect how well or how poorly substances are metabolized. For example, women get drunk faster than men and are more likely to become alcoholics likely to become alcoholics because the female body cannot rid the blood stream of alcohol as efficientlas the male body might.

The bi-products of tobacco, such as nicotine, are particularly destructive in women. The inability the female body to metabolize and rid the body of many of the negative substances in cigarettes has resulted in a higher incidence of lung cancer among women than in men.

The National Institutes of Health have embarked on studies on pain relief in both sexes. There is evidence that women metabolize drugs differently according to age and where they are in the menstrual cycle -- so this raises a flag that women should ask their doctors questions about the use of certain drugs during these times.

Osteoporosis

Men suffer from osteoporosis, too and should be aware of this fact. However, women are victims of this more than men. We know strength exercises and calcium help women maintain or rebuild bone density. For the pre-menopausal women 1-thousand milligrams of calcium a day is recommended. Postmenopausal women should take 14-hundred milligrams.

Research into women's medicine has also revealed estrogen supplements also helps to stave off bone loss - no matter the woman's age. Of course any women on estrogen therapy should be monitored regularly by a doctor since estrogen increases a women's risk of breast cancer.

The Immune System

Women's immune systems are more active than men's are, varying especially during pregnancy. This led to new insight into arthritis, systemic lupus erythmtosus and multiple sclerosis.

The Effect of Estrogen

There has been new research about estrogen's benefits to bone strength, heart health and brain functions and possible protection from colon cancer and cataracts. One of the hottest fields of pharmaceutical research is developing new designer estrogens that bring women some of the benefits of estrogen while eliminating the risk of breast cancer that comes with long-time estrogen exposure.


For more information:
Office of Research on Women's Health
NIH
One center Drive, Room 210
Bethesda, MD 20892
Visit the website

National Institutes of Health
www.nih.gov

Society for the Advancement of Women's Health Research www.womens-health.org

Food and Drug Administration www.fda.gov

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