Is there systemic sexism in science and healthcare?

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Fourteen years after the insomnia drug Ambien was released to the public, the United States Food and Drug Administration (USFDA) required that the recommended dosage prescribed to women should be halved, following the discovery that women metabolise the drug more slowly than men.

As a result, women would wake up feeling drowsy, with more of the drug in their system. Consequently, their risk of being in a car accident that day was massively increased.

Why did we not know about this sooner? According to emergency medicine doctor Alyson McGregor in her TED talk on the subject, the problem stems from the way the drug was tested. She said: “[the] cells used in that laboratory, they’re male cells, and the animals used in the animal studies were male animals, and the clinical trials have been performed almost exclusively on men.”

This is not an isolated problem; in fact, the USFDA have reported that the risk of adverse side effects to drugs is almost double for women than it is for men.

The disregard for the need to include women in medical studies has been widespread for at least a century. It was long thought that, beyond the difference in reproductive organs and hormone levels, men and women were biologically alike. So, it was considered more efficient to use men for trials, on the basis that the lack of hormonal fluctuation would give clearer results.

Recent research undertaken by Dr David Page of the Whitehead Institute and Dr X. William Yang of UCLA has shown that the chromosomes that determine our sex – XX for females, XY for males – stay active over our entire lives.

This means that there are far more fundamental biological differences between the sexes. Or, as Dr McGregor puts it: “Women are not just men with boobs and tubes.” The outcome of this is a startling lack of knowledge about common medical issues facing women. Take, for example, period pains. When menstruation is painful, a problem affecting over half of all women, it is known in medical circles as ‘dysmenorrhea’; if the pain is caused by uterine tissue growing outside the womb, as is the case for around 2 million women in the UK, it is called ‘endometriosis’.

However, there is no common consensus on the causes of either of these conditions, nor is there an effective cure or a known preventative measure for them.

A study published in the Journal of Neurology this month revealed another worrying oversight: Alzheimer’s Disease (AD) in women is often not diagnosed until the disease reaches a much later stage. Diagnosis is based on a verbal memory test, because these skills are often among the first to deteriorate in sufferers. However, since women are on average more adept at these tests before AD sets in, the deterioration goes unnoticed.

We can only hope that these new findings will bring more support and funding for organisations, such as Dr McGregor’s Sex and Gender Women’s Health Collaborative, which aims to broaden perspectives on this incredibly important issue.

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