Sex Matters when it comes to your health!

I picked up a book at the library called Sex Matters: How Male-Generic Medicine Endangers Women's Health and What We Can Do About It and I just have to say, "wow".  I learned so much about how medicine, diagnosis and  treatment is mostly based on a male centric model putting women in danger every day.  We need to get the word out,  and therefore, I must share some interesting things I learned from my read.  

Women are more likely to be misdiagnosed, given improper treatments and experience complications from medical treatments received.  This is because women are underrepresented in clinical and research trials, and most trials do not account for sex differences as a variable.  

Women need to know how their bodies work differently than a man’s.  It is necessary to know  how to ask the right questions of your health care provider to ensure proper diagnosis and treatment. 

Heart attacks and strokes present differently in men and women leading to women being sent home from the emergency wards without treatment.  Women are three times more likely to die of a cardiac event than men.  Women do not present with classical heart attack symptoms but rather have a host of symptoms such as unusual fatigue, shortness of breath, brain fog, nausea and digestive issues.  Female heart disease is often taken for anxiety and women are  often told to go home and relax.   There is even a delay once intervention is asked for (call for ambulance)  in getting help as professionals often do not feel a sense of urgency compared to if a male patient  complains of chest pain. 

Female heart disease looks different from men’s. Rather than have hardening of the arteries women's plaque erodes into the blood vessels, making them stiffer and less flexible.  No clotting shows up in the arteries.

Risk factors have different "weights" for  men and women.  Smoking is a higher risk for women than men, hypertension less of a risk factor for women.  Perinatal complications, use of hormones, migraines and autoimmune disease are risk factors for women.  Taking multiple medications is a major contributor to cardiac events in women but not in men. 

Strokes also present differently in women and often missed in diagnosis.  Whereas men show classic symptoms of loss of function,  women may get a headache, or have a sudden change in mental or emotional status.

Not all prescription drugs are studied on women.  Women are more likely to be prescribed medications and are more likely to have adverse reactions to drugs. We see this in alcohol metabolism as well. Taking into account height, weight and age women feel the effects of alcohol sooner and more strongly than men. This is also true for Ambien (sleep aid), and other drugs including pain killers.  Hormones impact drug metabolism.  We know this because women react differently to drugs depending on where they are in their menstrual cycle.  Women experience greater pain when estrogen levels are low. Not all pain meds work on women. Related to this factor is that women have a heightened inflammatory response compared to men when stressed due to the interaction of estrogen and cortisol. 

Women are more likely to be given a psychiatric diagnosis like anxiety than a physical one.  There is an implicit bias that exists in treating women. 

Fortunately for women, sex and gender differences are a hot topic in medicine today. Many physicians are fighting to change the research and clinical practice standards to reflect female biology.  Today a study came out that found that if a woman had a female doctor in the emergency department she was more likely to get proper treatment and less likely to have to return a second time with symptoms. 

Always ask your health provider about sex and gender specific tests, procedures, prescriptions and dosing.  Be your own advocate. Know your body and trust your instincts.  

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