Diseases have a gender bias

There's more to women

27/09/2004 13:00 - (SA)

# Health24: Women's health

Chicago - Beyond the tired cliches and sperm-and-egg basics taught in grade school science class, researchers are discovering that men and women are even more different than anyone realised.

It turns out that major illnesses like heart disease and lung cancer are influenced by gender and that perhaps treatments for women ought to be slightly different from the approach used for men.

These discoveries are part of a quiet but revolutionary change infiltrating US medicine as a growing number of scientists realise there's more to women's health than just the anatomy that makes them female, and that the same diseases often affect men and women in different ways.

"Women are different than men, not only psychologically (but) physiologically, and I think we need to understand those differences," says Dr Catherine DeAngelis, editor of the Journal of the American Medical Association.

DeAngelis, who became the journal's first female editor in 1999, says she has made it a mission to publish only research in which data are broken down by sex unless it involves a disease that affects just men or women.

In recent months, two medical textbooks billed as the first devoted to gender differences in all areas of medicine, not just reproductive medicine, were published; a widely cited Journal of the AMA report re-emphasised the neglected fact that lung cancer, not breast cancer, is the No 1 cancer killer among women; and the American Heart Association announced the first-ever heart disease prevention guidelines tailored specifically for women.

The gender-based medicine movement isn't an effort to diminish the importance of breast cancer, but is meant to emphasise that "we have more than one body part, folks. Up until now ... that awareness just hasn't been there", said Sherry Marts of the Society for Women's Health Research.

That organisation seeks to expand the definition of women's health beyond breast and reproductive health, what some call "bikini medicine".

Until the 1990s, scientists frequently excluded women from medical research, including drug studies. It was largely out of concern over effects on reproduction but also because of a long-standing belief that men and women "were biologically the same except for their reproductive organs", Marts said.

However, recent discoveries suggest that genes, hormones and lifestyle may be behind many of the differences.

For example:

# Heart attacks in women frequently don't involve chest pain and may involve more vague, flu-like symptoms.

# Women who don't smoke appear to be more susceptible to lung cancer than non-smoking men. Women also tend to get lung cancer at younger ages than men, and they appear to metabolise cancer-causing substances differently than men.

# Women are less likely than men to get oral cancer.

# Women are more prone to auto-immune diseases, including lupus, rheumatoid arthritis and multiple sclerosis, in which disease-fighting mechanisms mistakenly attack the body's own tissues.

# Some Aids-fighting medicines appear to metabolise more quickly in men than in women, who may require gender-specific doses.

# Women's symptoms for ulcerative colitis and Crohn's disease -debilitating intestinal diseases that affect men and women - vary considerably each month, requiring frequent medication adjustments.

Associated Press

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