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Gender specific medicine - an aspect of gender equality

Lady Rebecca Sieff, founder of WIZO, aimed to establish equal rights for women, who were to contribute their share to society as equal partners of men.  Providing vocational training for women and care and education for their children was the aim of WIZO founders.

September 18, 2014
Gender specific medicine - an aspect of gender equality

Lady Rebecca Sieff, founder of WIZO, aimed to establish equal rights for women, who were to contribute their share to society as equal partners of men. Providing vocational training for women and care and education for their children was the aim of WIZO founders.

The right to healthcare is a basic human right and a gender specific healthcare system is essential for better healthcare for women and for men. Gender differences are not only limited to the genital and hormonal level, as was assumed for many generations. These differences cover only 2-3 % of the life of women. Gender specific differences occur in the entire body, in all stages of life (not only in the reproductive age) and in all fields of medicine.

Observations were made during the HIV-AIDS epidemic in 1980, where women and men showed differences in manifestations of the disease and in reaction to treatment. Differences were first observed in cardiology. Women admitted to hospital with heart attacks died more frequently compared to men at same stage of the disease while receiving the same treatment.

Marianne Legato from Columbia University and Marianne Frankenhauser and Karin Schenk-Gustaffson from Karolinska Hospital in Stockholm have carried out pioneering work on the subject. The best investigated fields of medicine up to now are related to heart and vascular diseases. Cardiovascular diseases are the most common cause of death in women although even nowadays the common opinion is that it's “a man’s disease”.

Women (and children) were missing in all clinical “trials” up to the 1980s. It was forbidden in the United States to use women as subjects for clinical drug testing in order to protect them. As a result women even today suffer more from side effects. Drugs are often withdrawn because of side effects observed on women.

The subjects of trials were usually men: “Joe” was aged 30-50, 180 cm tall and 75-80 kg in weight. Only at the turn of the century was a female dummy called Emma created for crash tests in cars, after it had been observed for years that women suffer more severe injuries in car accidents than men.

Until today in experimental biology male mice are used for surgery because their muscles are thicker. Hearts of female animals cannot be used for heart catheter experiments because they are easily perforated. When the sex of cells in an experiment is occasionally changed, confusing adverse reactions may be observed. Joint replacement in a woman is usually subject to longer complaints, longer rehabilitation and restitution is less complete than in men. Women and men differ in their posture, in their physical and mental structure, in the function of most of their organs, in their genetics and epigenetics.

Interdisciplinary investigation in all fields of medicine in order to find out if and where significant gender specific differences occur is of great importance. Research and development is a vehicle for better understanding and for better treatment. Obtaining sex disintegrated data is essential in this context.

Doctors should be aware of the differences between male and female patients both in diagnosis and in treatment. A man that comes to see a doctor is very often sent by his mother, wife or girlfriend, while women often come out of their own initiative, even at a very young age. Questioning a man that is not accompanied by his spouse about his complaints is sometimes as painful as pulling out his teeth, while women are much more communicative. While women usually follow medical advice even if it entails long-term discomfort, men tendto be impatient, prefer short instructions and surgery over conservative therapy if hope for quick recovery is given. “He” will often forget to follow medical advice unless his spouse reminds him.

These are just a few visible examples of the practical applications of gender specific medicine. It is dealing both with men’s and women’s health. However, as a result of neglect in the past, when women were “invisible” and considered as smaller sized men, more attention should now be given to women to overcome this gap.

Women educated in health are valuable for the health of their entire families. Statistics correlated in Jerusalem and other places showed that the higher the education level of the women the better the health of their children and spouses. Mortality of children is reduced in correlation to the education level of the women in their families. Although there is a complexity of reasons for these results, we should keep this in mind.

Since the 1980s, more attention has been drawn to gender specific differences and needs than before. We have to keep in mind that if we want to improve health we have to give free access to a medicine sensitive to the special needs based on gender, age and ethnicity.

It was an achievement of WIZO that started the cooperation between the Austrian Society for Gender Specific Medicine and the international NGOs in Vienna, 6 years ago. This cooperation helped to promote gender specific healthcare in civil society and international UN bodies. WIZO has organized workshops on the subject in Vienna since 2008, as well as in Geneva in 2009 and in New York in 2010. WIZO is a founding member of the conference on gender specific medicine held once a year in Vienna in cooperation with International NGOs.

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By Dr. Hava Bugajer – President WIZO Austria and an expert on Gender Medicine