Why Medicine Often Has Dangerous Side Effects for Women | Alyson McGregor | TED Talks

Summary

In this thought-provoking presentation, an emergency medicine doctor highlights the significant gap in medical research, revealing that it has historically been based on male physiology, leading to gender-biased health outcomes. The speaker discusses how this oversight affects drug efficacy, diagnoses, and treatments, particularly for women, and calls for a more inclusive approach in medical research. Through examples like Ambien and heart disease, the speaker emphasizes the importance of understanding sex and gender differences in healthcare. Ultimately, the speaker advocates for personalized, gender-informed healthcare to improve outcomes for all patients.

Takeaways

• 😀 Medical research and treatments have historically been based on male-centric models, leading to significant gaps in understanding women's health.
• 😀 Women make up half of the population, yet most medical research, including clinical trials, has been conducted using male cells, animals, and subjects.
• 😀 A recent study revealed that 80% of drugs withdrawn from the market were due to side effects on women, highlighting the need for gender-sensitive research.
• 😀 Many drugs, including Ambien, were found to have harmful side effects for women because they metabolize substances differently than men.
• 😀 The exclusion of women from medical research dates back to World War II when fear of harming fetuses led to the protection of women of childbearing age in studies.
• 😀 This exclusion resulted in a narrow view of women’s health, focusing mainly on reproductive organs, leading to the term 'bikini medicine.'
• 😀 In the 1980s, medical research began to acknowledge the importance of including women, but significant gender disparities still exist in healthcare.
• 😀 Men and women often experience diseases differently, such as heart disease, which manifests with distinct symptoms in each gender, requiring tailored approaches to treatment.
• 😀 Medical tests, such as those for heart disease, were primarily designed for men, making them less effective for women.
• 😀 Gender-specific research in medicine is essential for personalized healthcare that addresses the unique physiological and anatomical differences between men and women.
• 😀 The future of healthcare involves incorporating sex and gender considerations into medical practice and education, ensuring better care for everyone.

Q & A

Why is there a lack of consideration for sex and gender in medical research?

Historically, medical research has been conducted primarily on male subjects—cells, animals, and clinical trials—because of assumptions that men and women are alike apart from reproductive organs and sex hormones. This oversight led to insufficient understanding of the unique health needs of women.

What impact did excluding women from medical research have on drug development?

Excluding women led to harmful side effects for women that were only discovered after drugs were released on the market. For example, the sleep aid Ambien was prescribed to women without understanding the difference in how women metabolize the drug, resulting in an increased risk of drowsy driving.

How does the example of Ambien illustrate the issue with gender differences in medical treatment?

Ambien was prescribed without considering that women metabolize the drug slower than men. This led to women having higher levels of the active drug in their system the next morning, making them drowsy and increasing the risk of motor vehicle accidents, an issue only addressed 20 years after the drug's release.

What historical event contributed to the exclusion of women in medical research?

World War II led to the establishment of guidelines protecting women of childbearing age from participating in medical research due to concerns about fetal harm. This resulted in a shift to using male subjects for clinical studies, which continued for decades.

What is 'bikini medicine' and how does it relate to the exclusion of women in medical research?

'Bikini medicine' refers to the narrow focus on women’s reproductive health in medical research, such as issues related to breasts, ovaries, and pregnancy. This focus was a consequence of excluding women from broader medical studies, leading to a limited understanding of women’s health needs.

How does the cardiovascular system differ between men and women?

Women and men have different heart attack symptoms. While men often experience crushing chest pain, women are more likely to report vague symptoms like fatigue or shortness of breath. Additionally, women’s heart vessels are smaller, and the diseases that develop in these vessels are different from those in men.

Why is aspirin harmful to healthy women but used as a preventative measure for men?

Aspirin is commonly used to prevent heart attacks in men, but in healthy women, it can be harmful. This discrepancy highlights the need for gender-specific medical research to understand how common medications affect men and women differently.

What is the significance of the discovery that sex chromosomes remain active throughout life?

This discovery challenges previous assumptions about the role of sex chromosomes, showing that they influence more than just reproductive organs. They may be responsible for differences in drug metabolism, disease susceptibility, and the severity of conditions in men and women.

How can medical education be improved to address gender and sex differences?

Medical education needs to integrate gender and sex differences into its curriculum. This includes educating future healthcare providers on the distinct physiological and medical needs of men and women, as well as training them to consider these factors when diagnosing and prescribing treatments.

What role does the Sex and Gender Women's Health Collaborative play in addressing these issues?

The Sex and Gender Women's Health Collaborative collects data to inform patient care and medical education. It works to integrate gender and sex differences into medical training and research, helping clinicians make better-informed decisions about treatments for both men and women.