Women’s Health Research: more than “bikini health”

Women’s health and medicine is concerned with much more than the areas covered by a bikini swimsuit. Certainly there are some obvious biological differences between males and females that are behind that bikini (reproductive organs and incidence of breast cancer, for instance).  But, if these were the only differences we considered, we would be missing many important issues that affect health and disease in each sex*.

5 important differences between female and male health and medicine (for more, visit the A to Z guide from NIH):

  1. Response to medicine – Females need a lower dosage of certain opoid (narcotic) pain relievers, drugs for high blood pressure, and sleeping aids to achieve the same therapeutic effect as in males. If data from animal and human studies are not available for females, the recommended dosages may exceed the therapeutic or safe range in females. (see Sex-based differences in drug activity by H. Whitley and W. Lindsey)
  2. Heart health – Females experience different symptoms and recurrence of cardiovascular disease than males.  In females, the onset of a heart attack is usually accompanied by shortness of breath, fatigue, and chest pain, whereas males primarily experience chest pain.  Females also have a higher rate of heart attack recurrence within 1 year after the first heart attack than males.
  3. Smoking risks – Females are more likely to develop lung cancer than males, given the same exposure to cigarette smoke.  The difference doesn’t appear to be related to body size or smoking history.
  4. Immune reaction – Females have a more aggressive immune response to infection than males.  This means that females will be affected in smaller proportions and with less severity than males for most infections.  However, females often have a higher incidence of autoimmune disorders, such as lupus and rheumatoid arthritis, than males. (see The X-files in immunity by E. Fish)
  5. Bone health – Due partially to a decrease in bone mass after menopause, females experience a higher incidence of osteoporosis than males.  Until menopause, females and males have an equal rate of bone loss of 0.3 – 0.5 % per year.  Following menopause, females enter a ~10 year period of increased bone loss at a rate of 2 – 3% per year.
Dr. Minder's Anatomical Mannikin of the Female Human Body
This work features eleven layered chromolithographed plates with detailed anatomical illustrations of the female human anatomy superimposed. Lifting the layers shows the anatomy as it would appear during dissection, moving from the surface to the muscles, bones, and internal organs. Courtesy of the National Library of Medicine, National Institutes of Health.

None of these examples shows that males or females are better than the other.  Simply put, research has uncovered sex-specific differences in health and medicine that should be better understood and used going forward.  Routinely including females in animal and human medical studies can significantly improve our understanding of these differences. [Current data show that male-only animal studies outnumber female-only studies up to 5:1 in disciplines such as neuroscience, pharmacology, and physiology.]

Considerations and guidelines are available for STEM journals that want to require sex-specific data in the published manuscripts.  More data on sex-specific health and medicine will help guide the development of new treatments, medical devices, and drug regimens.

Want to know more?  Explore these helpful resources:

FDA Office of Women’s Health Research
Institute of Medicine Reports: Exploring the Biological Contributions to Human Health and Sex-specific Reporting of Scientific Research
Office of Research on Women’s Health at NIH (The Director of the Office of Research on Women’s Health at the NIH, Dr. Janine Clayton, gave a wonderful seminar recently, hosted by the Women’s Health Research Institute at Northwestern University.)
Science of Sex and Gender in Human Health – Free e-course offered by NIH
Society for Women’s Health Research
Women’s Health Research Resources at NIH

*Throughout this article, I will use the terms “male” and “female” to indicate the biological differences of sex that largely arise from the chromosomes present, with the assumption that males are represented by XY chromosomes and females by XX chromosomes.  The terms “man” and “woman” usually refer to the gender that someone self-identifies with, which is informed by biology and environment/experience.