Recent studies have been published about heart disease and stroke risk in women. Those studies are, in fact, rare. Most medical research scientists neglect studying gender impact when conducting studies, a practice that is endangering the health of women.
Studies that have separated women’s data from men’s have proved that women experience illnesses differently and that symptoms can be different. Ailments where this is known but not clearly understood are cardiovascular disease, depression, lung cancer and Alzheimer’s disease. However, gender impacts are not acknowledged in all research, whether in the lab or clinics. Even animal studies typically use male subjects or fail to separate results by sex.
The gender research problem is outlined in Why Women’s Health Can’t Wait, a report on sex-specific medical research released Monday. The 28-page report was presented at a women’s health summit by the Connors Center for Women’s Health at Boston’s Brigham and Women’s Hospital and the Jacobs Institute of Women’s Health at George Washington University in Washington, D.C.
It has been 20 years since the Federal National Institutes of Health (NIH) Revitalization Act was passed. The legislation requires that NIH-funded medical research on people include and analyze information on women and ethnic minorities. The legislation, however, did not extend the requirement to non NIH-funded research or studies that used animals or cells.
Monday’s published report notes that studies that do consider gender do not go far enough. They control for gender differences rather than use them as part of the investigation. One example cited that one-third of heart disease clinical trial participants are women, but less than one-third of the trials that do include women report their outcomes separately by sex, in spite of the fact that more women die from heart disease than men.
Lung cancer is the leading cause of cancer death in women, exceeding totals combined for breast, ovarian and uterine cancers. Female non-smokers are three times more likely than male non-smokers to get lung cancer. However, the reasons have not been studied or the data analyzed by gender-related factors.
In the United States, depression occurs in two times as many women than men. Hormonal differences are believed to be the reason. It is also known women metabolize prescribed drugs differently from men. However, less than 45 percent of depression and anxiety animal studies use female animals.
The neglect of gender considerations in medical research has been noted for decades. For example, a 1985 U.S. Public Health Service task force noted that the lack of medical research on women’s health was endangering women and compromising the health care they receive. The Institute of Medicine (IoM) indicated in 2010 that progress had been made in some areas of gender studies.
The authors of the report released Monday acknowledge that money could be a barrier. Including adequate numbers of females (human and/or animal) would require an increase in sample sizes and more funding for studies. They pointed out, however, that researchers are missing opportunities that would not increase costs, such as reporting data by sex in studies that already include females.
The report contains various recommendations, including requesting that the Food and Drug Administration (FDA) require drug testing to include and report data separately for men and women. The FDA takes action now if variations between sexes are suspected, but not always in other situations.
Another recommendation was for peer-reviewed medical journals to disclose whether sex differences were addressed in any studies they publish. They also want it disclosed whether the study includes females. The same request was made to the Centers for Disease Control and Prevention (CDC), NIH and other government agencies.
Other recommendations include expanding sex-based research requirements and adopting gender-based clinical care practices, as well as a call to action to stop leaving women’s health to chance. The report’s authors point out repeatedly that neglect of gender considerations in medical research has negatively impacted the health of women in the past, and continues to endanger women now.
By Dyanne Weiss