Posted: February 14, 2014
As early as preschool, kids recognize that girls and boys aren't the same. That becomes even more clear in the teen years and beyond as we age into women and men. But believe it or not, it's taken medical practice a long time to fully recognize how different women and men are, and that the differences go well beyond "bikini medicine."
View "Sex Matters: Drugs can affect sexes differently" on CBS' "60 Minutes."
This past Sunday, CBS' 60 Minutes told us more about how sex matters for women and men taking some of the same medicines.
Why don't we know more about what's same and different between the sexes when it comes to health and disease? Over two decades ago NIH established the Office of Research on Women's Health to monitor the inclusion of women in clinical research and advance women's health research. At that time, conventional wisdom had fallen into question: Why apply results from male studies to women patients? It had become very clear that "protecting" women from potentially harmful research participation by excluding them from research studies was not good science.
We've come a long way, and now we know much more about the role of sex and gender in medicine, such as that women and men respond differently to low-dose aspirin, that women's and men's body organs are structurally really different , and that drugs like Ambien require different dosing in women and men. In 2014, we have a completely different model of inclusion of women in NIH-funded clinical research studies. Today, we know that not only is studying women important, but that it's essential for being sure health care meets a woman's needs.
In "A Missed Diagnosis, A Movement, and a Critical Moment for Women's Health ," in the Huffington Post, Dr. Betsy Nabel, former director of the National Heart, Lung, and Blood Institute and current president of Brigham and Women's Hospital, walks us through her own very personal story of learning that a woman's heart attack can look very different from that of a man. She argues for more gender-based medical research as well as for a fuller extension of sex and gender research across the research spectrum from cells to selves, noting "Finally, and most important, researchers should impose a gender lens at every stage of scientific discovery."
I could not agree more with Dr. Nabel's statement that using such a sex/gender "lens would sharpen what common sense already tells us: Women are different. To treat them as simply an extension or a subgroup of men's health — or, worse, to exclude them altogether… virtually assures worse health outcomes for women."
NIH Director Dr. Francis Collins has long supported the notion of personalized and more recently precision medicine, where treatment is specifically tailored to the particular biological characteristics of the individual patient. Certainly, sex and gender-appropriate health care are directly aligned with achieving these goals. In an interview with NPR's Diane Rehm on February 10 , Dr. Collins articulates this view and notes that NIH research must work to uncover the whys and hows behind sex and gender differences in health. He also co-authored a commentary recently in the leading scientific journal Nature that explains how including sex differences in experimental design is good science.
I urge you to check out these stories from some of the leading lights in biomedicine to learn more about some of the things we know, and to see how much more we need to learn.
Bikini medicine is behind us, and ahead of us is precision medicine that matters for individuals — for women, for men, for girls, and for boys. Because after all, we learned long ago that girls and boys are different.