It's one of the hottest areas in medical research today: the gender gap. Finally, medical science is awakening to the reality that the differences between women and men go far beyond our reproductive organs. Just for starters:
- Women are more likely to suffer from depression, while men are more likely to be alcoholic.
- Women have more trouble reaching orgasm than men, but men have to deal with premature ejaculation.
- Women suffer more often from migraines, while men get cluster headaches, which strike a few times a night over a period of weeks, usually interrupting sleep.
- Women die from heart attacks as often as men, but they don't get them until much later in life.
- Women make more antibodies than men and of the 8.5 million Americans who get autoimmune diseases such as lupus, 6.7 million are women.
- Also, we now know that our saliva and digestive systems are different from men's, and we even metabolize some medications differently.
Though the concept of gender-specific medicine germinated during the feminist movement of the 1950s, it wasn't until 1990 that the health world started to take notice. That's the year the National Institutes of Health put the ball into play by creating the Office of Research on Women's Health. Then in 1991, the NIH launched the Women's Health Initiative, a 15-year-long, wide-reaching clinical research project focusing on the health of post-menopausal women. And in 1993, the Food and Drug Administration mandated that all clinical trials of new medicines look at both women and men, which seems obvious but was in fact revolutionary. Before that, testing for everything from heart disease to depression (to women's cosmetics!) was conducted primarily on men. Researchers even avoided female animals, so they wouldn't have to bother with pesky hormonal cycles.
Now that it has been mandated, research on women is picking up steam--good news for women's health and their male counterparts.
"As we learn more, not only will we be able to treat women better, but men, too," says Phyllis Greenberger, executive director of the Society for Women's Health Research. "The point is to close the gap and understand the implications for both sexes."
The Heart (and Muscle and Liver) Beat
Research is beginning to uncover how our internal organs function vs. a man's. Perhaps most significant is the variation of the process in the liver that metabolizes medications: The male system breaks down drugs for excretion, moving them through the body quickly, which may mean that drugs stay in our bodies longer, and that we may need smaller doses. And although it's not clear if there's a link to liver function, women and men often experience different reactions and side effects from the same drugs.
Perhaps the most-publicized gender science in recent years has been in cardiology, where a campaign is under way to burst the myth that women don't have to worry about heart disease as much as men do. "Women just get it 10 years later," says best-selling author Dr. Dean Ornish, head of the Preventive Medicine Research Institute at the University of California San Francisco School of Medicine. Women are neither diagnosed nor operated on as often as men, and the ones who do have surgery are more likely to die. "The good news is that women seem to be able to reverse heart disease better and faster than men," says Ornish, adding that women seem more adept at making the lifestyle changes that are most effective in combating disease.
Those Hormones Again
Hormones and their impact on our menstrual cycles seem to affect far more than PMS . "There may be a hormonal impact that explains why irritable bowel syndrome is more common in women," says Dr. Marianne Legato, director of the Partnership for Women's Health at Columbia University in New York. Women are, in fact, three times more likely to suffer from IBS, a common illness that causes intense lower-abdominal pain, gas and diarrhea. And if research conclusively links hormones and IBS, better treatments may loom.
Hormones also have been implicated in differences ranging from the saliva in our mouths to the way we experience headaches. In the case of saliva, says Legato, "the chemical composition of women's saliva changes with the menstrual cycle, while men consistently have a more rapid flow of saliva than women." This may mean that we digest food differently, but we still don't know for sure. As for headaches, many more women than men suffer from migraines, and Legato says there are links between migraines and the menstrual cycle. In women, migraines don't usually show up until puberty hits, and they often attack just before menstruation. Men, on the other hand, suffer much more often from a painful headache called cluster, which doesn't appear until age 20 or 30, and has no apparent cyclic activity.
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