Did you know that the first twenty years of major federal studies in health and ageing included only men? Yet two-thirds of the elderly population are women.
Despite significant advancements in women’s health, significant gaps in medical research persist, often leading to underrepresentation and neglect of women.
“It often has been charged that women are not adequately included in clinical research. In particular, it has been charged that women frequently are excluded from studies concerning conditions affecting both women and men and that when women are included in such studies, they tend to be underrepresented,” said Debra A. Debruin.
Since 1992, researchers have been required by the National Institutes of Health to include gender representation and analysis information in their study proposals and renewal requests.
The lack of complete information on inclusion in clinical studies makes it challenging to estimate the extent of women’s exclusion and under-representation accurately.
Underfunding, historical prejudices, and lack of women-specific medical interventions are vital causes of health disparities, requiring urgent attention for improved health outcomes globally.
One might wonder:
How Has Women’s Health Been Neglected in Medical Research Over the Years?
In 1990, a study aimed to determine if continuous oral AZT treatment can reduce HIV transmission from mother to infant in HIV-infected pregnant women, during childbirth, and in newborns was carried out.
The study initially focused on fetuses without maternal health, excluding gynaecological care and non-obstetrical care for women.
The protocol was later revised in 1991 by the Women’s Health Core Committee.
The 1993 NIH Revitalization Act has made significant strides in advancing women’s health by mandating their inclusion in clinical trials, leading to more accurate, comprehensive, and equitable healthcare research and treatment protocols.
However, challenges remain, such as the recent announcement that aspirin can prevent migraine headaches based on male data and the exclusion of female rats in its research.
Gender Bias In Medical Research
Gender bias refers to a preference for one gender over another. Gender bias, based on prejudices and stereotypes, can be conscious and unconscious.
In the world of healthcare, it reduces medical diagnoses, leading to delays, misdiagnosis, and even death.
Historically, biological differences between sexes have perpetuated gender stereotypes, such as women being less intelligent due to brain size differences.
How Does Gender Bias Affect Medical Diagnosis?
A 2020 study by Wiley, a peer-reviewed journal, found that women with moderate haemophilia receive a diagnosis 6.5 months later than men, while severe haemophilia and VWD women face delays of 39 months and 16 years, respectively.
These delays are not medically related but more common due to heavy periods.
Although chronic pain is more prevalent among women than men, medical professionals often dismiss them as sensitive or time-wasters. They are more likely to diagnose women with psychological causes of their pain rather than physical ones.
This gender bias in chronic pain diagnosis can lead to inadequate medical support, incorrect diagnoses, and avoidable damage to their mental health.
Inequity in medical research also reinforces gender bias, as many studies from before the 1990s were flawed due to the belief that males were the best test subjects.
Influence Of Hormonal Variations On Disease Risk, Progression And Treatment Efficacy
Medical research should incorporate reproductive health and hormonal cycles to understand female biology’s complexity and develop effective, inclusive healthcare solutions.
Disease Risk: Hormonal fluctuations, including estrogen and progesterone, impact the risk of diseases like breast cancer and osteoporosis, with higher estrogen exposure linked to increased risk.
Disease Progression: Hormones can impact disease progression, with hormone-sensitive cancers like breast cancer growing faster in response to estrogen.
Treatment Efficacy: Hormonal status affects treatment effectiveness, with hormone replacement therapy (HRT) suitable for menopausal symptoms but not for all women, especially those with hormone-sensitive cancer histories.
Importance of Including Reproductive Health and Hormonal Cycles in Medical Research
Comprehensive Understanding: Including reproductive health and hormonal cycles in research provides a fuller understanding of disease mechanisms and variations in symptoms and outcomes between genders.
Personalised Medicine: Research on hormonal cycles can lead to customised treatment plans that account for hormonal influences, improving efficacy and reducing side effects.
Preventive Care: Understanding how hormonal changes affect disease risk can lead to better preventive strategies, particularly for conditions like cardiovascular disease and osteoporosis that are influenced by hormonal status.
Gender-specific Health: Ensures that women’s health issues are adequately studied, leading to better health outcomes and addressing gender disparities in healthcare.
Impact of Socio-Economic Status, Education, and Access to Healthcare on Women’s Health
Socio-Economic Status (SES): Lower SES is linked to poorer health outcomes due to factors like inadequate nutrition, higher stress levels, and limited access to healthcare services.
Education: Lower education levels correlate with less health literacy, leading to poorer health decisions and limited use of preventive services.
Access To Healthcare: Limited access to healthcare results in delayed diagnosis and treatment, poorer management of chronic conditions, and reduced access to reproductive health services.
The Role of Policy and Community Support
Policy:
Healthcare Access: Policies that ensure affordable and accessible healthcare for all women can mitigate disparities.
Education: Policies that promote education for girls and women improve health literacy and outcomes.
Economic Support: Policies providing financial assistance and job opportunities can alleviate the health impacts of low SES.
Community Support:
Health Programs: Community health programs that provide education, screenings, and healthcare services can improve health outcomes.
Support Networks: Community support groups can provide emotional and practical support, improving overall well-being.
Local Advocacy: Community advocacy for women’s health issues ensures that local needs and disparities are addressed effectively.
Effective policies and robust community support systems are crucial in reducing health disparities among women, ensuring equitable access to healthcare, and promoting overall well-being.
Recent Breakthroughs In Women’s Health Research And Treatment
Breast Cancer: Advances in targeted therapies, such as HER2 inhibitors and immunotherapies, have significantly improved survival rates.
Ovarian Cancer: PARP inhibitors are showing promise in treating certain types of ovarian cancer, particularly in patients with BRCA mutations.
Endometriosis: New treatments, like GnRH antagonists, relieve symptoms with fewer side effects.
Emerging Technologies And Personalised Medicine
Genomic Medicine: Genetic testing helps tailor treatments based on individual risk profiles, especially in breast and ovarian cancer.
Wearable Technology: Devices that monitor menstrual cycles and fertility provide personalised health insights.
AI and Machine Learning: These technologies predict disease risk and personalise treatment plans based on large datasets.
Necessity Of Ongoing Investment In Women’s Health Research
Addressing Health Disparities: Women have unique health needs and conditions that are often under-researched, leading to disparities in treatment and outcomes.
Improving Outcomes: Focused research can lead to better prevention, diagnosis, and treatment strategies for women-specific health issues like breast cancer, reproductive health, and autoimmune diseases.
Economic Benefits: Healthier women contribute more effectively to the economy, reducing healthcare costs and increasing productivity.
These combined efforts ensure that women’s health research is robust, inclusive, and geared toward achieving gender equity in healthcare.
In summary, achieving equity in women’s health is a complex and diverse process that requires consistent work by activists, legislators, and researchers. By tackling the ingrained prejudices and systemic obstacles in medical research and care, we can create a more positive future for women everywhere.
Every reader has a part to play in this critical project. If you work in the healthcare industry, support more inclusive research and consider the particular health requirements of women in your practice.
References
- Debruin, D. A. – Commentary on the underrepresentation and exclusion of women in clinical research.
- National Institutes of Health (NIH) – 1992 requirement for gender representation and analysis in study proposals and renewals.
- NIH Revitalization Act of 1993 – Legislation mandating the inclusion of women in clinical trials.
- Wiley – A study published in 2020 highlighted diagnostic delays for women with haemophilia and von Willebrand disease.
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