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HORMONAL HEIRARCHY: BREAKING DOWN THE STATE OF WOMEN'S HEALTH RESEARCH & BUILDING A BETTER FUTURE

We have always been the heroines of our hormones. In fact, in many ways, we’ve had to defend their very existence. 

There is no question our bodies are unique, both from each other individually and from a gender perspective. There is also scientific evidence that women’s bodies differ in the ways they react to, express and treat pain or disease. So there shouldn’t be a one-size-fits-all approach to our health. But it has taken quite some time to convince medical researchers, both male and female, that our unique bodies deserve unique observation. How can we rely on the healthcare system that eliminates us from studies that affect the way we approach our health?

It’s frustrating to consider the gap in attention to women’s healthcare and important to know that, while we’ve made many strides, we still face challenges in achieving complete understanding. With some knowledge about the state of women’s health, both historically and as it stands today, we can help our fellow women in tackling the health issues that matter to us.

HISTORICALLY | Our ovaries have been overlooked.

Historically, women have been overlooked in the medical research conducted to prevent and protect against disease and provide solutions toward healing. In the 80s and 90s women were essentially banned from clinical trials because of their hormones. According to the National Institute of Health, researchers vouched for male-only trials because men [were] cheaper and easier to study, and they also feared that the inclusion of women of childbearing age in clinical trials might endanger fetuses. Non-pregnant women, too, were excluded, as the reservations applied to future fetuses as well. Our cycles were considered a complication to such studies. 

So women and their hormones were deemed ineffective subjects, or worse, harmful to the studies being done on drugs that could potentially help us heal. Without our participation in these trials, the research, diagnosis, and treatment of diseases that affect women has been largely misunderstood. Interestingly, for example, “the first study of the role of estrogen in preventing heart disease was conducted solely on men, as it was considered a possible treatment.” It seems like common sense to include subjects whose estrogen levels are naturally higher than those found in men in a study about heart disease, but it didn’t happen that way. We all have hearts, right? 

In terms of this treatment research, leaving women out is a huge risk. The National Institute of Health reports that drugs developed for men and untested on women may be dangerous for women, [and] drugs that are potentially beneficial to women may be eliminated in early phases of clinical testing when the test group does not include women and no benefits are manifest in male subjects. Ignoring sex-dependent drug effects means we are oftentimes prescribing women the wrong solution and one that may cause even more harm. 

CURRENTLY | Gender bias in healthcare persists. And our hearts are at risk. 

Though the government has since required women to be involved in government funded trials, private trials are still conducted freely and can control their own test samplings. 

Thus, women are still largely misunderstood by medicine, which leads to misdiagnosis and ongoing diseases. One profound example is  the case of cardiovascular disease (CVD), these are potentially life-threatening misunderstandings. For example, an analysis of randomized controlled trials conducted in 2009 indicated that women comprised just 37% of subjects in [CVD] studies that included both men and women, and that 75% of studies did not report outcomes by sex

In addition to our hormones being historically problematic for research, there are misconceptions that serve to further widen the information gap on women’s healthcare. Women’s supposed tendency to exaggerate symptoms often leads to misdiagnosis. A study found that women who are more emotive in their expressions of symptoms are at higher risk of having their symptoms dismissed as psychogenic rather than cardiac. So they’re saying it’s in our heads… when it could potentially be our hearts in trouble. 

Equally disturbing, research shows that young women are seven times more likely to be sent home from the hospital in the middle of having a heart attack. This is just one horrifying example of the bias in the healthcare system. Not only are women accused of embellishing symptoms, but the notion that women are built to handle more pain than men conflates this so it seems no matter what, we are likely not to be trusted in regards to our own health.

There is also, of course, an ongoing disparity in healthcare for women of color. Without a balanced and diverse sampling of participants in clinical trials even today, certain diseases are sometimes incorrectly considered as affecting one group of women over another. As women are being included in research far less than men, African American and Hispanic women are, by default, not necessarily being properly screened and educated about the diseases for which they tend to be more at risk. 

NOW WHAT?

There are clear disadvantages to eliminating women from medical research and overlooking the importance of our health. A holistic approach to healing is considering the fact that hormonally, we are different from men. Education is key in being able to treat our bodies with the well-rounded care they deserve. 
It’s staggering to note that in U.S. healthcare today, only 4% of research and development goes towards women’s health issues. We share this knowledge not to scare you, but so we can all be armed with our best information, do our part in understanding our bodies, and live long, healthy lives.