Sex and gender perspective in medicine benefits everyone
The pandemic, beyond its drama in terms of mortality, disease and social and economic devastation, will have left us with some useful lessons for the future. Much has been said about how the impact of human activity on the environment has been proven with the significant drop in pollution. Also of the wonderful example of scientists from all over the world working at the same time to learn more about the virus and thus know how to act and how it can be fought with vaccines. Or the paramount importance of the entire health system and its spirit of sacrifice despite the lack of resources. Today we talk in our dossier of another effect that may be interesting for the future: the disease affects men and women differently, and this demonstration has shown that the same thing happens in other cases without the focus or the means to demonstrate it so clearly.
Most clinical research and the pharmaceutical industry take men as a basis and extrapolate the results to women's bodies. It seems, as the scientist Cristina Pujades comments, that one of the reasons could be that it is easier to experiment with, for example, male mice, because this way there is no hormonal variability. Curiously, despite the fact that the very reason why this is done - to avoid hormonal interference - already shows that there must be something different, even today it is still difficult to find studies in which there is parity, and gender bias is maintained in many laboratories.
The result is that in many cases there is underdiagnosis, less effective treatments or unexpected reactions to drugs. Women and men do not always have the same symptoms when they suffer a disease, as is the case of cardiovascular disease, which is the leading cause of death in women above breast cancer. Although they also have chest pain, other symptoms, such as nausea, headaches or vomiting, are usually common, and are often confused with anxiety attacks, which is, on the other hand, a disease that is greatly overdiagnosed in women and sometimes underdiagnosed in men. The result, however, is that women are more likely to die of a heart attack because neither they nor sometimes their healthcare environment recognises what is happening until it is too late.
Another important gender bias is that of diseases that only affect women, such as endometriosis, which affects 10% of women of reproductive age and is only now beginning to be recognised and diagnosed, because for years it has been considered that "period pain", as it was called, is normal. Pain and the fertility problems it can cause have not been considered relevant until recently, and there is a serious problem of underfunding research.
This gender bias, although it harms women much more, also affects men in some cases, since there are diseases, such as osteoporosis or depression itself, which tend to be considered only women's diseases and are underdiagnosed in men. Perhaps the avalanche of data we now have thanks to covid will contribute to a gender bias that is detrimental to everyone.
