Gender medicine – From man flu to women's cold
Rheumatism and osteoporosis are frequently described as "women's illnesses". Whereas, the risk of heart attack is clearly higher among young men.1 So do women and men get sick differently?
Sudden cardiac arrest during sports – a phenomenon that appears mainly among men. Women tend to suffer more often from broken-heart syndrome, an undefined form of heart muscle illness. Even heart attacks can vary from person to person. The medical complaints of the different genders vary tremendously and reactions to medication are also not always the same. For instance, in the 90s the medication Digoxin was prescribed against heart failure. However, gender-specific analyses found that that the substance worked well for men but could increase mortality among women. Another difference: age-related heart failure in men is often caused by a disorder of the pumping function, whereas in women it is caused by a disorder of the elasticity of the heart muscle.
The conclusion: illness risks, symptoms, and causes differ depending on gender. Different treatment strategies must be used accordingly.
Causes are already being studied
But why are there such differences between men and women? This is exactly what the research area 'gender medicine' is trying to find out. A few causes have already been identified: The female body absorbs medication differently and also excretes it differently. In addition, the interaction between medications and sex hormones plays a great role. The majority of medication tests were performed on young male mice. What impact testosterone or estrogen had on the different substances was therefore never determined. But today we know that hormones can significantly impact medication absorption. Environmental factors, such as stress, smoking, or exhaust fumes also have a different impact depending on sex hormones.
As we age, these hormone-related differences decrease, but then chromosome differences play a bigger role. The second X chromosome gives women a biological advantage. The Y chromosome mainly houses genes that are responsible for the expression of the gender. The X chromosome houses genes that determine heart, brain, and immune functions. If there is damage to the genome in this area due to mutations, women can compensate it via the second X chromosome. Men do not have this 'spare'. Genetic immuno-deficiencies, which mainly appear among boys are thus connected to genes on the X chromosome, for which there simply is no backup copy.
Women get sick more often
On the other hand, a number of studies (like the European Working Condition Survey) have shown that women stay home sick more often than men.2 Probably the most obvious reason for the additional sick days lies in nature: women get pregnant, men don't. Often the dual stress women experience of having to balance children and career is mentioned as a possible cause for the imbalance. However, there are also studies that link motherhood with a lower illness rate. So the research is not yet conclusive in this area.3
There is agreement, however, that it is very important to understand the gender difference in medicine. Only this way can both women and men receive optimal and efficient treatment. As early as 1988, the World Health Organization called upon national and international organizations to focus more on this research area.4 The Institute for Gender Research in Medicine in Berlin was founded in 2003. Only recently, it coauthored a report on gender differences in coronary heart disease together with a few other European health organizations.5