Over the past 20 years, society has worked to eliminate sex-based prejudice to in the workplace, at home, in sports and in society as a whole. Yet healthcare is one area where we need to distinguish between the sexes and develop a more in-depth understanding of physiological differences. Research indicates that differences triggered by the foetus’s sex may lay the groundwork for later health. These differences continue throughout life, establishing biological differences in health and disease.
These fundamental differences underpin Cook Women’s Health – a strategic business unit that recognises women’s distinct physiology and dedicates R&D to female-specific conditions. The differences have also prompted the launch of research bodies such as the Society for Women’s Health Research (SWHR), which campaigns to increase awareness of the conditions affecting women. The SWHR’s work with the National Institutes of Health (NIH) in the US has encouraged the inclusion of women in clinical studies and the broadening of obstetrics in gynaecology programmes.
As a result of the SWHR’s efforts, the Institute of Medicine (IOM) was also charged with reviewing and evaluating the current state of knowledge about, and scientific evidence for, sex-based differences. Until then, clinical trials and evaluations were based on men, who were assumed to represent the norm.
Clearly, this created a huge knowledge gap, with sexual disparities outside of the reproductive function dismissed as differences in body or organ size, body weight or proportion of body fat. The exclusion of women from clinical evaluations has created a gap in the knowledge of how devices, drugs and techniques could be optimised for better outcomes and quality of life.
Since the publication of the IOM benchmark report, Exploring the Biological Contributions to Human Health: Does Sex Matter? in April 2001, significant progress has been made in the research of sex differences and how they affect health problems and their treatment.
Findings have shown that men and women have variant patterns of illness and statistically different lifespan cycles. Research into these differences has been vital in furthering our understanding of male and female biology. Sex differences are responsible for variants in bone composition, drug metabolism and the rate at which the brain synthesises neurotransmitters, chemicals important to mood and functioning.
The male-centric approach has resulted in a lack of female-centric data on all forms of health issues. The IOM’s study underscored the need to better understand the importance of sex differences and how to translate that knowledge into improved medical practices and treatments. Among its key findings was the fact that every cell has a sex and that multiple differences in the basic cellular structure of males and females can affect an individual’s health.
The overall conclusion of the research is that gender differences affect the health of the individual and should be considered a biological variable in all health-related research, as are ethnicity, pre-existing conditions and current health status.
Regardless of age, there are a number of health considerations that have broad implications for women. Sexual differences affect every area of health, from bone and muscle conditions to eye diseases and sleep disorders. Sex can also affect disease prevention and treatment. There is, therefore, a real need for dedicated research into specific conditions affecting women.
An example of the benefits of such dedicated research is the treatment of pelvic organ prolapse, particularly common among older women and those who have had more than one birth. Medical manufacturers are now focusing on using biomaterials for pelvic reconstruction. Cook Women's Health’s Surgisis® is an example of soft-tissue graft that once implanted in the patient, can encourage and support the regrowth of new tissue. This is just one of the many new medical technologies geared towards improving the health and well-being of women.
In the UK, research bodies are changing the way research is conducted and how sex-based differences in health and disease are examined. Research bodies such as the SWHR are continuing to champion the increased funding for research on women’s health and will continue to challenge the traditional male-centric approach.
The improvement of women’s health through the education of women, the medical community and policymakers is significant, but more needs to be done. Medical device manufacturers such as Cook Women’s Health are also realising the significant benefits of distinguishing between male and female R&D. There is still much to be discovered – but we are now on the right path, with the right focus to have a significant impact on women’s quality of life.