“Bikini Medicine” Is Costing Women Their Lives

In her eye-opening TED talk Alyson McGregor talks about a truth that’s not as widely discussed as it should be: health issues and medical care are different for men and women.

FindMeCure is very now-centered when it comes to clinical trials but clinical trials have undergone an evolution of their own in order to get where they are, be as safe and as inclusive as they are and stay on the right track of developing drugs which are efficient and considerate of individual differences. There’s still a long way to go, however, but let’s take a look for a minute at how things used to be.

After the monstrosities of World War II, policies were set into place to make sure no one has to undergo unnecessary painful or potentially unsafe medical procedures or unconsented to medical research ever again. So, due to a number of considerations women of fertile age were excluded from medical research with their and their potential children’s safety becoming a huge priority. This well-intended approach, however, turned male physiology into the only point of reference in medical research: from the cells on which a new drug was tested, to the animals in animal trials, to the exclusively male participants in human clinical trials.

We should also be aware of the general belief at this time which stated that, apart from their reproductive systems, men and women are fundamentally the same. But, as Alyson McGregor reminds us, just like kids are not small adults, women are not “men with boobs and tubes”. And approaching them as such has become the source of the catchy phrase “bikini medicine” – it’s the kind of medical approach, which dictates that “women’s health” only means reproductive health, that it only has to do with uteruses and ovaries, and mammary glands, hence the term referring to bikini areas.

This history of female exclusion is not separate of course from the implicit sexism going on in society at large and we have already talked about some sexist patterns in medicine in previous articles. The most striking example of how medicine treats men and women differently remain the numerous cases of women who die from heart attacks after being sent back home from the emergency rooms. Alyson McGregor explains why: women experience heart attack symptoms differently than men, and these symptoms – the symptoms experienced by women – are generally considered atypical.

But instead of taking the male model as the sole framework and labeling everything else “atypical”, we should start considering the reality that male and female physiology is different not only when it comes to the respective reproductive organs. While men experience a certain set of symptoms in one case, women experience another. Men and women respond differently to drugs too, with one of the most popular examples being the sleeping-aid drug Ambien, which women metabolize twice as slowly as men and so they need half the dosage.

For one thing, women – generally speaking – are smaller than men. And in some cases having a higher concentration of a drug in your body can be absolutely safe… in other cases, however, it can put the woman in danger and even be toxic.

And yet, up until 1987 when the National Institute of Health began encouraging female participation in clinical trials, women were absent from medical research altogether but were still given medicine proven safe in (and for) men. Apart from the safety considerations, there was also one other thing – not including women was easier. It was cheaper and this way tests didn’t have to account for fluctuations in hormone levels.

Much like minority participation in clinical trials, female participation is crucial for determining safe dosages or even safe substances. We may not like the idea of biological differences as it could lead to unequal treatment in other areas of life, after all, there are way too many historical examples of bioessentialism gone racist. But we’re not talking about biological determinism here, nor are we endorsing such an approach in any way. We’re simply suggesting that there are some differences that need to be taken into account when developing new drugs in order for women (or minority groups) to get the best possible treatment. And as it turns out sometimes, in order to be treated equally, we need to acknowledge our differences.

It’s more expensive, it takes more time and effort, but developing drugs based on individual responses could be the future of medicine. As Alyson McGregor puts it, “This is not just about improving medical care for women. This is about personalized, individualized healthcare for everyone.”    

Before you go….. Did you know that there are over 60 000 clinical trials accepting patients with various conditions right now? Use the search to find a trial for yourself in seconds.               

Article by Nelly Katsarova