SALT LAKE CITY — Medical professionals must become more aware about how a person's sex can both affect their body's responsiveness to certain treatments and create blind spots leaving their health needs unmet, researchers contended in a three-day summit at the University of Utah that concluded Tuesday.
Gaps exist in scientific knowledge about how men and women experience certain medical conditions differently, including acute events, such as a heart attack, in addition to long-term illnesses, said Dr. Marjorie Jenkins, a co-chair of the Sex and Gender Health Education Summit hosted at the U.
Jenkins believes modern scientific research has long ignored the distinction between male and female subjects for the study of anything not overtly connected to a person's reproductive system or explicitly masculine or feminine traits.
"We're sexing diseases," said Jenkins, an executive with the Laura W. Bush Institute for Women's Health at the Texas Tech University Health Sciences Center. "(We say) men get heart attacks, women get depression. When we sex diseases, everybody loses."
For example, ingrained and subtle biases about how a health emergency should look can work against a woman whose heart attack symptoms show up slightly different than a man's typically would, Jenkins said.
A woman in that situation is more likely "to be told she has some stressors going on," as opposed to a bona fide cardiac event, she said. And according to a new Cleveland Clinic study, "It takes women a longer time, who were having a heart attack, to get to a cath lab" where their condition is formally diagnosed.
"Those few minutes can save a life," Jenkins said.
A scarcity of well-kept data has consistently been missing in important medical studies due to the assumption that most conditions affect men and women the same, and men have traditionally been overrepresented in clinical studies in part because of government advisories not to do such testing on women at the height of childbearing age, according to Jenkins.
"I don't think there was any mal-intent," said Dr. Ana Maria Lopez, associate vice president of health equity and inclusion for University of Utah Health Sciences and a professor of medicine at the U. "I think people just thought … we must be OK if we study heart disease — it must work the same in men and women. But I think we're learning it doesn't work the same."
Added Jenkins, "We just didn't know there was a difference. Now, we don't have the luxury of saying that."
The federal government's broad warning about clinical testing of childbearing-age women wasn't rescinded until 1993, Jenkins said.
Since then, the National Institutes of Health has completed a federal about-face on not only clinical trials, but in 2014 the body also announced that researchers seeking grants should seek to eliminate any sex bias among the animal subjects they examine.
"That ripple effect is huge," Jenkins said.
Still, many scientific journals have not issued the same directives, she said.
University of Utah Health spokeswoman Suzanne Winchester said that research has shown a sex-based "difference in the prevalence, manifestation and response to treatment" of several conditions such as obesity, autoimmune diseases and coronary heart diseases.
"However, these differences have still not routinely been incorporated into medical curricula and research," Winchester said in a release.
The spokeswoman added that "some drugs are metabolized differently in women and men — necessitating considerations of sex for dosing."
Lopez, also the director of cancer health equity for the Huntsman Cancer Institute, said she is optimistic that "in 10, 20 years, there may be very specific therapies that are based on whether the person's male or female," improving outcomes for patients. Already, researchers know that some medications such as zolpidem — a sedative popularly known by the brand name Ambien — work differently on men and women.
"It has very different effects in males and females, so now there's a recommended starting dose for males and a different recommended starting dose for females," she said.
Jenkins, Lopez and other summit organizers said they hope to shore up the curriculum in medical schools to see to it that the importance of gender equity in research — and by extension, clinical practice — becomes a priority for the rising generation of caregivers. About 250 attendees from more than 170 academic institutions and other medical organizations participated in the summit at the U.2 comments on this story
"One way for this approach to really become integrated to day-to-day practice is that this learning needs to really be part of medical education," Lopez said.
This week's event is just the second ever Sex and Gender Health Education Summit, with the prior one being held at the Mayo Clinic in Rochester, Minnesota, in 2015. Lopez said the chance for the U. to host what is "really … an international meeting" was a big get for the university.
"I think it's just really great to have the opportunity to bring (in) scholars … and to be able to host them and engage them in what is really a leading edge work," she said.