Why Does Medical Science Know So Little About The Female Body? - What Your GP Doesn't Tell You Podcast
Most studies done on male humans, male animals and male cells
The latest episode of the podcast What Your GP Doesn’t Tell You (Why Does Medical Science Know So Little About the Female Body?) is now available on Apple and Spotify .
One of the things that I’ve always wondered about is how much medical science really knows about the female body, given that women were excluded from many drug trials up to the mid-1990s, what impact has that had on what we know about women’s health?
So, I thought there was no one better to invite onto the podcast than journalist Gabrielle Jackson, who spent several years carrying out in-depth research looking into this for her book Pain and Prejudice. And as this clip explains, she was shocked by what she found.
It turns out that most studies on human biology have been done on male humans, male animals and male cells.
As a result, as Dr Janine Clayton, Director of the Office of Research for Women’s Health at the US National Institutes of Health has commented: “we literally know less about every aspect of female biology compared to male biology”.
Historically, the assumption was made that women’s bodies functioned like men, but there is increasing evidence that this is not true. We know that there are a number of diseases that are more common in women such as auto-immune conditions and chronic pain, and that at least some diseases which affect both sexes may produce different symptoms in men and women.
It's been well documented that female symptoms for heart disease are very different to men but despite this, a 2018 study1 in Australia’s major tertiary hospitals found that women were half as likely as men to be treated effectively, when presenting with a major heart attack, and they were twice as likely to die within six months. Today, women are still being sent home with anxiety while having a heart attack.
For a long time, women were excluded from drug trials because as Gabrielle explains there was a concern that their menstrual cycles might disrupt the results, but this meant that the first time doctors would find out how women responded to the drugs would be when they were prescribed.
And, in fact, of the ten prescription drugs taken off the market by the US Food and Drug Administration between 1997 and 2000, eight had greater health risks in women2 .
A paper in 20183 reported that the lack of information about women's health was due to serious male biases in both preclinical and clinical research.
And although today, women regularly take part in clinical studies, there is still a huge problem in the pre-clinical stage of research, prior to the human trials. A study in 20104 looked at ten biological fields of medicine and found male bias in eight. Not only were five times as many male animals being used in pre-clinical studies, but biological differences (outside of reproductive) between the two sexes were largely not being analysed.
The whole point of using female and male animals is to see if they respond differently, not to do this negates the entire purpose of using both sexes. A follow-up study in 20205 , found that while studies were now including more female animals, they were still not effectively analysing the results for sex differences betweeen the genders.
Remarkably, the US’s National Institutes of Health, one of the world’s biggest funders of biomedical research, didn’t require female animals to be included in all its funded work until 2016, so clearly women’s health still has a lot of catching up to do.
You can find out more about the podcast at What Your GP Doesn't Tell You and follow me on Twitter at @lizctucker
Putting together a podcast likes requires a large amount of work and resources, so if in the coming weeks you feel able to support the podcast, I’d be very grateful. You can do so at Patreon or via Paypal on my website.
Ehsan Khan, David Brieger, John Amerena et al., Differences in management and outcomes for men and women with ST-elevation myocardial infarction, Medical Journal of Australia, 2018, 209(3): 118–23, doi: 10.5694/mja17.01109.
A.K. Beery and I. Zucker, Sex bias in neuroscience and biomedical research, Neuroscience and biobehavioral reviews, 2010, 35(3): 565–72, doi: 10.1016/j.neubiorev.2010.07.002.
Woitowich NC, Beery A, Woodruff T. A 10-year follow-up study of sex inclusion in the biological sciences. Elife. 2020 Jun 9;9:e56344. doi: 10.7554/eLife.56344. PMID: 32513386; PMCID: PMC7282816.
S.K. Lee, Sex as an important biological variable in biomedical research, BMB Reports, 2018, 51(4), 167–73, doi: 10.5483/BMBRep.2018.51.4.034.