How Medical Research is Failing Women: A Deep Dive into Gender Bias and Its Consequences

Medical research has long been a cornerstone of advancements in healthcare, but it has also been plagued by significant biases that have profound implications for women. Kate Womersley, a former medical student at Cambridge University, was confronted with this reality when she noticed a glaring omission in her anatomy course: the topic of breasts was completely absent from her course handbook. This oversight was not just puzzling but infuriating, highlighting a broader issue within medical education and research. Womersley, now a doctor in psychiatry, found it shocking that such an important organ for women’s health could be disregarded at one of the world’s most prestigious medical schools. This incident was a catalyst for her career, leading her to co-found the Medical Science Sex and Gender Equity (MESSAGE) project in 2022, which advocates for the inclusion of sex and gender considerations throughout the research process.

The MESSAGE project is not just a niche initiative; it addresses a systemic problem in the medical field. Scientists and clinicians have increasingly recognized that both biological and societal factors affecting women’s health have not received the attention they deserve. This form of bias is evident from the pre-clinical testing phase, where male animals and cells are predominantly used, to human trials, where women are often underrepresented. The underrepresentation of women in clinical trials can be traced back to historical concerns about testing medicines on women of child-bearing age, a cautionary approach stemming from the Thalidomide scandal of the 1960s. However, other factors like caring responsibilities and the time commitment required for participating in clinical trials also contribute to this disparity.

The consequences of this gender bias in medical research are far-reaching. Women may be prescribed drugs that are not as effective or safe for them because the dosages and side effects were primarily studied in men. Jill Fisher, a Professor of Social Medicine, points out that using primarily male bodies for safety and tolerability studies can result in doses that are unsuitable for women. Data corroborates this, showing that women experience more adverse events from approved medicines compared to men. Despite efforts to include more women in clinical trials, such as the NHI Revitalization Act in the US in 1993 and the Canadian Institutes of Health Research’s mandatory reporting of sex and gender design, progress has been slow. Historically, drug development has been focused on male bodies, a trend that continues to affect women’s health outcomes negatively.

This underrepresentation is particularly troubling when considering conditions that are more prevalent in women. For instance, heart disease presents differently in women, leading to delayed diagnosis and increased mortality rates. Early studies on heart disease only included male subjects, despite women exhibiting lower rates until menopause. Similarly, a NIH-funded study on obesity and cancer included only male subjects, ignoring the unique ways these conditions manifest in women. This lack of gender-specific research extends to other diseases like kidney disease and coronary heart disease, further marginalizing women’s health needs.

Stacey Missmer, a professor and associate chair for epidemiology and translational research at the University of Michigan, has been vocal about this issue. She recently co-authored a report urging the NIH to prioritize and improve research on chronic conditions affecting women. Discussed in a recent episode of the podcast MedCity FemFwd, the report highlights the need for more focused research on women’s health. Missmer and her colleagues found a significant lack of research on chronic conditions affecting women and provided several recommendations for improvement. The current healthcare landscape, with hospitals struggling to retain staff and adapt to value-based care, underscores the importance of technology and efficiency in the industry. Health systems must balance improving efficiency with maintaining quality patient care and supporting their staff.

One way to enhance financial health and streamline administrative processes in healthcare organizations is through best practices in revenue cycle management. These practices can help healthcare organizations become more efficient without sacrificing patient care or staff support. However, the modern trend of urbanization has led to a growing appeal for countryside living, especially when it comes to health and well-being. This shift can be attributed to factors such as pollution and stress in urban areas. Countryside living may offer a more peaceful and natural environment that promotes better health. However, the growing population and development in rural areas may also bring challenges to maintaining good health and access to healthcare.

It is crucial for healthcare systems to recognize and address the needs of those living in the countryside. This may include providing access to specialized care, adapting to the unique challenges of rural living, and improving infrastructure and resources. Overall, there is a pressing need for more research and resources dedicated to understanding and addressing the impact of chronic conditions on women’s health, both in urban and rural areas. The report and podcast episode highlight the importance of continuing to advance and prioritize women’s health research to improve overall health outcomes for women.

The historical exclusion of women from medical research has roots in various ethical and practical concerns. Until 1977, women of childbearing age were excluded from early phases of drug studies unless they had life-threatening illnesses. This exclusion was largely due to concerns about reproductive health and the potential risks to unborn children. Additionally, women were often viewed primarily as caregivers rather than independent patients, further marginalizing their health needs. This perspective has contributed to a medical research paradigm that prioritizes male bodies and overlooks the unique physiological and hormonal differences of female bodies.

Female bodies metabolize drugs differently than male bodies, leading to potential under or overdosing when treatments are based on male-centric research. Women’s hormonal fluctuations can complicate research and treatment, yet these factors are often overlooked. For example, early studies on heart disease included only male subjects, even though women exhibit different symptoms and risk factors. This oversight has led to delayed diagnoses and higher mortality rates for women suffering from heart attacks. The gender disparity in medical research is also evident in animal studies, where male subjects are predominantly used. This bias extends to research on diseases such as kidney disease and coronary heart disease, where women are underrepresented despite being at significant risk.

There is a growing emphasis on considering sex and gender differences in medical research. Overcoming biases, securing funding, and designing comprehensive studies are significant challenges in addressing this gender gap. Prioritizing women’s health research can lead to more effective treatments and better patient outcomes. Gender equity in medical research is an ongoing journey that requires acknowledgment and proactive steps. Researchers and policymakers must work together to ensure that medical research is inclusive and representative of both sexes. This includes not only increasing the participation of women in clinical trials but also analyzing data by gender to identify differences in treatment efficacy and safety.

The journey towards gender equity in medical research is fraught with challenges but also opportunities for meaningful change. The inclusion of sex and gender considerations in the research process is not just a matter of fairness but a critical component of scientific rigor and accuracy. As the MESSAGE project and other initiatives continue to advocate for these changes, it is essential for the medical community to listen and act. By addressing the historical biases and gaps in research, we can move towards a more inclusive and effective healthcare system that benefits everyone, regardless of gender.

In conclusion, the failure of medical research to adequately address women’s health needs is a multifaceted issue that requires concerted efforts from all stakeholders in the healthcare ecosystem. From educational institutions to research organizations and policymakers, there is a need for a paradigm shift towards inclusive and gender-sensitive medical research. The experiences of Kate Womersley and Stacey Missmer underscore the urgency of this issue and the potential for transformative change. By prioritizing women’s health research and addressing the biases that have long plagued the field, we can pave the way for better health outcomes for women and, ultimately, for all individuals. The journey towards gender equity in medical research is not just a goal but a necessity for a healthier future.