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The Doctor Game: Gender differences must be considered in medicine

George Carlin, the American comedian, once remarked when referring to God: 鈥淗e, and if there is a God, I am convinced He is a He because no woman could or would screw things up this badly.

George Carlin, the American comedian, once remarked when referring to God: 鈥淗e, and if there is a God, I am convinced He is a He because no woman could or would screw things up this badly.鈥
Karen Jensen, one of the world鈥檚 authorities on women鈥檚 health would agree. Her new book, Women鈥檚 Health Matters, reveals how medical researchers and doctors screw up big time when it comes to women.

Her main point is that women are different. I say thank God for that, or as Maurice Chevalier remarked 鈥淰ive la difference!鈥 But what is forgotten is the fact that this difference has to be considered in both research and medical treatment.

There鈥檚 a basic fact that I bet no reader knows and, I admit, I didn鈥檛 know it, either. According to the Institute of Medicine, every cell in the body has a sex. So right down to the cellular level, women are different.

But how important is this fact? It helps to explain why women are more susceptible to several diseases, such as diabetes, Alzheimer鈥檚 disease, osteoporosis, urinary tract infections, irritable bowel syndrome and depression.

How many readers know that when women eat food or take medicine, it takes twice as long for it to pass through the digestive tract than with men?
But how many doctors prescribe different doses to women? Rather, it鈥檚 鈥渙ne dose fits all.鈥 But this means women experience more drug reactions than men.

It鈥檚 also been known for years that women don鈥檛 metabolize alcohol as quickly as men. I admit that these are hardly fair metabolic reactions and whoever created us failed to consider this difference. But facts are facts, and it means that women have to consume less alcohol than men.

But the difference between sexes is not just at the cellular level. For years, women have suffered more urinary tract infections (UTIs) than men because of a major anatomical difference. The urethra, the tube that carries urine from the bladder to the outside, is much shorter in women. This means that bacteria can more easily enter the bladder, triggering urinary infections. For example, in 1997, fewer than one million visits to hospital emergency departments were made in the U.S. for this problem. In 2007, there were 8.6 million outpatient UTI visits, of which 84 per cent were made by women.

What about the No. 1 killer, heart attack? Even here, women get the short end of the stick. First of all, heart disease is more likely to go undiagnosed in women than in men, as symptoms are often different. But even if the diagnosis is quickly made and bypass surgery required, women have a worse prognosis than men. Why? The coronary arteries in females are smaller, making the operation more technically
difficult.

Jensen offers only one solution to overcoming this problem. Women must become proactive and reduce their risk of disease. The best way is to start educating themselves. That way, if symptoms strike, they will be better able to determine whether the treatments they receive are safe, effective and specific to their gender.

If readers want a comprehensive, easy-to-read book about women鈥檚 health, Jensen鈥檚 book fits the bill. It covers everything from how stress has a major effect on adrenal glands to the fact that cholesterol-lowering-drugs are associated with the onset of Type 2 diabetes. She looks at why more women suffer from autoimmune disease and how dementia is becoming an increasing threat to women.

There鈥檚 also information on what women should know about common hormone imbalances. And what causes low libido in women, and how natural remedies can be helpful.

And yes, Dr. Jensen, you are quite right. Women are different from men. Many differences make us what we are, and I say thank God for that!

Women鈥檚 Health Matters is available at health-food stores.