Women's Medical Needs Are Vastly Different Than Men's

Yet, there's a cavernous void in research based on sex and gender. Historically, most studies have been done on men and the findings applied to women.

Northwestern University's Feinberg School of Medicine has launched the Institute for Women's Health Research to spur much needed research on health issues that affect women throughout their lifespan. Some topics on the ambitious research agenda: cancer, autoimmune disease, anesthesia, cardiovascular disease, depression, sleeping disorders, osteoporosis, osteoarthritis and menopause.

Another mission of the institute will be to create an Illinois Women's Health Registry to provide a large pool of potential study subjects for researchers, who often have trouble recruiting enough participants for their studies. Scientists at the institute also will identify gender-based guidelines for the treatment and prevention of disease in women. For example, do women need a differently designed knee joint than men in replacement surgery or do women need to be given anesthesia differently? The institute will link physicians to these guidelines as they are developed.

"We should look at every research study with a sex and gender lens and see what applies to women as opposed to men," said Teresa Woodruff, executive director of the new Institute for Women's Health Research and the Thomas J. Watkins Professor of Obstetrics and Gynecology at the Feinberg School. "What are the differences between women and men that need further exploration? What does gender mean in development of disease throughout the lifespan? What is the influence of hormones? We have many questions, but we don't have concrete answers."

But that is starting to change. Melina Kibbe, M.D., assistant professor of surgery at the Feinberg School and a vascular surgeon at Northwestern Memorial Hospital and the Jesse Brown VA Medical Center. Kibbe researches how to extend the effectiveness of such vascular procedures as balloon angioplasty and stenting, bypass grafting and other vascular procedures with limited durability.

Kibbe wasn't doing any gender-based research until Woodruff met with her a few months ago and asked if she would include a cohort of women in her research. Thus, Kibbe began a new study with funding from the new institute to see whether her therapy -- which extends the effectiveness of the vascular procedures with nitric oxide-- produced different results in male and female animals. To her surprise, preliminary findings showed it did.

Kibbe's early results reveal male animals respond better to the nitric-oxide-based therapy better than females. "If we actually see gender differences in our therapy when the study is complete, it may mean that we have to tailor our therapy so that it could be equally effective in both genders," she said. "This could lead me down a whole new research path."

One reason researchers have shied away from using women in studies is their fluctuating hormones. "Hormones are complex, but they can be taught," Woodruff said.

Women's Health Issues

Cancer -- Lung cancer is the leading cause of cancer death in women, and women are more susceptible to the carcinogenic effect of tobacco as smokers and nonsmokers.

Autoimmune disease -- Women are two to seven times more likely to develop an autoimmune disease, which often coexists with vascular and musculoskeletal problems. Lupus affects nine times as many women as men.

Anesthesia -- Women wake sooner from anesthesia, experience more nausea and respond to pain medications differently than men. The institute plans to develop research fellowships in gender biology and develop evidence-based guidelines for administering anesthesia to women.

Cardiovascular disease -- Women are more likely to have less familiar symptoms of cardiovascular disease and be misdiagnosed upon assessment. Cardiovascular disease is the top cause of mortality in women (and men), yet men are treated more aggressively when they are admitted with suspected acute coronary artery disease.

Gastroenterology -- Gender plays a significant role in acid peptic and motility disease of the stomach. Women between ages 20 to 60 are three times more likely to develop gallstones than men.

Menopause -- The institute will develop a task force to explore the potential of a multidisciplinary Menopause Clinic and is seeking to recruit an expert on menopause and adult female sexuality. Menopause can cause potential health problems related to most body systems that impact the quality of life.

Musculoskeletal -- Women are at significantly higher risk to develop osteoporosis and osteoarthritis. Eighty percent of hip fractures occur in women. Women also are prone to different types of knee injuries than men.

Neurological -- Women are two to three times more likely to suffer from depression and twice as likely as men to have a sleeping disorder.