The doctor spoke about the risks of a universal approach to patient treatment

Modern medicine continues to use male biology as a universal standard in many ways, although gender differences can affect disease symptoms, diagnostic accuracy, and drug response. As a result, women risk later diagnoses, less effective treatment, and more side effects. This is stated in a study published in The Lancet journal.

Why has the male body become the medical norm?

Many diseases occur in people of both sexes, but they can develop, manifest, and respond to treatment in different ways. These differences are influenced by chromosomes, hormones, gene expression, metabolism, and the functioning of the immune and cardiovascular systems.

In a review published in The Lancet in 2020, researchers emphasized that biological sex can change the epidemiology of diseases, their development mechanisms, clinical symptoms, and response to therapy. Gender-related social factors have an additional impact: working conditions, lifestyle, patient behavior, and the attitude of medical professionals.

Despite this, in scientific research and clinical practice, the male body has long been considered as a basic model. The results were then transferred to women, even if the effect of gender was not studied separately.

Professor of Emergency Medicine Basma Safdar believes that simply including women in clinical trials is no longer enough. The data should be analyzed taking into account gender differences, and then the mechanisms behind the identified discrepancies should be studied. This approach does not mean that separate medicine is required for all women. Gender should become one of the parameters of personalization along with age, genetic characteristics, chronic diseases, lifestyle and medications taken.

How differences manifest themselves in diagnosis and treatment

The consequences of an incomplete evidence base are becoming particularly noticeable in emergency medicine. Women may describe the signs of angina pectoris, heart attack, or stroke differently. If the doctor focuses mainly on the symptoms that are more often recorded in men, the dangerous condition may be recognized late.

According to Safdar, when choosing diagnostic procedures, it is necessary to take into account the likelihood that the manifestations of the same disease in men and women will differ. Otherwise, the patient's complaints may be mistakenly considered atypical or insufficiently serious.

Gender can also influence the effect of medications. Differences in body composition, liver and kidney function, hormone levels, and metabolic rate can change the concentration of the drug in the body. As a result, the same dose does not always provide the same effect and risk of adverse reactions.

Safdar calls for a biology-based approach to the diagnosis, prognosis, and treatment of diseases that occur only in women, disproportionately affect them, or have specific course features. It's not just about the reproductive system. Gender differences are important for cardiology, neurology, immunology, psychiatry, oncology, endocrinology, and other fields of medicine.

Why longer life expectancy does not mean better health

On average, women live longer than men, but they spend most of their lives with illnesses or health limitations. According to the McKinsey Health Institute and the World Economic Forum, they are in poor health for about 25% longer than men.

The report's authors attributed the gap not only to biology, but also to delays in diagnosis, lack of data, uneven funding, and differences in access to medical care. According to their calculations, reducing this gap could bring at least $1 trillion annually to the global economy by 2040.

At the same time, the concept of women's health often continues to be reduced to pregnancy, childbirth and diseases of the reproductive system. In fact, they represent only one part of the total disease burden. Safdar also draws attention to the fact that women make up about 51% of the population and make a significant part of decisions related to family health. However, research on their physiology is still perceived as a separate or narrow field, and not as a necessary part of general medicine.

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Why is it not enough to simply divide the results by gender?

Separate analysis of the data of men and women allows you to see the differences, but does not always explain their origin. Safdar suggests moving from a simple comparison of indicators to a systematic study of female biology at different stages of life. The changes that occur during puberty, pregnancy, the postpartum period, menopause, and aging affect more than one organ. They can simultaneously affect metabolism, the immune system, blood vessels, the brain, and mental health.

Traditional medical science is organized around individual specialties. Cardiologists study the heart, neurologists study the nervous system, and endocrinologists study hormonal disorders. However, sex differences can affect several systems at once and do not fit within the boundaries of one direction.

Therefore, the author of the commentary suggests bringing together specialists from different fields around biological processes, and not just individual diagnoses or organs. This approach should help to transfer fundamental discoveries to diagnosis and treatment faster.

What does this mean for patients

Safdar's commentary does not contain the results of a new clinical trial and does not suggest an immediate change in treatment regimens. This is a conceptual model for reforming research, medical practice, and funding.

Its main idea is that a universal approach does not always turn out to be truly universal. If the biological sex is able to change the symptoms, course of the disease and the effect of drugs, it must be taken into account when creating diagnostic criteria and clinical recommendations.

The development of this area can benefit not only women. A more accurate understanding of the differences will allow us to determine which diagnostic and treatment methods work best for different groups of patients, including men.