Men and women are equal before the Basic Law. However, there are significant differences when it comes to being sick. Heart attack, osteoporosis and depression are three examples. There have been findings on this for a long time, but gender-specific medicine is still far too rarely taken into account in practice.
Berlin – Isn’t the “men’s cold” a myth? The expression used to make fun of the pity of the “stronger sex” when they have a cold apparently has a scientific background. “Men have a weaker immune system than women,” explains Gabriele Kaczmarczyk, visiting professor at the Berlin Charité and board member of the German Society for Gender-Specific Medicine. That’s why men with a cold can feel really weak while women just keep working.
“Women and men are sick differently. There is no such thing as a gender-neutral reality,” emphasizes Kaczmarczyk. As a representative of gender-specific or gender-sensitive medicine, also known as gender medicine, she advocates for such differences to be recognized and taken into account in all areas of medicine.
The woman and the Eva infarction
A sudden pain in the chest, sweats and fear of death – in men the symptoms of a heart attack are usually clear. In women, however, this often manifests itself in a seemingly harmless, non-specific manner with sore throat and neck, nausea and shortness of breath. Therefore, in the case of a so-called Eva infarction, it takes an hour longer on average until it is diagnosed and the patient gets to the hospital. Although significantly more men are treated in cardiac intensive care units, more heart patients die.
“The heart attack is the most well-known, but by no means the only example of why we have to think in terms of gender,” warns Kaczmarczyk. Corona has proven this again: “Women are often significantly more ill with the virus, but die from it less often due to their sophisticated immune systems,” says the doctor. The “broken heart syndrome” also speaks for a differentiated view: the heart muscle disease occurs when there is severe emotional stress, and more than 90 percent of it occurs in women.
Medicine has so far been based on men’s bodies
Despite these findings, medicine is still largely based on the male body in prevention, diagnostics and therapy. Because there could be an undetected pregnancy, women have been excluded from studies for decades and treated like some sort of smaller, lighter man. And this despite the fact that the female body not only has less muscle and less water content, but is also subject to a monthly cycle for decades, which, according to Kaczmarczyk, causes a real “hormone storm”.
In concrete terms, this means: The messenger substances are distributed throughout the body through the blood and can dock on certain organs. “This can mean, for example, that a tablet at the beginning of the cycle works differently than during bleeding or during the menopause,” explains the doctor. This must be taken into account when dosing and possible side effects and interactions. However, package inserts usually do not contain any relevant information.
Gender medicine also benefits men
When it comes to new drug approvals, female test subjects have had to be taken into account proportionately for several years. However, according to the professor, older products on the market were only tested on men or male rats. “If female rats are not used in necessary animal experiments, the transferability of the results to women remains questionable. The male rats then died in vain,” says Kaczmarczyk.
The change in thinking towards gender-specific medicine is happening slowly. At the 36 German university hospitals that combine research, teaching and patient care, there are only one and a half chairs for gender medicine. The Berlin Charité is a pioneer, where the only institute for gender research was founded in 2007. “The gender-specific perspective is still used far too little in training,” complains Kaczmarczyk. The male-centered way of thinking is particularly persistent among male colleagues.
Gender medicine also benefits men, because they are also affected by prejudices that can lead to misdiagnoses. In men, osteoporosis, breast cancer or depression are often recognized too late because these diseases are considered classic women’s diseases. With a gender-equitable perspective, mocking comments about “men’s cold” could also be a thing of the past.
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