Miss treatment

Female and male patients suffer differently from disease. So why are doctors treating them the same — and endangering women’s lives?

The medical world needs to acknowledge a simple fact: All patients should be cared for equally — but treated differently.

Studies show that the male and female anatomies not only differ in make-up, but also in function. Women, for instance, experience pain differently than men and react differently to medications than men.

Yet the vast majority of clinical research on diseases and medications is performed on men, which means that half of the population is treated based on data that doesn’t necessarily apply to them.

There are many reasons for this sex and gender bias, but for a change, it isn’t because of discrimination. Women are more challenging test subjects. Men are easier to measure because they do not menstruate, can’t become pregnant (scientists are always concerned about unwittingly subjecting fetuses to research) and are less likely to skip appointments due to domestic obligations. The reasons are plenty, but what matters is the end result: Women receive worse medical treatment than men.

Here’s a list of some of the medical differences between men and women — but it’s only the tip of the iceberg: Heart

More women die annually from cardiovascular disease than from all cancers combined at least partly because most of what we know about the symptoms of heart attacks is based on research conducted on men.

While the classical symptoms in men include intense pain radiating in the left shoulder and arm, some 20 percent of women will develop “not classical symptoms” of moderate pain in the neck or jaws. Misinterpretation of these symptoms often causes fatal delays in treatment for women — with the risk of misdiagnosis two to four times higher in women than in men.

In addition, the hearts of men and women react differently to hypertension. The hearts of men with hypertension (which occurs when the left chamber has to overcome increased blood pressure) grow in size and their walls become thinner. Women’s hearts grow less in size, but the walls become thicker and stiffer.

It should not come as a surprise then that medications for hypertension may work differently in men and women. One popular group of medications called ACE inhibitors are less effective in women (and change in effectiveness around a woman’s menstrual cycle). Another group, called beta blockers (like Lopressor), which aim to treat irregular heartbeats may actually do the opposite in women and cause a life-threatening irregular heartbeat. Brain

Women who have experienced a stroke respond to treatment and recover speech abilities better than men. This may be due to the fact that 80 percent of women have two or more speech centers in the brain, whereas most men have only one. More women than men suffer from Alzheimer’s disease. And their symptoms differ, too. Women often display behavioral changes and depression, while men exhibit a greater degree of physical impairment and aggressive behavior. Gut Gut microbes — which are essential to our health and play a crucial role in our immune systems — differ greatly between the sexes. It takes women twice as long as men to digest their food and medications. Women are more likely to suffer from colitis and Crohn’s disease, have four times more gallbladder stones and are five times more likely to suffer from irritable bowel syndrome than men. Medications Men and women respond to medications differently — and women often suffer more severe side effects than men. This may be one of the reasons why women tend to adhere less to treatment plans laid out by doctors.

Sleep medications affect women differently, and in the past three years the FDA has already issued recommendations varying the dosage of two types of sleeping pills for men and women.

The examples go on from here: Antiemetics (drugs to treat nausea) are less effective on women; while women are more sensitive to an- tihistamines. Aspirin is more effective in stroke prevention for women and conversely more effective in heart attack prevention for men.

Women and men eliminate certain medications from their bodies at different speeds. Aspirin, for one, is cleared faster from the body of men, while prednisone is cleared more rapidly from the body of women.

Since medications have been studied predominantly in men, the fact that womenclear certain medications more slowly from their body means that they actually are exposed to these drugs for a longer time and thus receive dosages that may be too high — and may cause more side effects. On the other hand, drugs that are removed faster from the system in women may indicate they receive dosages that may be too low for them and hence less effective. Immune system Women are more resistant to infectious diseases but are more likely to suffer from autoimmune diseases, which are characterized by our immune system “going wild” and attacking our own body. Examples are lupus, arthritis and certain thyroid diseases. Out of about 90 known autoimmune diseases, about 75 percent are more frequent in women and are among the top 10 leading causes of death in women and children. Lungs Female lungs are more vulnerable to disease than men, and women’s risk of lung cancer (for the same number of smoked cigarettes) is 70 percent higher than that of men. Asthma and chronic obstructive lung diseases are usually more severe in women than in men. To make matters worse, studies suggest that women have greater problems quitting smoking than their male counterparts.

Neglecting the differences between men and women’s biology poses grave health risks affecting both sexes. So what can be done?

First, we must change the way we dispense medications. The first steps in this direction have already been taken by the FDA, which issued new recommendations for applying different dosages for men and women in two sleeping pills (Ambien and flurazepam).

Secondly, we need to invest more time and money into recruiting women for research and better understand why women are reluctant to take part in testing to begin with. Men and women might suffer from the same diseases, but identifying gender differences could hold the key to unlocking better treatments for all.

Dr. Marek Glezerman is the president of the International Society for Gender Medicine and the director of the Research Center of Gender Medicine at Rabin Medical Center in Israel. His book “Gender Medicine” (The Overlook Press) is out now.