At the dawn of third millennium medical researchers still
know very little about gender-specific differences in illness, particularly
when it comes to disease symptoms, influencing social and psychological
factors, and the ramifications of these differences for treatment and
prevention. Medical research conducted over the past 40 years has focused
almost exclusively on male patients.
A new article titled "Gender medicine: a task for the
third millennium" presents research on gender-related differences
conducted by Giovannella Baggio of Padua University Hospital and her team.
The article, which appears in the Journal "Clinical Chemistry and Laboratory Medicine"
(CCLM), highlights evidence for considerable differences between the sexes in
five domains – cardiovascular disease, cancer, liver diseases, osteoporosis,
Typically perceived as a male illness, cardiovascular
disease often displays markedly different symptoms among women. While a
constricted chest and pain that radiates through the left arm are standard
signs of heart attack in men, in women the usual symptoms are nausea and lower
Although heart attacks in women are more severe and
complicated, when complaining of these non-specific symptoms women often do not
receive the necessary examination procedures, such as an ECG , enzyme
diagnostic tests or coronary angiography.
Colon cancer is the second most common form of cancer among
men and women. However, women suffer this illness at a later stage in life.
Furthermore, colon tumours typically have a different location in women, and
they respond better to specific chemical treatments. Gender also has an impact
on the patient's responsiveness to chemotherapy administered to treat cancer,
such as colon, lung, or skin cancer. In this way, gender impacts the course of
the disease and the patient's chances for survival.
Primary biliary cirrhosis is a liver disease that primarily
affects women. The authors of the study provide clear evidence that for this
disease and chronic hepatitis C, the genetic make-up and differing hormone
levels of females are a primary risk factor. This finding also applies to
osteoporosis. While typically viewed as a female disease because of the much
higher rate of female patients, osteoporosis also strikes men. The study
contends that osteoporosis is too often overlooked in male patients, and it
documents a higher mortality rate among men suffering bone fractures.
Baggio and her team also show variation between men and
women in the pharmacology of aspirin and other substances. Differences in
action and side effects are attributable to different body types, varying
reaction times in the absorption and elimination of substances, and a
fundamentally different hormonal status. Thus, to administer medication safely
and effectively, the dosage and duration of treatment must take the patient's
gender into account.
The study concludes that additional and more far-reaching
clinical investigations of gender differences are needed in order to eliminate
fundamental inequalities between men and women in the treatment of disease.