Shining a spotlight on the importance of advocating for gender-based medical research and taking into account differences in women and men when diagnosing and treating them, Hadassah hosted a parallel event during the United Nation’s Commission on the Status of Women (CSW)’s 61st session.
Hadassah's presentation reflects how it lives up to two UN Sustainable Development Goals, to "Ensure healthy lives and promote well-being for all at all ages" and “Achieve gender equality and empower all women and girls.” Hadassah UN Team Chair Ruth Cole explained this to the audience in introducing the program, “Improving Women's Health through Gender Equity in Medical Research.” The panel featured Neurology and Radiology Professor Anat Biegon, PhD, Founder and Director of the Center for Gender, Hormones, and Health at Stony Brook University School of Medicine; Prof. Yoram Weiss, Medical Director of Hadassah Hospital Ein Kerem; and Karen Goldman, a cardiac survivor, who has been part of a National Institutes of Health study.
Providing a historical perspective as to how the medical establishment has traditionally viewed women, Dr. Biegon emphasized that, despite recognition of the reality that specific diseases affect just women, they ignored these differences except in the fields of gynecology and obstetrics. “Now this perspective is being revisited,” she says, noting that “biological sex and hormonal environment affect treatment outcomes, whether we are talking about a medical procedure or a reaction to medicine.” Further, she explains, “female hormones fluctuate throughout the life cycle; each stage--whether it be puberty or menopause--makes a woman susceptible to different outcomes.”
Men, in contrast, exhibit more individualized hormonal changes; their hormone profile is not driven by stages of life. Despite these pivotal gender differences, Dr. Biegon brings out, research has been conducted primarily on men. Furthermore, most pre-clinical research is conducted on male mice.
The National Institutes of Health recently issued guidelines requiring pre-clinical research to include female subjects in order to qualify for federal funding. But, Dr. Biegon emphasizes, “What we need is a law against developing a drug without doing pre-clinical research on female mice too!” To achieve quality health care for women, she adds, drugs must be attuned to women’s bodies, medical devices need to be designed specifically for women, and medical professionals need to be educated about gender impact on diagnosis and outcomes. For example, physicians need to be educated as to how women often have different symptoms than men do when they are having a heart attack. They may not experience chest pain. Rather, they may have pain in their back or jaw. By the same token, Dr. Biegon says, physicians assume that because they have cardiac surgical devices in different sizes, they can accommodate all patients. “But really we need to go back to the drawing board and design medical devices specifically for women.”
Prof. Weiss noted that medicine is being taught very differently today in Israel. At the Hadassah-Hebrew University School of Medicine, he noted, during years one to six, medical students have a course that heightens their awareness about gender and individual differences. The students, he says, “are taught to see the patient in front of them; to interpret what that person is telling them.” Hadassah medical students, he explains, learn with which lens to interpret the information they receive from patients.
Prof. Weiss also shared with participants the work of Hadassah’s Linda Joy Pollin Cardiovascular Wellness Center for Women, which reaches out to local communities to raise women’s awareness of heart disease risks and to help them develop a healthier lifestyle. Prof. Weiss noted that the Pollin Center is a "cornerstone partner of the Israeli government’s efforts on behalf of women’s health and gender equity in health care.”
Karen Goldman, past Region President of Northern New Jersey Hadassah and a member of Hadassah’s Portfolio Council, told her personal story of surviving two cardiac episodes. After being diagnosed with aortic insufficiency (a “leaky aortic valve”), she participated in a long-term study at the National Institutes of Health (NIH) in Bethesda, Maryland. Because insufficient research has been done on women and heart disease and because she was asymptomatic, she was readily accepted into the study. During the years when she was part of the medical protocol at the NIH, she experienced a potentially fatal coronary artery dissection. A number of years after that problem was addressed, she had successful open-heart surgery to replace the aortic valve.
Sharing what she learned from her experiences, Mrs. Goldman urged members of the audience to take responsibility for their own health and to seek a professional diagnosis when something simply is not right medically. She cautioned participants about physicians who dismiss women’s complaints, chalking them up to hysteria or overreactions. She also emphasized that women have a tendency to take care of everyone else first and to delay addressing their own medical needs. “But,” she said, “if you don’t take care of yourself, you won’t be able to take care of anyone else.”
Ruth Cole served as program Chair. Ruth Grossberg, Vice Chair, moderated the discussion and Q & A and also spoke about the Pollin Center, along with Rae Gurewitch and Judy Padolf, UN On-Site Representatives.
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