What's Sex Got To Do With It?
When it comes to your health, gender equality is off the table. We all know "Women are from Venus and Men are from Mars." Ok, that's a book title, but the implied connotation is not too far from the truth - especially, when it comes to our health. Not only do women have completely different signs (diagnostic findings like, blood pressure or glucose levels) and symptoms (how we feel) for certain diseases, women process them differently than men. These differences are not only important for recognizing when to call 9-1-1 in case of an emergency, but crucial in preventative care and for medical research. Here are some gender differences for some of the most common ailments.
Aches and Pains
In general, women report more intense, more numerous, and more frequent bodily symptoms than men. It doesn’t mean they are sicker or less healthy. It just means that women view and express pain differently than men. Simply, when viewing women and men, there are “innate differences in somatic and visceral perception; differences in symptom labeling, description, and reporting; the socialization process, which leads to differences in the readiness to acknowledge and disclose discomfort; a sex differential in the incidence of abuse and violence; sex differences in the prevalence of anxiety and depressive disorders; and gender bias in research and in clinical practice.” (1.) This finding is very important for doctors when they are obtaining clinical history, understanding the meaning and significance that symptoms hold, and in providing symptom relief when treating female patients. More importantly, it’s important for women to state their symptoms exactly without holding back or exaggerating.
Drug Interactions and Side Effects
By and large, women experience more adverse effects to drugs, especially cardiovascular drugs. This may be due to BMI or hormone differences in women. Another theory as to why women experience more adverse reactions to drugs might be due to, partly, a greater use of drugs in women compared with men. But one thing is for sure, sex differences in the incidence of adverse effects for certain cardiovascular drugs make it even more important for doctors to take gender into consideration when prescribing them. In addition, because of more severe reactions, women tend to require hospital admissions more often. Again, it’s important for doctors to take patients’ history very carefully to determine if the symptoms are drugs reactions or something else.
Heart Attacks
We all know the classic heart attack signs like a scene from a movie - a man clutches his chest as he falls to the ground, his face wincing in pain. And while this look of intense pain, pressure, squeezing, fullness or pain in the center of the chest is very common for someone suffering a heart attack, there are other symptoms, like pain or discomfort in one or both arms, the back, neck, jaw or stomach. In addition, shortness of breath. with or without chest discomfort, breaking out in a cold sweat, and nausea or lightheadedness are also signs and symptoms we are all familiar with. For women, while the most common heart attack symptom is also chest pain or discomfort, women are somewhat more likely than men to experience shortness of breath, nausea/vomiting and back or jaw pain. Women also report "flu-like" symptoms, acid reflux, upper back pain, and indigestion-like symptoms. Women also tend to take aspirin and not call 9-1-1 when they experience these symptoms, which is attributed to 'taking care of the family first' mentality.
Angina
Angina, an early sign of heart disease, is caused by an obstruction of the arteries that surround the heart, usually coronary arteries in most cases. In fact, men's angina is usually caused by an obstruction of coronary artery whereas for women, it's usually caused by blockage of smaller arteries that branch out of coronary arteries. When men have angina, they have tightness, pressure or discomfort in their chest during physical activity or when stressed. The symptoms go away shortly after the activity or stressed period is gone. But women, in addition to chest pain, can also have a feeling of being out of breath, nausea, vomiting, discomfort or sharp chest pain during the episode. These symptoms can easily be attributed to other common causes and many women overlook angina as the cause when they experience these symptoms. Furthermore, since these symptoms go away after the physical activity is over and stressful period passes, it’s very common for women to neglect further tests to determine the real cause.
Sleep Apnea
Sleep Apnea is more common in men than women. A study (7.) showed that, structurally, men have longer airway length in the throat and bigger mass of soft tissues in the soft palate and tongue, which makes sense that men would suffer more. However, one of my female patients who suffered with Sleep Apnea for years reported that when she eliminated gluten from her diet, it went away. She no longer snored or gasped for air when sleeping. Thus, while women may suffer with Sleep Apnea too, the cause might be different than men.
Alzheimer’s Disease or Dementia
When you hear someone mention Alzheimer’s disease, an image of an old frail woman - not a man - looking up with a blank stare comes to mind. In fact, 1 in 6 women aged 65 years or older has a chance of developing Alzheimer’s disease, whereas the incidence is only around 1 in 11 for men. And the difference in length of a lifespan - the fact that women live longer - is not correlated with why women suffer from this mind robbing disease. Unfortunately, to this date, researchers still don't know why women suffer more. Studies (8. and 9.) that analyzed the gender differences, the neurological and physiological hallmarks showed the difference between genders but not ‘why’ more women will develop Alzheimer’s than men. “It's not just that women are living to be older. There's something else going on in terms of the biology, the environment, for women compared to men that may make them at greater risk, or if they have some symptoms, change the progression," said Dr. Yaffe of University of California, San Francisco. (9.) It’s worth noting that older people who had general anesthesia declined faster. Therefore, it’s important to alert doctors when there is a history of surgery with general anesthesia. But more importantly and maybe easier said than done, to prevent surgical procedures that require general anesthesia for older people. Statistics show that mortality rates for women are lower than for men, and maybe that’s attributed to the fact that women care for their illnesses better than men. They also visit the doctors more often and can discover illnesses quicker than men, who do not seek medical care often enough and who are socially conditioned to not complain about aches and pains. Regardless, it’s attitudes about symptoms, medical care, drugs, and self-care that are extremely important for preventing more serious illnesses. Furthermore, it’s also important for doctors to ask the right questions when examining patients as women and men answer differently when it comes to description of their symptoms. Also, gender difference should be a factor when designing medical research for cure for diseases and for pharmaceutical inventions. References:1. http://www.ncbi.nlm.nih.gov/pubmed/6750677/2. http://eurheartj.oxfordjournals.org/content/early/2015/05/05/eurheartj.ehv161.long#sec-103. http://onlinelibrary.wiley.com/doi/10.1111/j.1472-8206.2010.00873.x/full4. http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Heart-Attack-Symptoms-in-Women_UCM_436448_Article.jsp5. http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Warning-Signs-of-a-Heart-Attack_UCM_002039_Article.jsp6. http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Angina-in-Women-Can-Be-Different-Than-Men_UCM_448902_Article.jsp7. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970937/8. http://www.ncbi.nlm.nih.gov/pubmed/204424969.