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Our Life | Наше життя May | Травень 2021 20 Women’s health is a relatively new field. Until recently, women were considered “mini men” – i.e., smaller/lighter versions of males. But clearly, women’s biochemistry, physiology, metabolism, and hormonal and chromosomal make-up are separate and unique. In medicine, we are rethinking how to apply our medical and diagnostic models, since research shows that disease in women manifests and evolves along different pathways than it does in men. Here’s a useful analogy: In the late 19th/early 20th century, the discipline of pediatrics was born, and it was a revolutionary idea at the time, based on the premise that children were “not just small adults” as previously thought, but had their own spectrum of different diseases (think measles, mumps, chicken pox, etc.). Since babies could not explain what was ailing them and children’s language skills were inadequate, the approach was almost like that in veterinary medicine – i.e., based on observation, examination, and formulation of diagnosis. That thinking was then extended to what were then known as “primitive” people and to women, who were seen as primitive and childlike, with smaller brains and bodies than men, and with emotions dominating intellect and logic. From Victorian times to the 1920s, Western (middle- and upper-class) society believed that strenuous physical activity challenged child bearing and affected the ability to conceive. In 1936, Scientific American published an article stating that muscular development in women interfered with motherhood. Menstruation was an illness that required a week of bed rest (every month). Apart from long promenade walks to “catch some air,” any sports or exercise activity was dangerous to the “womb” and very unladylike. Women were thought of as delicate and fragile creatures. Even now, the majority of clinical research trials fail to include gender-specific analyses, despite continued citations by the U.S. government. Most drug trials are performed on homogenous subjects (white Caucasian males, in their 40s with normal BMIs). Therefore, these studies are neither relevant nor applicable to women (or minorities), and may even be counterproductive or harmful. Though women are now in the majority in the U.S. population (just over 50%) and are also living longer than men, they face inadequate and poorly coordinated health care, even for routine medical issues, according to the U.S. Department of Health and Human Services (Council of Graduate Medical Education, 5th Report). Women live approximately seven years longer than men but experience higher levels of chronic illness, disability, and pain in their lifetimes. Often, a woman’s “golden years” are marred by medical disability. WHERE ARE WE NOW? Areta Podhorodecki, MD , Branch 64, New York City Women’s Health Women’s Health Women live approximately seven years longer than men but experience higher levels of chronic illness, disability, and pain in their lifetimes. Often, a woman’s “golden years” are marred by medical disability. Dr. Areta Podhorodecki
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