Debate explores impact of gender on medical treatment

Women have often been excluded from clinical research throughout history, and the same symptoms in the two sexes are often interpreted differently by society and doctors, the panel heard on Tuesday.

Darja Zaviršek of the Faculty of Social Work of the University of Ljubljana said women were excluded from clinical research for different reasons throughout history.

Until the 19th century they were not allowed to study medicine and study was based on male bodies as a prototype for all bodies. The female body was seen as a problem because of its specific features, such as the ability to give birth, lactate and menstruate.

Although science is embedded in the social environment today, it tends to neutrality, said Mojca Jensterle Sever of the UKC Ljubljana medical centre Clinical Department of Endocrinology, Diabetes and Metabolic Diseases.

The woman's body is a much more complex organism than man's. Any changes during the menstrual cycle represent a less controlled environment for clinical testing, Jensterle said.

She is optimistic that science in modern times will be better able to address the complexities inherent in the female gender, while at the same time making it easier to ensure greater safety for women in research.

There are many neurological conditions where there are gender differences in morbidity, said Milica Gregorič Kramberger, head of the Centre for Cognitive Disorders at the UKC Ljubljana Division of Neurology.

The smallest, early symptoms of neurogenerative diseases can often be mistakenly attributed to characteristics that society and doctors attribute to women, leading to later diagnoses, she noted.

Zaviršek said women who reported the same problems as men would in the past often receive a different diagnosis. Doctors would interpret women's symptoms as more psychological and men's symptoms as more psychosomatic.

The structural focus on men in the past had led to more money being spent on research into this gender.

However, understanding disease as a condition of only one gender can harm both women and men, Jensterle Sever said, giving osteoporosis as one such example.

Being more common in women, it is considered a woman's disease, and systematic screening is not available for men, although men with osteoporosis have more severe consequences after a bone fracture than women.

Damjana Rozman, head of the Centre for Functional Genomics and Biochips at the Ljubljana Faculty of Medicine, whose research has revealed important differences between genders, especially in cholesterol-related liver disease, believes that in the future researchers and practitioners should look for differences between genders.

Some of the biochemical differences between the genders can only be revealed with modern tools. "I believe that post-menopausal women are still significantly under-represented in research," she said.