WHY DRUGS OFTEN HAVE DANGEROUS SIDE EFFECTS FOR WOMEN?

 We all go to doctors.

And we do so with trust and blind faith that the tests they are ordering and the medications they're prescribing are based upon pieces of evidence, evidence that's designed to help us. However, the reality is that it hasn't always been the case for everyone. What if I told you that the medical science discovered over the past century had pre-trailed indiscriminately one half the population?

Doctors order the same tests, and prescribe the same medication, irrespective of patients gender- male or female.

A recent Government Accountability study revealed that 80 per cent of the drugs withdrawn from the market are due to side effects on women. Why are they discovering side effects on women only after a drug had been released to the market?

So why are we discovering unacceptable side effects on half the population after all the clinical trials that had gone through?

Well, it turns out that those cells used in that laboratory for clinical testing were male cells and the animals used in the animal studies were male animals and the clinical trials performed were almost exclusively on men.

How is it that the male model became our framework for medical research?

Let's look at a case that was popular in the USA that had to do with the sleep aid Ambien (Zolpidem). Ambien was released in the market over 20 years ago and since then, hundreds of millions of prescriptions had been written, primarily to women, because women suffer more sleep disorders than men. But just this past year, the Food and Drug Administration recommended cutting the dose in half for women only, because they realized that women metabolized the drug at a slower rate than men which caused them to wake up in the morning with more of the the active drug in their system causing a drowsy feeling in them and in turn resulting in motor accidents. Imagine how many of the motor vehicle accident could have been prevented if this type of analysis were performed and acted upon 20 years ago when this drug was first released.

How many other things need to be analyzed by gender?

World War II changed a lot of things, and one of them was this need to protect people from becoming victims of medical research without informed consent. So some much-needed guidelines or rules were set into place, and part of that was this desire to protect women of childbearing age from entering into any medical research studies.

There was fear: what if something happened to the fetus during the study? Who would be responsible? And so, the scientists thought, that this, was a blessing in disguise. Men's bodies are pretty homogeneous. They don't have the constantly fluctuating levels of hormones that could disrupt clean data. It was easier, It was cheaper. Not to mention, that there was a general assumption that men and women were alike in every way, apart from their reproductive organs and sex hormones. So, it was decided, medical research was performed on men, and the results were later applied to women. What did this do to the notion of women's health?

Women's health became synonymous with reproduction: breasts, ovaries, uterus, and pregnancy. It's this term we now refer to as "bikini medicine.”And this stayed this way until about the 1980s.when this concept was challenged by the medical community and by the public health policymakers. Virtually nothing was known about the unique needs of the female patient. Since that time, an overwhelming amount of evidence had come to light that showed us just how different men and women were in every aspect.

There is a saying in medicine:

Children are not just little adults which reminds us that children actually have a different physiology than normal adults. And it's because of this that the medical speciality of paediatrics came to light. And now researches are conducted on children in order to improve their lives.

Same thing can be said about women. Women are not just men with a different reproductive organ. But they have their own anatomy and physiology that deserves to be studied with the same intensity.

Let's take the cardiovascular system, for example.

This area in medicine has done the most, to try to figure out why it seems men and women have completely different heart attacks. Heart disease is the number one killer of both men and women, but more women die within the first year of having a heart attack than men. Men will complain of crushing chest pain like an elephant is sitting on their chest which is called typical.

Women have chest pain, too. But more women than men will complain of "just not feeling right," "can't seem to get enough air in," "just so tired lately. “Which for some reason is classified as "atypical", even though, as mentioned, women do make up almost half the population. And so, what are some of the evidence to help explain some of these differences?

If we look at the anatomy, the blood vessels that surround the heart are smaller in women compared to men, and the way that those blood vessels develop the disease is different in women compared to men. And the tests that we use to determine if someone is at risk for a heart attack, which was initially designed, tested and perfected in men aren't as good at determining that in women.

What this is doing is merely telling us that we are scratching the surface. It's about training future health care providers correctly. Because this cannot just be left up to the health care leaders. We all have a role in making a difference. But it is not so easy.

The first step towards change is awareness. This is not just about improving medical care for women. This is about personalized, individualized health care for everyone. This awareness has the power to transform medical care for men and women. The conversation has begun, and together we can all learn.

Martin Luther King, Jr. had said, "Change does not roll in on the wheels of inevitability, but comes through continuous struggle."

Ms. OLIVIA SUNNY, Pharm.D Intern.