OT: differences between men’s health and women’s health

[colomom]

And it appears that the dismantling of maternity care has already begun:

36% of U.S. counties are maternity care deserts, places with no OBGYN doctors, hospitals providing obstetric care, birth centers or certified nurse midwives.
https://www.pbs.org/newshour/show/why-t ... ting-worse

As you rightly point out, a lack of maternity care is a huge problem.

Add to that Catholic Health Systems now controls about 1 in 7 of US hospital beds.
The only hospital that offers maternity care within 45 miles of where I live is a Catholic hospital. Which means my local hospital follows directives from the United States Conference of Catholic Bishops which prohibits treatment they deem immoral; things like sterilization including vasectomies, postpartum tubal ligations, contraception, and abortion are prohibited in many Catholic hospitals.
The elephant in the room when talking about woman’s health care, is how much of woman’s health at times is dictated by people other than the patient.

I’m hoping to somehow avoid being to political (politics should have no place in women’s health) but most of all I hope I’m not coming off as anti religious.
I was raised Catholic, and I appreciate the many things I learned from the church. I just don’t appreciate the fact that a church I am no longer a part of has veto power and can force woman like me to travel great distances for things like obtaining birth control.

[Julie]

You have so far (on the forum) sounded like such a caring, hard working person, I don't think anyone could fault you anyhow, and based on the news lately, they'd only have to look in the mirror to find monstrous fault anyhow... I'm old enough to remember the times when abortion was illegal (at least in Canada), and we all went bonkers trying to help friends (and occasionally ourselves) when help was needed, but the 'help' was too often not really 'medical' and some results were awful for the women!

Crossing my fingers for all of you there... hope things change asap.

[lazarus]

Let's see:

Sexual bias/medicine/religion/politics all mixed into one thread.

I mean, what could possibly go wrong?

[insert one of Zonker's prescient, classic gifs here]

[robysue1]

No question in the truth that there has been an unfair bias in the history of medical research, that "male issues" are better studied and documented. Not always nefarious in motivation (sometimes the "simpler" sex has been just plain easier to study) but still a historical wrong to be corrected, yes.

I don't think it's really that men are "simpler" biologically speaking than women.

It's that for the last century and a half (i.e. since the invention of "modern" medicine), male doctors pretty much defined "typical, default human being" as "adult male". And so most studies were done on men unless what was being studied only affected women. And everybody pretty much thought this was OK up until pretty recently because up until the 1970s or 1980s, a whole lot of men (as well as a lot of women) did not regard women as "equals". And so almost everything in modern medicine has been pretty much based on what happens to adult men.

It's not just women who get short shrift by defining "typical human" as "adult male": Kids also get short shrift---as in it is much harder to study what happens in kids because of informed consent.

And, quite frankly, it's not just medicine. For example, car safety systems (both seatbelts and airbags) were designed to protect crash dummies that were the size of a typical adult male. And it was only long after the fact that people started to notice that very short women and kids could actually be injured (sometimes seriously) by systems that were designed to protect someone with a much larger body. They've worked hard to "fix" this problem---crash dummies now come in various sizes to mimic what happens to a variety of people of both genders and all ages, and cars are safer for that.

As another example: The design of the kitchens one in my late MIL's senior citizens' condo always bugged the daylights out of me. In her complex at least 50% of the residents were widows living alone, many of them well over 65 and many of them suffering "shrinkage" from osteoporosis. But the kitchens were designed with the counters at a height that is comfortable for a 5'11" male to use and the upper cabinets are literally out of reach for many of the residents, particularly once they get to be in their 80s. Most of the residents would have been a whole lot more comfortable in their kitchens if everything had been lowered by just a couple of inches.

[lazarus]

All good points.

I was only mentioning one factor of many, and I even put it in quotes. It isn't necessarily that men ARE "simpler" in purely biological terms, but for many reasons they were perceived as easier, less risky legally, and with fewer hormonal-variation and hormonal-status factors for confounding considerations.

Not making excuses. But legal-risk considerations and sureness that pregnancy would not occur made for many cascading knee-jerk decisions alongside the biases you rightly mention. They didn't all necessarily set out to do a bad job of it; they just did.

Now they know better, but they still aren't necessarily doing any better at it, for many of the same reasons, and despite governing bodies trying to mandate improvement. I personally don't think much progress has actually been made even among those researchers who want very much to do better.

Researchers often thought that women would have the same response as men from drugs in clinical trials. They also viewed women as confounding and more expensive test subjects because of their fluctuating hormone levels. Concerns of potential reproductive adverse effects led to policies and guidelines that considered pregnant women as a “vulnerable population” and, subsequently, excluded these women from research and restricted the ability of women of child-bearing potential to enroll in trials, especially in early stages of research.--Women’s involvement in clinical trials: historical perspective and future implications; Pharm Pract (Granada). 2016 Jan-Mar; 14(1): 708.Published online 2016 Mar 15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800017/

[lynninnj]

All good points.

I was only mentioning one factor of many, and I even put it in quotes. It isn't necessarily that men ARE "simpler" in purely biological terms, but for many reasons they were perceived as easier, less risky legally, and with fewer hormonal-variation and hormonal-status factors for confounding considerations.

Not making excuses. But legal-risk considerations and sureness that pregnancy would not occur made for many cascading knee-jerk decisions alongside the biases you rightly mention. They didn't all necessarily set out to do a bad job of it; they just did.

Now they know better, but they still aren't necessarily doing any better at it, for many of the same reasons, and despite governing bodies trying to mandate improvement. I personally don't think much progress has actually been made even among those researchers who want very much to do better.

Researchers often thought that women would have the same response as men from drugs in clinical trials. They also viewed women as confounding and more expensive test subjects because of their fluctuating hormone levels. Concerns of potential reproductive adverse effects led to policies and guidelines that considered pregnant women as a “vulnerable population” and, subsequently, excluded these women from research and restricted the ability of women of child-bearing potential to enroll in trials, especially in early stages of research.--Women’s involvement in clinical trials: historical perspective and future implications; Pharm Pract (Granada). 2016 Jan-Mar; 14(1): 708.Published online 2016 Mar 15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800017/

In light of the fact that females are born with all the eggs they will ever have, the legality of drug trials gets tricky and yes that makes men “simpler”. Can’t mess with the eggs.

[chunkyfrog]

Uterus envy?
Superstitions relating to menses are still quite common.
Men not only do not understand--they don't want to.

[KittyMom22]

in one thread, we were discussing how a poster is having back pain with one type of mask versus another. I mentioned inflammation.

in another thread, we were having come to Jesus moments under the big tent, talking about the difference between men’s health and women’s health.

I believe that sleep apnea is very well-treated, and probably started out as mainly a man’s disease. I guess we should all be thankful for that.

I wanted to post a link to support what I said about information but I want you to also pay attention and what do you see?

Inflammation is associated with changes in neurocognition, mood, behavior, cardiovascular function and metabolism, as well as a host of related conditions including chronic kidney disease, erectile dysfunction, eye disease and cancer.

https://medicine.missouri.edu/news/obst ... ysfunction

mmmmhmmmm

You lost me again Lynn. Nothing in your post or in the link has anything to do with differences between men and women in terms of inflammation or apnea. Are you thinking there are gender differences in symptoms? Treatment bias from healthcare professionals? Or...?

(edited: I spent most of the afternoon researching statistics on racial and gender differences in prevalence, risk factors and treatment of heart disease, so I was expecting some data. lol)

[ozij]

And not only in medicine - this happened to be published yesterday:

The crash dummy aimed at protecting women drivers
https://www.bbc.com/news/technology-62877930

Until now the most commonly used dummy has been based on the average male build and weight.

However, women represent about half of all drivers and are more prone to injury in like-for-like accidents.

The dummy that is sometimes used as a proxy for women is a scaled-down version of the male one, roughly the size of a 12-year-old girl.

At 149cm tall (4ft 8ins) and weighing 48kg (7st 5lb), it represents the smallest 5% of women by the standards of the mid-1970s.

However, a team of Swedish engineers has finally developed the first dummy, or to use the more technical term - seat evaluation tool - designed on the body of the average woman.

Their dummy is 162cm (5ft 3ins) tall and weighs 62kg (9st 7lbs), more representative of the female population.

So why have safety regulators not asked for it before now?

'A male decision'
"You can see that this is a bias," said Tjark Kreuzinger, who specialises in the field for Toyota in Europe. "When all the men in the meetings decide, they tend to look to their feet and say 'this is it'.

"I would never say that anybody does it intentionally but it's just the mere fact that it's typically a male decision - and that's why we do not have [average] female dummies."

At least things are improving. And I googled "Tjark Kreuzinger". He's a male.

Really worth reading the whole article.

[babydinosnoreless]

My husband was involved in vehicle testing before he retired. The company he worked for did military blast testing. They were using both male and female dummies and have been for many years. The NHTSA has been using them since 2003.

https://www.hg.org/legal-articles/femal ... used-27482

[ozij]

However, although things have improved somewhat, male dummies are still the norm, especially when it comes to determining the safety of the driver versus the passenger. In that situation, as discussed in the ABC.com article, male dummies are still the most tested and there is, therefore, far less data available regarding how automobile crashes affect women drivers:

(A)ny woman trying to use Safercar.gov to determine in which car she would be safest as the driver (as compared to passenger) is in for a frustrating experience: Two out of the three of the NHTSA’s test situations presume the driver to be male: In the head-on crash and the crash into a side barrier, it’s a male dummy behind the wheel. Data for a female driver is not provided. Only in the third test situation–a side crash into a pole–is the driver female.

So, while we’ve made some strides to protect women who travel in automobiles, far more needs to be done. After all, women make up more than 50% of the population, so shouldn’t at least 50% of the crash test dummies used to test the safety of cars be comprised of female crash test dummies? It only makes sense and women deserve to know whether a particular car will protect them in the event of a car accident, don’t they?

ABOUT THE AUTHOR: Ankin Law Office, LLC
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Copyright Ankin Law Office LLC

[chunkyfrog]

It distresses me that car airbags are mostly unsafe for a person of my height (4'9").
If I could deactivate my airbag, and rely only on my seatbelt I would feel much safer.
I woke from my back surgery with a badly abraded mouth and a very sore throat.
Later, it was explained that the operating table was oversized, and not adjustable.
I would have been much better cared for on a pediatric table--which was not available.
Short people get no damn respect.

[lazarus]

I respect you, CF.

But then this is the Internet where I can picture you as a 15-ft-tall frog, if I want to.

[lynninnj]

in one thread, we were discussing how a poster is having back pain with one type of mask versus another. I mentioned inflammation.

in another thread, we were having come to Jesus moments under the big tent, talking about the difference between men’s health and women’s health.

I believe that sleep apnea is very well-treated, and probably started out as mainly a man’s disease. I guess we should all be thankful for that.

I wanted to post a link to support what I said about information but I want you to also pay attention and what do you see?

Inflammation is associated with changes in neurocognition, mood, behavior, cardiovascular function and metabolism, as well as a host of related conditions including chronic kidney disease, erectile dysfunction, eye disease and cancer.

https://medicine.missouri.edu/news/obst ... ysfunction

mmmmhmmmm

You lost me again Lynn. Nothing in your post or in the link has anything to do with differences between men and women in terms of inflammation or apnea. Are you thinking there are gender differences in symptoms? Treatment bias from healthcare professionals? Or...?

(edited: I spent most of the afternoon researching statistics on racial and gender differences in prevalence, risk factors and treatment of heart disease, so I was expecting some data. lol)

I didn’t want to go too far OT so vaguely referenced two other threads that got me thinking.

Inflammation studies are everywhere. I found that particularly interesting given my bloodwork shows jump in wbc and other items when I had shit sleep the night before. I am paying close attention to diet for inflammation.

that said I was speaking broadly of differences in men vs womens healthcare. If we wanted to go further into racial disparities we could be here all day.

[KittyMom22]

ah, no need for that I think.I was just trying to connect the title of the post with the content. I had been doing research for work, so just trying to explain my mindset.

Here's some stuff to chew on:
"There are a number of pathophysiological differences to suggest why men are more prone to the disease than women. Although the exact mechanisms are unknown, differences in obesity, upper airway anatomy, breathing control, hormones, and aging are all thought to play a role. "

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560552/

"Overall, females appear to be more symptomatic, with lower apnoea–hypopnoea index scores compared to males. Furthermore, they appear to have more prolonged partial upper airway obstruction, and may report insomnia as a symptom of OSAHS more frequently. As a consequence of these differences in clinical presentation, females with sleep disordered breathing are often underdiagnosed and undertreated compared to males."

https://err.ersjournals.com/content/28/154/190030