Studying Differences Between the Sexes May Spur Improvements in Medicine
BY MARY-LOU PARDUE
It's hard to believe that only a little more than two decades ago, the U.S. government issued guidelines recommending that pharmaceutical companies exclude women of childbearing age from participating in clinical trials. Now the National Institutes of Health has an office devoted to women's health research, and more women are being included in critical medical research.
That is progress, to be sure. But it has become increasingly clear that to improve medicine for both men and women, more also needs to be done to study differences between the sexes. For too long, the research community has ignored the fact that being male or female encompasses far more than reproductive systems and hormones. Sexually determined characteristics can be found all the way down to the cellular level, and they have important implications that influence how long we live, how we are affected by disease and medication, and even how our brains function.
I recently chaired a panel of the Institute of Medicine that examined the scientific literature on how molecular and biological differences between the sexes affect health. We concluded that it would benefit everyone -- men and women alike -- if biomedical researchers started paying more attention to these differences. Doing so could identify new ways to promote good health and improve the way diseases are diagnosed and treated.
Of course, it's obvious why only males can develop prostate cancer, and only females get ovarian cancer. But it's not at all obvious why women are more likely than men to recover language ability after suffering a stroke, or have a far greater risk of developing life-threatening irregular heart rhythms in response to potassium channel-blocking drugs. Sex differences appear to play a role in the severity and incidence of several diseases; they need to be studied at the cellular level to determine how sex influences susceptibility to disease and functioning of organs and organ systems.
Being male or female is a basic human variable that should be routinely considered when designing and analyzing studies in all areas of biomedical and health-related research. Until it is and the results -- positive or negative -- are routinely reported, many opportunities to obtain a better understanding of disease and to advance human health will surely be missed. It is widely known that studies on variables such as sex, age, race, or ethnicity have all too often been biased and have led to discriminatory practices. History must be taken into consideration so that discriminatory practices will not be repeated.
Mary-Lou Pardue, Boris Magasanik Professor at the Massachusetts Institute of Technology, Cambridge, recently chaired an Institute of Medicine panel that wrote the report Exploring the Biological Contributions to Human Health: Does Sex Matter?
This article was adapted from a piece distributed by the National Academies Op-Ed Service, which produces accessible, compelling, and timely articles written by prominent scientists, engineers, physicians, and other experts. Visit the Service's Web site at <national-academies.org/op-ed> for a comprehensive collection of authoritative commentary on issues involving science, technology, and medicine.