“Morning sickness, endometriosis, menopause, migraines, polycystic ovaries / What’s wrong with your body? We don’t know / ‘Cause we’ve never really studied the female body.” This is how the song that has recently gone viral on TikTok and Instagram begins. Originally a parody, this song is in English, but many Spanish content creators have translated it to share and raise awareness about the lack of understanding of women’s bodies in medicine. For instance, the first study to confirm the efficacy of feminine hygiene products containing real blood was published in August 2023.
Silvia Rueda, director of the Women and Science Unit at the Ministry of Science, Innovation and Universities, states that this issue exists across all scientific fields. However, in medicine, the impact of this gender bias is particularly evident as it directly influences health outcomes. The first problem is that most research is conducted using male subjects, which is lamentable, according to her. Even in the early stages of trials, when experiments involve animals, females are often excluded.
The justification for this exclusion is that female hormonal cycles may influence the results. Additionally, it is more costly since tests would need to be conducted separately for both sexes. Historically, these factors have led to men being seen as the standard subjects and women as anomalies. “If we start from that foundation, we’re in trouble,” Rueda asserts and adds, “You cannot exclude 51% of the population.”
[Doctor Carmona: “If men had testicular pain three days a month, the world would stop”]
Another facet of this issue is that women have traditionally been underrepresented in scientific and medical research. “When you are developing something, what you have around you is crucial,” explains the director of the Women’s Unit of the Ministry of Science. If women are absent from laboratories, there is less motivation to study issues that affect them exclusively or predominantly. Moreover, Rueda points out that, aside from breast and uterine cancer, diseases specific to women are typically not researched in medicine.
Endometriosis serves as a clear example of this gender bias. Although it affects 10% of the global population, according to the WHO, there is no specific treatment, and the average time to receive a diagnosis is 10 years. “If it were something that affected men, it would have been treated long ago,” states Rueda. A similar situation has occurred with fibromyalgia, which women experience much more frequently than men and, for a long time, it was mischaracterized as a psychological disorder, she recalls. “We have wasted a lot of time.”
Another striking issue is that, despite cardiovascular diseases being the leading cause of death among women, most research in this area does not take them into consideration. Carme Vall, a physician specializing in medicine with a gender perspective, explains in her book Invisible Women in Medicine (Capitán Swing, 2020) that only 38% of studies include female subjects.
The director of the Women’s Unit and Science at the Ministry of Science clarifies that the veins and arteries in a female body have different shapes compared to those in a male body. Consequently, when issues arise, the symptoms may not be the same. A clear example is heart attacks, which may go undetected in women due to differing symptoms from those in men. “They experience more pain, but we have a higher mortality rate.”
The combination of gender bias and deeply ingrained societal beliefs (such as the notion that a heart attack always results in pain in the left arm) means that often only cardiology specialists are aware of these differences. Sometimes, it is women themselves who struggle to recognize their symptoms, resulting in delays in seeking medical attention. When they do visit a doctor, if the healthcare provider cannot identify the problem as it does not align with the typical presentation, they may leave the emergency room with a diagnosis of anxiety instead of a heart attack. “They receive a prescription and are sent home.”
Even feminine hygiene products are subject to this bias. A recently published study has revealed the presence of toxic metals in tampons, including lead. For Rueda, this is just further evidence of the neglect of women in science and medicine. She describes the absence of this type of data regarding a product that women have used for many years, backed by significant financial investment, as “incomprehensible.” “Since we have no choice but to buy them, there is no need for innovation either.” [or research] too much,” she laments.
Mental health is not exempt from these issues either. Women are prescribed five times more antidepressants and twice as many anxiolytics compared to men. “We are still seen as the hysterical ones by doctors,” she says. However, the director of the Women’s Unit of the Ministry of Science acknowledges that this behavior is not exhibited “out of malice or to harm the patient.” Although this situation is prevalent, not all professionals behave this way, she emphasizes. “They just believe the stereotype and act accordingly.” Rueda argues that this phenomenon arises because women are still perceived as overly sensitive and prone to complaining.
Women: the Majority in Health
Currently, health-related fields have more female students than male students, and they also represent the majority in professional practice. Despite this, men still hold most leadership positions and “continue to decide what research is conducted,” says the director. One of the significant advancements in recent years at both European and Spanish levels has been the requirement for all research to incorporate a gender perspective, she states. Without this stipulation, access to public funding will be denied.
Despite the adverse effects of this gender bias, Rueda believes it is something that can change. This will require efforts on multiple fronts: “When we address issues that are culturally ingrained within society, there isn’t a single cause.” The first step is to make visible what is happening and its implications for women’s daily lives. The solution also involves gender perspective training to eliminate stereotypes and biases from an early age,” she states.
We must also find ways to disseminate this information to the entire population. Rueda believes that it is “essential but not empathetic,” and empathy is crucial when conveying this information. “If we are merely a percentage on a chart indicating that we die more each year, no one will identify with that,” Rueda reassures us, reminding that the ongoing fight to acknowledge women in science, especially in medicine, has yielded positive results, although it must continue. “Much has been achieved, but years of inequality still need to be addressed.”
Understanding the Gaps in Medical Research on Women’s Health
“Morning sickness, endometriosis, menopause, migraines, polycystic ovaries / What’s wrong with your body? We don’t know / ‘Cause we’ve never really studied the female body.” This is how the song that has gone viral in recent weeks on TikTok and Instagram begins. This song, which was born as a parody, is originally in English, but numerous Spanish content creators have translated it to share it and denounce the lack of knowledge about women’s bodies in medicine. For example, the first study to prove the effectiveness of feminine hygiene products containing real blood was published in August 2023.
Gender Bias in Medical Research
According to Silvia Rueda, the director of the Women and Science Unit at the Ministry of Science, Innovation and Universities, gender bias in medical research is evident across all scientific fields. However, in medicine, this bias significantly impacts healthcare outcomes. Research predominantly utilizes male subjects, with female subjects often omitted from initial studies, including trials conducted on animals.
The rationale for this exclusion is that female hormonal cycles can skew results and increase costs, as separate tests would be required for each sex. Historically, this has led to men becoming the standard subjects in research, rendering women as anomalies. As Rueda poignantly states, “If we start from that base, we’re in trouble.” She emphasizes the reality that we cannot afford to exclude 51% of the population from medical research.
The Impact on Women’s Specific Health Issues
[Doctor Carmona: “Si el hombre tuviera dolor de testículos tres días al mes, el mundo se pararía”]
Moreover, historically low female representation in scientific research means that there is a diminished interest in studying medical issues that primarily affect women. Rueda notes that, outside of breast and uterine cancer, other pathologies specific to women are often overlooked.
Case Study: Endometriosis
Endometriosis serves as a stark reminder of this gender bias. It affects approximately 10% of the global population according to WHO estimates, yet no specific treatments exist, and diagnosis averages a decade. Rueda’s sentiment encapsulates the frustration felt: “If it were something that affected men, it would have been cured a long time ago.” Similarly, fibromyalgia, which occurs much more frequently in women, was misclassified for years as a psychological disorder.
The Prevalence of Cardiovascular Disease
Cardiovascular diseases, the leading cause of death among women, also reveal glaring gaps in research. Dr. Carme Vall, a specialist with a focus on gender perspectives in medicine, reveals that merely 38% of cardiovascular studies involve female subjects.
As Rueda outlines, the anatomy of veins and arteries differs greatly between sexes, influencing symptoms and diagnoses. For instance, heart attacks in women can exhibit completely different warning signs compared to men, often leading to fatal misdiagnoses. “They suffer more, but we have a higher mortality rate.”
Challenges in Recognition and Treatment
The interplay of gender bias and societal beliefs complicates the recognition of symptoms. Women frequently leave the emergency room with incorrect diagnoses like anxiety, despite experiencing life-threatening conditions. Women can leave the emergency room with a diagnosis of anxiety instead of a heart attack.
The Consequences of Neglecting Female Health
Feminine hygiene products, too, have come under scrutiny, as a recent study highlighted toxic metals present in tampons, including lead. The lack of research surrounding these everyday products, which women use regularly, highlights systemic neglect in women’s healthcare.
Mental health is not free from scrutiny, either. Women are prescribed antidepressants at five times the rate of men, and anxiolytics twice as often. Rueda notes this is not due to malice from health professionals but stems from entrenched stereotypes that categorize women as “hysterical.” “You just believe the stereotype and act accordingly.”
The Current Landscape of Women in Healthcare
In health-related fields, there are now more female students than males, and women represent a significant portion of professionals. Despite this, men disproportionately occupy leadership roles, influencing which aspects of female health are prioritized for investigation. Notably, recent advancements in Europe necessitate a gender perspective in all research for public funding.
Moving Forward: Strategies for Change
Despite these considerable challenges, Rueda insists that change is possible. Action must be taken on multiple fronts to dismantle culturally entrenched beliefs. “There is no single cause,” Rueda states. Making the issues visible and offering training in gender perspectives from early education are crucial steps.
Communicating this information effectively to the public is vital, with a focus on empathy. As Rueda notes, “If we are a percentage on a graph that says we die more each year, no one is going to identify with that.” She encourages a continuous effort toward gender equity in science and medicine, reminding us that significant strides have been made, yet persistent inequalities require ongoing attention.
:quality(85)/cloudfront-us-east-1.images.arcpublishing.com/infobae/4SSWIXIAX5ACHNA4S3TUKPTHVA.jfif "Juan Brujo, Legendary Lead Vocalist of Brujería, Dies at 61")
