The field of medical research has long favored men in clinical trials of many treatments. But “women are not just slightly smaller and lighter men”, insists Carole Clair, doctor and co-head of the Health and Gender Unit at Unisanté. While this may seem obvious today, things are slow to change, especially in Switzerland.
“We realized that it was problematic for certain diseases. We realized that the observations made on the effectiveness of certain drugs, on their risks or their side effects, were not always applicable to women, for example. This is why we had to restore this knowledge deficit by requiring the inclusion of women in research”, explains in La Matinale this specialist in the question of gender in medical care.
Beyond stereotypes
This paradigm shift was first implemented in the United States, then in Europe. “But this is unfortunately still not the case in Switzerland”, deplores Carole Clair.
Therefore, concerning the dose of certain drugs for example, the height and weight of a woman should not be the only data to be taken into account by the doctor. According to her, gender differences go far beyond these simplistic stereotypes.
“The distribution of fats also plays an important role in the metabolism of drugs. Sometimes, it will even be necessary to give more treatments to women than to men, precisely because they metabolize certain molecules more quickly.”
This is why it is essential, according to the specialist, to study the mechanism of these drugs more closely, by including women in the research. So do older people or people of other ethnicities, she continues.
The example of cardiovascular diseases
These inequalities are not only reflected in the medical treatments prescribed to women. Some diseases can also suffer from these gender biases. Cardiovascular diseases are the best known and most studied example of this, underlines Carole Clair.
“We know that a woman who has a heart attack has a greater risk of dying, especially if she is under 65. The reasons for this are multiple, but we know that a woman who will have chest pain will be diagnosed a little later. In particular because it is difficult to imagine this kind of pain in a woman as being something that comes from cardiovascular disease.”
Not to mention the symptoms which can sometimes vary according to the gender of the patient. Thus, to take the example of a heart attack, the famous left arm which can cause pain is a less frequent warning sign in women, illustrates the specialist.
The important role of politics
In order to correct these gender biases in medicine, politics has a key role to play, assures Carole Clair.
“The policy will be able to ensure that there are clearer guidelines. In Switzerland, for example, when you submit a research project, there are not yet requirements to include mixed samples. The policy will therefore be able to play a role, at least to encourage more regulations at this level. But this is not the only way, it is also necessary to raise awareness among caregivers, population.”
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Adaptation for the web: Fabien Grenon