I am a woman, not a shorter, less-hairy man. My body does not respond to illness the same way as a man’s body would. It does not function the same, it does not react to medication the same, nor is my chemical make-up the same. My diseases will be different, as will my recovery. While only being twenty-nine and living in the age of information, my biggest concern as a woman is that women are still being under-used and misunderstood in the medical research field, which can profoundly affect women everywhere.
Women have many issues facing them because they are women. Cervical issues, uterine issues, ovarian and fallopian issues, breast issues, and the list could go on (making any man in the room cringe at the word vagina). Issues such as these arise simply because we are the only sex to have these organs. It is a sad state of affairs that medical research has historically ignored women with simplified responses to illness, such as heart disease, on the assumption that we are shorter, less-hairy men with breasts. Our uniqueness has not been taken into account in many research studies, including one medical trial in which it was determined that aspirin could prevent a second heart attack in an all-male participant group, however these results are not transferable to women (Mitchell, 2000).
A combination of diseases are more common to women in general because of female attributes, such as having a cervix and certain hormones that contribute to other diseases. The rates of breast cancer are far higher for women than for men. Men account for less than 1% of diagnosed breast cancer (Public Health Agency of Canada, 1999). Women’s rates of developing osteoporosis are higher than men, with 1 in 4 women as compared to 1 in 8 men (Sunnybrook and Women’s College Health Centre, 2002). What I find quite alarming is our higher rate of death attributable to cardiovascular disease, with 39% of female deaths attributed to cardiovascular disease as compared to 36% for men (Canada. Public Health Agency of Canada, 1997). While 3% does not seem like a significant amount, it actually is when considering the other diseases I mentioned. There is no discernible reason as to why females are more likely to die from cardiovascular disease than their male counterparts. While heart disease is the second leading cause of death for all Canadians (Statistics Canada, 1997), only passed marginally by the total of all cancers, more women than men die from their first heart attack (Donatelle, 2002, 418). Is it because there is a lack of information out there? Or is it because the information available is based mainly on the research derived from the male portion of the population?
There are related issues associated with the lack of women in clinical studies that require women. I believe everyone has heard of the devastating results of Thalidomideâ?¢, a drug that was marketed by a German company to pregnant women to curb their morning sickness. The drug was available from the 1950s until 1962 when Canada finally pulled it from the pharmacies’ shelves. A full ten years of use produced the most severe deformities in the children of the women who took the drug (Thalidomide Victims Association of Canada, 1998). While the benefits of this drug have now been researched, there is no indication whatsoever that this drug was ever researched on anyone, let alone women, before giving it to pregnant women.
There is another medication given to women from the years 1938 and 1971 that didn’t seem to be researched, and if it was, the research was conducted by the manufacturer. Diethylstilbestrolâ?¢ (DES) was a drug given to pregnant women, which was claimed to reduce the chance of miscarriage. The repercussions of this drug are three-fold. Firstly, the women that ingested it have a higher risk of breast cancer. Secondly, the daughters born to those who have taken it have an increased risk of suffering from a rare form of cervical or vaginal cancer, infertility, abnormal reproductive structural changes, and pregnancy problems. Pregnancy problems include ectopic pregnancy, miscarriage, and preterm labour. Finally, the sons of women who have taken DES may be affected with problems of epididymal cysts, testicular varicoceles other testicular problems, hypospadias, meatal stenosis, and microphallus (an abnormally small penis) (DES, n.d.). DES is not believed to have an effect on men’s fertility (Ibid.).
These are just a few examples of how manufacturers, not research facilities, have shaped women’s health to be what it is today — a mess. Hormone Replacement Therapy (HRT) is another issue that has received attention from women recently. Up until 2002, HRT was believed to prevent diseases in aging menopausal women, such as cardiovascular disease (or more specifically, heart disease), osteoporosis, and endometrial cancer (Your Medical Source, 2003a). These are good intentions, but there are risks to be noted as well. These risks were often negligible according to many older studies and include: blood clots, breast cancer, asthma, gallstones and fibroids (Your Medical Source, 2003b). But, as reported in an issue of the Women’s Health Journal, a U.S. study of HRT conducted in July of 2002 was halted because its findings were astonishing. “Rather than preventing diseases in aging women, as many had claimed, the study found : actually increases a woman’s risk of heart disease and breast cancer:. there is no role for HT in disease prevention” (Research Bulletin). This is another example of how effective medical testing on women who would take these drugs could have been used to fully understand the ramifications of this drug, instead of relying on manufacturers’ claims.
Medical research for women is vital to understand how different our bodies are from our male counterparts. Over the ages, delving into the information regarding women’s health has barely scratched the surface. In the 1960s, women had to face a panel of men who would decide their fate about whether or not their uterus could be removed. In the 1970s, articles in medical journals began to surface as to how to deal with “the new breed of women who asked questions and demanded to know why they were getting a particular treatment” (Kennelly, 2002). However, it wasn’t until 1981 that a committee was formed to head-up The Canadian Women’s Health Network.
At that time, the committee was one of few sources for this valuable information. Women formed these groups to attempt to fill the knowledge gaps not filled by the Canadian National Health and Wellness organization. Without the support of Canada’s health system, this committee easily lost momentum until 1983 when a theatre company developed a play called “Side Effects” which was based on women’s stories of their struggles. A full three years later, in 1987, funding was finally approved for the Canadian Women’s Health project. Over the next 6 years, the proposal was presented, rejected, revised, reformed and firmed-up. In May of 1993, the Canadian Women’s Health Network was officially unveiled (Canadian Women’s Health Network, 2005). The network’s vision statement is: “The Canadian Women’s Health Network is a Network of individuals, groups, organizations and institutions concerned with women’s health. The CWHN recognizes the importance of information sharing, education and advocacy for women’s health and equality. We work to build and strengthen the women’s health movement in Canada and throughout the world” (Canadian Women’s Health Network, 2005).
A network such as the CWHN can provide vital information to women and their health service providers. The network can help to induce the necessary changes in our medical research system to include women in their clinical trials. I personally do not want to suffer, nor have my daughters suffer, needlessly because researchers did not want to deal with the fluctuations in a woman’s hormone cycle.
What is needed moreso than the plethora of information available through the CWHN is an advocate that lobbies the government to ensure women of this country are included in any medical trials. Connecting research funding to the inclusion of women in the trials will provide a level of assurance. For far too long, the health of Canadian women has been compromised in the name of the economic good. I suggest changes to the research sector must be made to include the following:
1. Research companies must be separate from the manufacturers so as to avoid potential bias and unethical marketing strategies.
2. Research companies must be required to include women. If the drug being researched has a chance of affecting a woman’s future ability to bear children, women must be provided a choice as to whether they wish to proceed. Informed consent should be confirmed by the signing of a waiver.
What I hope for in a program such as this is a change in the public’s expectations for quality medical research that doesn’t exclude individuals from one gender. As well, a change is needed in who is performing the research. Preferably, manufacturers of marketed items should not be conducting the research trials. When the research process changes, Canadian women can feel assured that their health is finally in good hands. Good hands means individuals who respect women and who do not merely consider us as shorter, less-hairy men with breasts.
References
Canada. Public Health Agency of Canada (1997). Heart Disease and Stroke in Canada. Retrieved April 5, 2005, from http://www.phac-aspc.gc.ca/publicat/hdsc97/s02_e.html
Canadian Women’s Health Network (2005, January 20). Canadian Women’s Health Network: About us, background. Retrieved April 7, 2005, from http://www.cwhn.ca/about.html
Canadian Women’s Health Network. Winnipeg Consultation Organizing Committee (2004, December). The Strength of links: Building the Canadian Women’s Health Network. Retrieved April 7, 2005, from http://www.cwhn.ca/ ARCHIVE/strength/index.html
DES Action USA (n.d.). General information. Retrieved April 7, 2005, from http://www.desaction.org/index.htm
Donatelle, R.J. (2002). Access to health. 7th ed. California: Pearson Education.
Kennelly, J. (2002, March). Making connections: women’s health and the anti-globalization movement. Canadian Woman Studies, 21(4), 160(5).
Mitchell, P. (2000, March). A Prescription for female complaints. Herizons, 13(4), 48.
Public Health Agency of Canada (1999, April). Breast Cancer in Canada. Retrieved April 5, 2005, from http://www.phac-aspc.gc.ca/publicat/updates/breast-99_e.html
Research Bulletin (Spring 2003). Hormone Therapy: Health Protection Lessons from the Women’s Health Initiative, v3 n2. Retrieved April 27 from http://www.cewh-cesf.ca/bulletin/v3n2/page2.html#4
Stats Canada (1997). Selected leading causes of death, by sex. Retrieved April 4, 2005, from http://www.statcan.ca/english/Pgdb/health36.htm
Sunnybrook and Women’s College Health Science Centre (2002, February 7). Women’s health matters: Osteoporosis Health Centre. Retrieved April 5, 2005, from http://www.womenshealthmatters.ca/centres/osteo/index.html
Thalidomide Victims Association of Canada (1998). What is Thalidomide? Retrieved April 7, 2005, from http://www.thalidomide.ca/en/information/what_is_thalidomide.html
Your Medical Source (2003a, December). What are the benefits of HRT? Retrieved April 7, 2005, from http://yourmedicalsource.com/library/hrt/HRT_benefits.html
Your Medical Source (2003b, December). What are the risks of HRT? Retrieved April 7, 2005, from http://yourmedicalsource.com/library/hrt/HRT_risks.html
