Lately there is talk of more and more insistence gender medicine and the need to arrive at a clinical approach that takes into account the biological and genetic differences of those born with a male or female body. A distinction it does not have nothing to do with gender identitymuch less with thesexual orientation, but simply with different objective characteristics in the two sexes, often ignored to the detriment of women, who have always been treated less and worse. “From a physiological point of view, men and women are not the same and science has never hidden it, it simply has decided not to take care of them as much as it should have,” he explains. Antonella Violaimmunologist, scientific director of the Pediatric Research Institute IRP-Città della Speranza and author of the book, Sex is (almost) everything published by Feltrinelli.
How do you explain it?
“Over the centuries this topic has been considered of little interest to the scientific community and pharmaceutical companies and the reasons are above all cultural. Suffice it to say that until 1993 women were not included in clinical studies carried out to measure the efficacy and safety of drugs and that only in that year the American Food and Drug Administration decided to include them ».
Have things changed since then?
“In part but not enough. At the end of the clinical studies, in fact, the data are still put together today without distinction and the evaluation of the efficacy and safety of the therapies is not made on the basis of gender. The reasons in this case are mainly economic since really applying gender medicine in each step would mean for pharmaceutical companies to significantly increase costs “.
Even if in perspective for the National Health System it could actually prove to be a saving, given that incorrect or useless treatments due to inaccurate diagnoses would decrease.
“Of course, but unfortunately we live in a world that looks to the short-term advantage and doesn’t know how to be far-sighted”.
Does the scientific community’s lack of sensitivity on the subject also depend on the fact that most of its members are men?
“Yes without a doubt. The female body has always been less studied than the male one because medical schools were attended only by males who carried out studies and measurements on themselves. Now things are changing, universities also train doctors on this issue and within our world there is talk of it but to arrive at a real change it is necessary to make sure that politics are interested in it, which instead only moves if there is one. it is a popular consensus to reach ».
What are the areas in which the difference between men and women is greatest?
“Different, starting with the immune system. That of women is stronger and more reactive and has a greater ability to produce antibodies and react to infections because from an evolutionary point of view it has the purpose of protecting the fetus.
However, women suffer more from autoimmune diseases, are prone to developing Alzheimer’s and, despite getting Parkinson’s less frequently than men, have a worse course and a higher mortality.
The female response to painkillers is also lower and for this reason they are often accused of complaining excessively of pain when in reality they should probably only be treated with higher doses ».
Are gender differences also reflected in diagnostics?
“Absolutely. Take for example a heart attack: if you ask a person to describe the symptoms they will almost certainly mention severe pain and constriction in the chest that radiates to the arm. However, this is what happens to men and only rarely to women, in which heart attack much more often presents with back pain lasting for days, gastrointestinal complaints such as nausea or vomiting, tiredness and exhaustion. All symptoms not known and consequently ignored ».
The pandemic could have been an opportunity to change course, but once again the same patterns have reappeared.
“Unfortunately. When I started writing this book a year ago, I realized that only 4% of Covid studies had fully included women, despite the differences with which the virus works are there for all to see. For example, it has been seen that men get sick more seriously and have a higher mortality and women are more interesting from long Covid. The latter have also developed many more adverse reactions to vaccines, a widely predictable fact given that it is also found for other vaccines ».
Do you see changes on the horizon?
“We must ask for them by disseminating as much as possible and keeping the attention of the media and politics high”.
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