Category: Gender

Categories : GenderTags :

Article Highlights Lack of Healthcare’s Anaemia Support for Women

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An article entitled  “The misogyny of iron deficiency”, published today in Anesthesia addresses the history of anaemia and how women’s health has often been overlooked.

The article was written by researchers from The University of Western Australia and University College London coincides with International Women’s Day. Sex differences in haemoglobin begins in puberty due to the effects of menstruation on iron stores and also varies by age, and can be affected by factors such as smoking and pregnancy.

Team lead Professor Toby Richards, Lawrence-Brown Chair in Vascular Surgery at UWA, is calling for greater recognition and equality for women’s health. He said that one in three women would need to take iron supplements at some point in their life.

“Our figures show that up to 18 percent of women who appear fit and healthy are actually deficient in iron, with heavy menstrual bleeding the most common cause. Symptoms reported by women range from fatigue to brain fog, hair loss and eating ice,” Prof Richards said.

Iron deficiency was a particular problem for women involved in fitness or sport with up to one in five athletes affected, he added.

“Issues with a women’s menstrual cycle and particularly heavy periods are surprisingly common and often not recognized with more than half also suffering iron deficiency.

“It’s so common it’s hiding in plain sight and both are under-diagnosed issues in women’s health. Unfortunately, there has been a dogma to accept these as ‘in the normal range’ for women,” said Prof Richards.

Prof Richards’ team also recently surveyed two groups of women, including 68 triathletes and 181 students, at UWA’s recent Orientation Day.

The women completed a simple questionnaire about previous iron status, menstrual blood loss, diet and motherhood. They were then tested for anaemia. Of the 181 women tested 14.5% were anaemic and most were unaware.

“This is alarming that so many apparently fit and healthy women are actually anemic, which may impact on their physical and mental health,” said Prof Richards.

He said many women simply coped with constant tiredness among a host of other symptoms, without addressing the root cause.

“We want to raise awareness of these conditions and help women recognize the signs and symptoms, in order to get the treatment that their body needs to improve their health and welfare.”

Source: News-Medical.Net

Categories : Gender HospitalsTags :

UK Says ‘Strong Evidence’ of Gender Health Gap Exists

On By ModernMedia
Woman in a hospital bed. Photo by Andrea Piacquadio from Pexels.

As an inquiry into the disparity of health service provision to women begins this week, Ministers in the UK say there is “strong evidence” of a gender gap.

The Women’s Health Strategy will speak to women and girls over the next 12 weeks on a variety of issues, ranging from maternity care to mental health.

Nadine Dorries, minister for women’s health, said: “Women’s experiences of healthcare can vary and we want to ensure women are able to access the treatment and services they need.

“It’s crucial women’s voices are at the front and centre of this strategy so we understand their experiences and how to improve their outcomes.”

Patients have told the BBC they have felt overlooked in conditions like endometriosis, or procedures such a pelvic floor mesh.

There is less knowledge on female conditions and their treatment among clinicians. Despite the fact that they make up half of the population, female conditions are often considered a ‘niche’ area. Research shows that a large part of the problem is due to the fact that clinical trials have  failed to take into account gender. Eight out of ten drugs that were withdrawn in the US between 1997 and 2000 were as a result of side effects in women.
While campaigners have welcomed the view, they say that it is still vital to listen to women’s views and act on them.

Gill Walton, chief executive of the Royal College of Midwives, said: “We know that placing women at the centre of their own care not only improves outcomes in pregnancy, but also improves a woman’s experience of birth and maternity care.”

Mika Simmons, co-chair of the Ginsburg Women’s Health Board, filmmaker, and host of The Happy Vagina podcast, said: “Every single woman I speak to, myself included, has experienced either misunderstanding or loss as a direct result of slow or inaccurate diagnosis of their health concerns.

“I am delighted that this – the gender health gap – which grew out of a severe lack of historical research into women’s health issues, is not only finally being acknowledged but that steps are being taken to right size it.”

Source: BBC News

Categories : Gender GeneticsTags :

Health Conditions Driven By Evolution and Genetic Sex Differences

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A new study shows that the human genome has been subject to selection pressures favouring different characteristics in females and males, which makes males more susceptible to a variety of health conditions.

Genetic sex differences have long been known to have an impact on health. On balance, while females have certain conditions unique to them (eg, cervical cancer), or are more prone to (eg, multiple sclerosis), males are more prone to certain medical conditions, bringing down their average life expectancy compared to women.

Their research adds to a body of knowledge on genomic influences on health, which can map hereditary traits onto individuals and populations to guide healthcare. Looking at health conditions through the lens of genomics can help clinicians to better understand them and guide development of new treatments.  

“Our cells have memories and they carry the accumulation of all the changes our ancestors have experienced over millions of years,” said Rama Singh, a McMaster biology professor who wrote the paper with his son, Karun Singh, an associate professor of neuropathology at the University of Toronto, and Shiva Singh (no relation), a biology professor at Western University.

The researchers focussed on autism, which is a good example of the way men and women develop medical conditions differently; though they inherit the same sets of genes from the parents, the expression of those genes differs greatly by sex.

Though human behaviour regarding mate selection has changed, those genetic characteristics remain and continue to be expressed in the health and development of modern men.

The male genome has been shaped over millions of years, and favours reproduction in the early years of male maturity to pass on genes, at the expense of genetic well-being in the long term.

Women are less vulnerable to most health conditions, living longer than men because their genomes have evolved to protect against unhealthy traits in the male genome, resulting in better immunity and more longevity.

The same forces shaping human selection also apply to mental health, even though it is complex. Women are more prone to anxiety and depression, while men are more prone to anti-social disorders.

“If women and men were any more different, they would be different species,” joked corresponding author, Prof Karun Singh.

Male-female imbalance is especially pronounced in autism, with being up to four times more likely to have some form of autism, and are also more likely to have severe symptoms. Evolution has resulted in a higher threshold, protecting females from developing the condition.

Although autism is not solely the result of inherited characteristics, it does appear that boys are more likely to develop it as a result of other inhertied characteristics rendering them more vulnerable to environmental, developmental and other factors that give rise to autism.

“One of the reasons I think this is interesting is that it offers a perspective that is not well represented in the medical literature. This is a really good example of the perspective that geneticists and evolutionary biologists can add to health research,” said Prof Karun Singh.

Source: News-Medical.Net

Journal information: Singh, R. S., et al. (2021) Origin of Sex-Biased Mental Disorders: An Evolutionary Perspective. Journal of Molecular Evolution. doi.org/10.1007/s00239-021-09999-9.

Categories : Gender NeurologyTags :

LGBTQ Concerns Put Brain Imaging Study on Hold

On By ModernMedia
Person holding rainbow-themed cake slice. Photo by Sharon McCutcheon on Unsplash.

A study investigating brain functions of gender dysphoria at UCLA’s Semel Institute for Neuroscience & Human Behavior, has been put on hold after concerns from LGBTQ groups.

According to the Diagnostic and Statistical Manual of Mental disorders, gender dysphoria is a “marked incongruence between their experienced or expressed gender and the one they were assigned at birth.” Gender Justice LA and the California LGBTQ Health and Human Services Network released a joint statement, citing major ethical concerns.

Study leader Jamie Feusner, MD, a psychiatrist, told MedPage Today that he has asked UCLA’s Institutional Review Board to “re-review our entire protocol to ensure that it meets all ethics and safety standards.”

He added that his team is “actively engaged with members of the LGBTQ community” to help inform potential adjustments to study protocols. It wasn’t clear whether the entire study is on hold or just enrollment of new participants.

Ezak Perez, executive director of Gender Justice LA, wrote that the “research design unapologetically aims to cause mental health distress to trigger ‘dysphoria’ to an already marginalised and vulnerable community.”

The advocacy groups said that researchers from the Semel Institute reached out to the transgender, gender non-conforming, and intersex community in the region to take part in a meeting to help the study design. When they expressed concerns during this meeting and realised the study was already underway with approval from the IRB, leaders from Gender Justice LA and the California LGBTQ Health and Human Services Network wrote a letter to UCLA’s Office of the Human Research Protection Program.

“The researchers are falsely advertising this study without clarity about the expectations of participants and without consideration of the need for direct access to mental health after care,” wrote Perez and Dannie Cesena, program manager of LGBTQ Health and Human Services Network.

The call for participants was for looking for transgender, nonbinary, and cisgender adults to complete an assessment and one or more MRI scans. Participants would also be “photographed from the neck down while wearing a unitard,” a point of contention cited by Perez in his statement. The enrollment announcement also noted that participants who experience discomfort during this process could withdraw from the study at any point. Requirements included not being psychiatric medications, and that trans and nonbinary participants could not already be on hormone therapy or have had gender-affirming surgery. Participants would be paid a small amount and have expenses reimbursed.

The study in question would use the ‘body morph’ test, designed in 2015 by Feusner and colleagues. During the test, participants are photographed from various angles in a nude-colored, full-body unitard, with faces, hand and feet cropped out.. Participant images are then morphed with pictures of different bodies.

Writing to MedPage Today, Feusner and co-researcher Ivanka Savic-Berglund, MD, PhD, wrote that at the time that Feusner created the ‘body morph’ test, “experiences of body-self incongruence were not easily understood. The test uses images to estimate the degree of alignment between individuals’ body perception and their gender-specific self-identity.”

Perez and Cesena strongly objected to the idea that capturing the neurological response of gender dysphoria through brian imaging could provide any scientific data that could ‘help’ trans people.

“It is suggestive of a search for medical ‘cure,’ which can open the door for more gatekeeping and restrictive policies and practices in relation to access to gender-affirming care,” the letter stated.

Feusner and Savic-Berglund, however, explained that “by demonstrating that body-self incongruence was linked to brain structure and function, we aimed to help provide a biological basis and increase empathy for the life stories of transgender individuals. From the beginning, the aim was to help increase acceptance of transgender individuals.”

Source: MedPage Today

Categories : Gender Mental Health NeurologyTags :

Women are Better ‘Mind Readers’ Than Men, Study Finds

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Women are better at ‘reading minds’ than men, finds a new study aimed at better understanding social interaction and the challenges faced by people with autism. 

Sometimes known in the field of psychology as ‘mentalising‘, the process is when people try to ascertain what others are really thinking, for example when they are sarcastic or even lying. Mind-reading has some basis in neuroscience: for example, some research indicates that sensitivity to social interactions is associated with the posterior superior temporal sulcus, an area of the brain which is also known to process biological motion. Everybody has some proficiency with mind reading, and some are inherently better than others. However, some lack the ability to a point where it becomes difficult to function in society, for example in autism.

The study made use of a self-report questionnaire asking participants to rate how well, for example, they could relate to others. It used four questions, each with ratings from one to four, giving a maximum total score of 16. The researchers determined that women scored higher than men on the questionnaire, and also confirmed the challenges reported by those with autism. 

Senior author Dr Punit Shah, at the University of Bath’s Department of Psychology explained: “We will all undoubtedly have had experiences where we have felt we have not connected with other people we are talking to, where we’ve perceived that they have failed to understand us, or where things we’ve said have been taken the wrong way. Much of how we communicate relies on our understanding of what others are thinking, yet this is a surprisingly complex process that not everyone can do.”

Dr Shah emphasised that there is a different between mind-reading and empathy, saying: “Mind-reading refers to understanding what other people are thinking, whereas empathy is all about understanding what others are feeling. The difference might seem subtle but is critically important and involves very different brain networks. By focussing carefully on measuring mind-reading, without confusing it with empathy, we are confident that we have just measured mind-reading. And, when doing this, we consistently find that females reported greater mind-reading abilities than their male counterparts.”

Lead researcher, Rachel Clutterbuck, emphasised the clinical importance of the questionnaire. She said: “This new test, which takes under a minute to complete, has important utility in clinical settings. It is not always obvious if someone is experiencing difficulties understanding and responding to others—and many people have learnt techniques which can reduce the appearance of social difficulties, even though these remain.

“This work has great potential to better understand the lived experience of people with mind-reading difficulties, such as those with autism, whilst producing a precise quantitative score that may be used by clinicians to identify individuals who may benefit from interventions.”

Dr Shah added that this study was about helping to understand mind-reading capabilities, and had created a freely available questionnaire for other efforts in this regard.

Source: Medical Xpress

Journal information: Rachel A. Clutterbuck et al, Development and validation of the Four-Item Mentalising Index., Psychological Assessment (2021). DOI: 10.1037/pas0001004

Categories : Cardiovascular Disease GenderTags :

Heart Attack Deaths are Increasing in Young Women

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Fatal heart attacks are increasing among young women in the US, a study has found.

The increase has reversed a trend from 1999 to 2010 of falling heart disease deaths in young women. Cancer deaths meanwhile have been consistently falling over the period 2010 to 2018. 

“Young women in the US are becoming less healthy, which is now reversing prior improvements in heart disease deaths,” said senior author Dr Erin Michos, Johns Hopkins University School of Medicine. “With worsening epidemics of diabetes and obesity across developed countries, our findings are a warning sign that we need to pay more attention to the health of young women.”

“Women frequently put others’ health and needs before their own, often caring for children and parents and working full-time,” continued Dr Michos. “But if they have a fatal heart attack, they won’t be there for loved ones. Women must prioritise their own health, especially since heart disease is largely preventable.”

From 1999 to 2018, the respective age-adjusted mortality rates for cancer and heart disease were 52.6 and 24.0 per 100 000. Ischaemic heart disease (56%) was the most common cause of heart disease death. Respiratory tract/lung cancer (23%) was the leading cause of cancer death.

Across the 19 year study period, age-adjusted mortality rates decreased for both cancer and heart disease. However, while cancer death rates experienced a consistent decline, heart disease death rates initially fell and then increased between 2010 and 2018. This resulted in the absolute mortality gap between cancer and heart disease significantly decreasing from 32.7 to 23.0 per 100 000 per year.

The authors urged “extreme public health measures” should be taken, stressing that most heart disease was preventable, and urgent action was needed to reverse this upward trend.
“There is a misconception that women are not at risk for heart disease before the menopause, yet one-third of their cardiovascular problems occur before 65,” said Dr Michos. “Studies of young heart attack patients show that compared to men, women were less likely than to have been told they were at risk for heart disease before the attack and less often received stents and medications.”

“Most heart disease can be avoided with a healthy balanced diet, physical activity, not smoking, and maintaining healthy blood pressure, blood glucose, cholesterol level, and body weight. Just because a woman is before menopause does not mean she is not at risk. Unfortunately, the first attack can be fatal, so we need to do better with prevention,” she concluded.

Source: Medical-News.Net

Journal information: Khan, S. U., et al. (2021) A comparative analysis of premature heart disease- and cancer-related mortality in women in the USA, 1999–2018. European Heart Journal – Quality of Care and Clinical Outcomes. doi.org/10.1093/ehjqcco/qcaa099.

Categories : Cardiovascular Disease GenderTags :

Women are Less Likely to Undergo Critical Heart Surgery

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A scientific presentation at the 57th Annual Meeting of The Society of Thoracic Surgeons revealed that women are less likely to have a coronary artery bypass grafting (CABG) using guideline-recommended approaches, possibly resulting in worse post-surgery outcomes.

CABG is a major surgical operation involves bypassing atheromatous blockages in a patient’s coronary arteries with venous or arterial conduits harvested from elsewhere in the patient’s body.

Dr Oliver Jawitz and colleagues from Duke and The Johns Hopkins University School of Medicine used the STS Adult Cardiac Surgery Database (containing records of nearly all CABG procedures done in the US), and identified adult patients from 2011 to 2019 who underwent first-time isolated CABG, along with detailed demographic, clinical and procedural data.

The association between female sex and three different CABG surgical techniques from US and European guidelines was investigated. Grafting of the left internal mammary artery to the left anterior descending artery, complete revascularisation, and multiarterial grafting have been linked to better short and/or long-term outcomes. Despite this, the results indicated that women were 14%-22% less likely than men to undergo CABG procedures with these revascularisation strategies.

“With these findings, we did in fact see less aggressive treatment strategies with women,” said Dr Jawitz. “It is clear that sex disparities exist in all aspects of care for patients with coronary artery disease (CAD), including diagnosis, referral for treatment, and now, in surgical approaches to CABG. We must ensure that female patients undergoing CABG are receiving evidence-based, guideline-concordant techniques.”

The results are in accordance with an overall neglect of heart disease treatment in women. Women are much more likely than men to have non-typical symptoms of heart disease which are also subtler, such as abdominal pain and fatigue, as well as having their own particular set of risk of factors. This is compounded by women being underrepresented in cardiac disease study cohorts.

Women’s health historically focused on mother and child, and breast cancer. As such, the period from symptom onset to diagnosis and treatment is longer, allowing the disease to progress and worsen outcomes. This is also reflected by fewer women being referred for beneficial treatments such as CABG. 


“Delayed diagnosis of CAD in women leads to late initiation of key behavioral and pharmacologic interventions for minimizing heart disease risk, as well as delayed referral for invasive diagnostic and therapeutic procedures, including surgical revascularisation with CABG,” said Dr Jawitz. “This often means that by the time female patients undergo these procedures, they have more severe disease than males, as well as a greater number of comorbidities, which leads to worse outcomes.

“Now that we have identified specific differences in surgical approaches to CABG between females and males, we must further elucidate how these differences result in disparate outcomes such as increased mortality, readmissions, and complications,” he concluded. “These findings will help inform the development of sex-specific guidelines for the diagnosis and management of cardiovascular disease.”

Source: News-Medical.Net

Categories : Gender Mental HealthTags :

Protein ‘Flavours’ Cause Gender Difference in Psychiatric Drug Responses

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A new study has shown that different isoforms or ‘flavours’ of key proteins have different effects in males and females, causing psychiatric drugs to function well in one gender and in others to be ineffective or a have host of side effects.

“The ultimate goal is to find the kink in the armor of mental illness—the proteins in the brain that we can specifically target without impacting other organs and causing side effects,” explained Charles Hoeffer, an assistant professor of integrative physiology at the Institute for Behavioral Genetics. “Personalisation is also key. We need to stop hitting every mental illness with the same hammer.

AKT was discovered in the 1970s and known as a gene which resulted in cancer when mutation was present. It is now known to play a role in “synaptic plasticity”, where synaptic connections between neurons are strengthened to encode memories.

“Let’s say you see a shark and you’re scared and your brain wants to form a memory. You have to make new proteins to encode that memory,” explained Hoeffer.

Different isoforms have different functions in the brain; AKT1 together with AKT2 in the prefrontal cortex is important for making new memories.
“These subtle differences could be really important if you wanted to personalise treatments for people,” explained Marissa Ehringer, an associate professor of integrative physiology who partnered with Hoeffer on some of the research.

The researchers spent six years examining the brains of male and female animals, and the role the loss of AKT played. For example, male mice with functioning AKT1 were much better than those without AKT1 when it came to “extinction learning”—replacing an old memory, or association that is no longer needed. However, in female mice, not having AKT1 did not make much difference.

“We found the difference between males and females to be so great it became the focus of our work,” Hoeffer said. “It was like night and day.”

Although there is much still to be learned, Hoeffer suspects that there are many other such key proteins having different effects or purposes in males and females.  

“To help more people suffering from mental illness we need much more knowledge about the difference between male and female brains and how they could be treated differently,” Hoeffer said. “This study is an important step in that direction.”

Source:Medical Xpress
Journal information: Helen Wong et al. Isoform-specific roles for AKT in affective behavior, spatial memory, and extinction related to psychiatric disorders, eLife (2020). DOI: 10.7554/eLife.56630

Categories : Cardiovascular Disease GenderTags :

Women’s Heart Attack Death Risk Higher than Men’s

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Compared to men, women have a 20% higher risk of death or heart failure after their first serious heart attack, according to an article in the journal Circulation. Prior research was unclear as to the difference in vulnerabilities to heart attack between the sexes.

The research focused on two types of heart attack; ST-segment elevation myocardial infarction (STEMI) and a less serious but more common type referred to as Non-STEMI or NSTEMI. Women were found to be at greater risk of death after either STEMI or NSTEMI attacks, although accounting for confounding variables narrowed this difference.

Women tended to be older (72) than men (61) at the age of their first serious heart attack, and had more complicated medical histories.

In the hospital setting, women were seen less frequently by a cardiovascular specialist (72.8%, versus 84% for men), prescribed fewer drugs and had fewer surgical procedures.

Lead author Justin A Ezekowitz, MBBCh, MSc, cardiologist and co-director of the Canadian VIGOUR Centre at the University of Alberta in Canada said, “Identifying when and how women may be at higher risk for heart failure after a heart attack can help providers develop more effective approaches for prevention. Better adherence to reducing cholesterol, controlling high blood pressure, getting more exercise, eating a healthy diet and stopping smoking, combined with recognition of these problems earlier in life would save thousands of lives of women—and men.”

Padma Kaul, PhD, co-director of the Canadian VIGOUR Centre, said that the next step is to address inequalities in provision of care: “Close enough is not good enough. There are gaps across diagnosis, access, quality of care and follow-up for all patients, so we need to be vigilant, pay attention to our own biases and to those most vulnerable to ensure that we have done everything possible in providing the best treatment.”

Source: Medical Xpress