Monday, November 28, 2016

Should medical research take in gender and sex?

Wait a hot one--aren't sex and gender the same thing? No, according to Cara Tannenbaum of the University of Montreal and Janine Austin Clayton, NIH.

These two have written a Viewpoint article in JAMA making a case for dividing research into sex and gender.

By their definitions, sex refers to biology, anatomy and sex hormones. Gender, they say, encompasses social, behavioral, and cultural interactions and the roles between men and women.

Too often, they say sex and gender-specific results are missing in evaluating therapies--because scientists trained last century learned to conduct research mostly in men, believing these results would also apply to women.

But now we know women metabolize drugs differently than men. Sick women may also be pregnant--not segregating results may mean not treating women safely.

Reasons to separate results by sex and gender:

--These results may be hidden in combined results.

--To provide raw material for meta-analyses, a way of combining results to see if results are the same or different across diverse populations of men and women.

--To avoid the need to repeat a trial to check for gender-specific matters that arise.

This brings us to dosage--same for men and women? The FDA is already recommending lower doses of some drugs for women, so no, this probably needs to change.

Also, Addyi, a drug to boost sexual desire in women, was tested for compatibility with alcohol on 23 men and two women--even though it was FOR women. Even in men, the drug increased the likelihood of fainting, dizziness and low BP.  The risk was probably greater for women.

When will the research be 50/50 men and women? Stay tuned--some journals have already adopted guidelines in this direction.

About time! Stay tuned. And stay skeptical.

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