One common misconception in the field of medical care is that heal thcare is not different for men and women. The latter have fundamentally different medical needs because of two basic biological functions: reproduction and menopause. Over the past decade, crucial health differences between men and women have been explored and confirmed in detail. Subsequently, scientific studies have been designed to better understand the importance of gender differences with the aim of translating this knowledge into improved medical care and treatments. Dr. Lina Bassar is a consultant in Internal Medicine and Deputy Director of the Department of Medicine at King Faisal Specialist Hospital and Research Center (KFSH) Jeddah and she told Saudi Gazette that medical experts in the past never realized that gender differences can affect treatment outcomes. Most scientific studies were done on men and the findings were applied to women as well. Today, Dr. Bassar added, medical experts are aware that gender affects the prevalence and severity of a wide range of medical disorders and conditions, at every stage of life. These differences – listed below - are at a cellular level, affecting the entire body. Cardiovascular diseases • Heart disease is the number one killer of women. • Risk factors include hypertension, diabetes, high cholesterol, obesity and smoking. • Heart attacks strike women 10 years later than men on average. • Women with cardiovascular disease are often asymptomatic - or present with atypical symptoms - thus misdiagnosed and untreated. • Even when diagnosed, women are usually treated less aggressively. • Women are more likely than men to have a second heart attack within a year of the first one. • Women with heart disease are 50 percent more likely to die from it than men. • More women than men have a stroke in mid-life, and they have a poorer quality of life after a stroke than men. Lung cancer and smoking • World-wide, female teenagers today smoke at higher rates than male teenagers. • Today, women are seen publicly smoking cigarettes and shisha in all major Arab cities. The “shisha culture” has been successfully exported to major cities in Europe and America. • Smoking lowers estrogen levels and increases the risk for pregnancy complications, as well as the risk of early menopause. • Smoking has a more negative effect on cardiovascular health, lung cancer, and cervical cancer in women than men. • Women are reportedly less likely to be counseled by their doctors to quit smoking than men, and have more severe withdrawal symptoms. Breast cancer • Breast cancer affects one in eight women during her lifetime. • Saudi women are diagnosed with more advanced breast cancer, and at a younger age than their American and European counterparts. • Guidelines for breast cancer screening have been revised recently to include women in the decision making process. Breast MRIs may be indicated for select high-risk women. • There have been ground-breaking advances in the treatment of breast cancer recently, which have made a profound improvement on the treatment outcome. • A new molecular test can determine the likelihood of breast cancer returning after treatment. Gynecologic cancers • New vaccines for the number one cause of cervical cancer - the Human Papilloma Virus - have been developed. These are only effective before exposure to the virus. • Screening for cervical cancer has greatly improved with the liquid cytology technique, leading to appropriate treatment. • Ovarian cancer has long been considered a silent killer. Recently, new treatments have been developed for early ovarian cancer which bring new hope. This has led to new guidelines for screening and medical management. Thyroid disorders • Thyroid disorders are five to ten times more common in women than men. • More than half of the cases in women go undiagnosed. • If left untreated, thyroid disorders may increase the risk for heart disease, infertility and osteoporosis. Rising obesity rate Due to recent changes in the environment and lifestyles, females even as young as four are at greater risk for obesity. This explosion of childhood obesity increases their risk for developing medical problems later on, including cardiovascular diseases and type 2 diabetes. Mood Disorders • Women are afflicted with depression twice as often as men. Part of this is related to the brain hormone, serotonin. • Approximately a quarter of women suffer from depression at some point in their lives. • Less than three out of ten depressed women seek treatment. Without treatment, the frequency and severity of symptoms tend to increase over the years. • Women are twice as likely as men to have a sleeping disorder. • Women are affected twice as frequently as men by panic attacks. • Eating disorders are ten times more common in women than men. Medication • Women wake up from anesthesia more quickly than men. • Women experience more effective pain relief from men to certain pain medications such as opiates. • Women can experience different reactions to common medications such as antibiotics and antihistamines than men. Auto-immune disorders Autoimmune disorders such as lupus, and rheumatoid arthritis affect women four times more often than men. Oral health Women's oral health needs are affected by different stages of her life. These changes are often affected by changes in hormones. During puberty, menses and pregnancy, estrogen may lead to swollen, more sensitive gums. What women can do Every woman should be aware that there are steps she can take to improve her health. By eating right – both quality and quantity are important - exercising and avoiding smoking, women can reduce the risk of many diseases such as heart disease, diabetes and lung cancer occurring. Every woman should take responsibility of her own health by getting medical information from trusted sources and implementing these changes in her life. “When she prepares for a medical visit, she should go armed with a written list of questions,” advised Dr. Bassar. “She should ensure that she gets the counseling, screening and treatment she needs. Although these may not be covered by her insurance, they are nevertheless important. Women often decide to forego the discomfort or inconvenience of a screening, smear or mammogram, forgetting that an ounce of prevention is worth a pound of cure; often unaware that a delay in diagnosis can impact the outcome of even the best treatment she may later seek.” Dr. Bassar also indicated that it is important for women to seek medical care before marriage and before the contemplation of pregnancy. Indeed, many countries have premarital testing requirements. However, these are often a small component of what may be medically recommended and each couple should consult their doctor to see if additional tests are needed. In addition to a few important tests, folic acid and iron may be prescribed before pregnancy as a preventive measure. Although most women who consume a healthy diet do not need vitamin or mineral supplements, there are certain medical conditions and treatments where supplements may be indicated. It is well known that adequate calcium and vitamin D consumption throughout a woman's lifespan is important to prevent osteoporosis, and women should ensure they consume adequate amounts of each from their diet. A woman's lifestyle will not only impact her, but her whole family since women are major decision-makers and role models in the family, particularly when it comes to lifestyle and nutrition. What she decides to place on the table affects what her family eats. When her children see her eating healthy food in moderation, and exercising, they are as likely to follow her example, as they will if they observe her drinking sweetened beverages, snacking on fatty packaged food and smoking. “Exercising is not just for those who wish to lose weight, or look good, but at least 150 minutes of exercise a week is necessary to preserve good health,” concluded Dr. Bassar.
