“Communities and countries and ultimately the world are only as strong as the health of their women” Michelle Obama.
When it comes to medical and drug research and treatment, it might not surprise you to know that women yet again get the short end of the stick compared to men. It’s not that medicine is inherently misogynistic, rather it is something about women that makes them less than desirable to use as research subjects. I speak of course of the menstrual cycle. While men hormonally ‘cycle’ each day, women go through a complex hormonal cycle every 28 days. One consequence of the menstrual cycle is that women hormonally, biochemically, psychologically and even physiologically change each week throughout the month. Ask any man who has lived with a women whether they have Premenstrual Syndrome (PMS), and most will say yes. However, regardless of the fact that 90% of women suffer PMS (45% of the worlds human population) it rarely gets any serious funding for research because according to medical science, PMS does not apparently exist.
A wide range of Symptoms of PMS are mood swings, period pain (dysmenorrhea), anxiety, painful breast tenderness, bloating, acne, headaches and migraines, excessive blood loss in severe periods, stomach pain, and sleep problems. There are few treatments or real understanding of the underlying causes, and apparently no rush to find out. OB-GYNs are more preoccupied with pregnancy, fetus development, and acute health problems (e.g., cancer) and for reasons to be given, use little effort to deal with PMS. While some treatments do exist for some female sufferers, most do not work for over 40% of women with PMS problems. Why this is, is apparently not a mystery that medical science is willing to fund research finding out.
We can gauge what is important when we note that five times as much research funding goes towards Erectile Dysfunction (ED) suffered by 5-18% of men under the age of 70, which has a wide selection of medical treatments available. And without sounding glib, being unable to get your pecker up is more of an embarrassing inconvenience than a medical emergency, unless you take too many pills to keep your pecker hard for too long. Notably, around the globe, during the course of their premenopausal lives (average 10-50 years of age) women will suffer some 12 years of ill-health attributable to PMS. If 90% of men suffered over 20% of their lives in ill-health, I feel sure it would be a major focus of medical research with extensive data available to understand why.
Despite the growing advances in female rights occurring during the feminine revolution of the 1960-70s some things went backwards. Medical drug research being one of them. To further emphasize how women have been excluded, and that men knew about the extent of biological differences, in 1977, the US-FDA (Federal Drug Administration) released a policy recommending that women of childbearing age be excluded from drug trials. The female period was to put it mildly as inconvenient as the ‘Placebo effect’ (e.g., see earlier post). It wasn’t until 1993 that the NIH Revitalization Act required the US-FDA to reverse its 1977 guidance, now officially mandating the inclusion of women in research unless there is a justification for exclusion (for example, if the disease only affects men, e.g., prostate problems) in phase 1 trials.
Big Pharma had long known that males and females have many differences in how they reacted to drug metabolism (pharmacodynamics and pharmacokinetics). Indeed, females are more likely to experience adverse drug reactions than males, but there was no data understanding why. The given reason for the exclusion was the fear of possible reproductive risks for women of childbearing potential and the belief that the menstrual cycle would skew the results making the trial drugs look less effective.
Even using just males, there is a big difference in how individuals overall react to drugs! Today, some 95% of the available medical drugs (many from the pre-1993 ruling) were authorized for men and women despite women not being part of the trial population, so preclinical data for adverse effects on women is missing. Many dosage recommendations are often the same for both sexes and even when adjusted for body weight, do not take into account how the drugs are potentially metabolized differently by each sex. From more recent studies, we now know that drugs tend to linger longer in the blood and tissues of women differently than they do in men, and that women’s organs generally metabolize drugs at different rates. “Women’s health needs to be front and center – it often isn’t, but it needs to be” Cynthia Nixon.
I could go on about how half of the world’s population has been sidelined and ignored for millennia. It not new to women and many men see it as a natural order of things. That is just a mindset, and all mindsets can be changed through mindfulness and a willingness to challenge status quos. The world we live in has designed by men for men with the assumption that it will fit women.
Even musical instruments do not fit most women. Statistics show that women suffer from more strains and injuries to the hands, arms and neck when using musical instruments. The piano for instance with its standard keyboard is designed for an average hand of 9-9.5 inches of handspan. The holes on most wind instruments are similar. The average women has a handspan of 8-8.5 inches. We know women tend to be smaller and lighter than men, but that hasn’t ever been considered when it comes to most things we use.
Any man who has ever gone clothes shopping with a woman (and not fallen asleep), will know why women have a hard time. It’s not just the coordination aspect (which most men are totally clueless about) but about fit. Men tend to have a similar frame structure – hence men tend to have small, medium and large with long and large options. Women’s sizes vary considerably. Yet, when women are in the services (e.g., medical and military) uniforms tend to be male focused, and protection devices so uncomfortable as to be almost useless to women in some cases. (One-piece jumpsuits with fly’s just one example, and safety vests that cannot accommodate large breasts as another.)
Most women are not as physically strong as men – its an inherent consequence of male and female physiques. Having said that, the amazing rock climber, Lynn Hill, can outclimb most men and she still looks feminine. So, trying to stereotype either gender is silly. Yet in most situations where men set up care and safety protocols, the data (when available) shows that women get the sort end of the stick yet again. Usually because of male assumptions and where women are not consulted about their needs.
Male architects have designed buildings for ever, but ask any women about building functionality and you will get differing stories on how functional a building is to their needs. And then ask any pregnant women, or mother hauling her children around with her, and you will hear stories about how male functionally designed buildings do not work well for women. If we collected data and then separated it into sex-disaggregated data we would learn a lot.
And we haven’t talked about the physical and psychological abuse that women suffer globally from male patriarchal systems. The gender-neutral assumptive nightmare is heightened in times of social unrest, war, and natural disaster. Refugee camps that are hard for everyone, are nightmares for women who face greater negative effects from sanitation, sexual harassment, and violence problems. And it isn’t just in refugee camps that women face these problems every day.
Women have a strength that is largely ignored. They tend to be more intuitive and innately tuned into natural rhythms of the world. The menstrual cycle is probably a large part of the reason for this. But they also see the world differently when they are not forced to view the world from a male perspective (e.g., in the economic or academic work environment). It is not about creating a female-matriarchal world either. It’s about creating a world where men and women have an equitable voice in how it is designed and functions to serve their needs.
Within most indigenous systems, men and women have their roles – men tend to do the heavy strength work while women tend to do the more home related work, but both are part of the caring and nurturing aspects of the family and community. While men are often the ‘chiefs’ (not always) they do not make decisions without consulting the ‘mothers’ who exhibit broader wisdom than the men and often have strong veto powers. The women have a voice that is not only heard but also listened to.
And it doesn’t end here with seeing ‘the invisible women.’ In indigenous cultures, both genders know and listen to another voice that is even more important – that of the natural world. It is not a voice that interacts in any discussion, but one that provides guidance and teachings in how it works as a complex interactive system. This is yet another ‘voice’ that ‘modern’ humanity has ignored for far too long.
Androgyny
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