ISS
Epidemiology for public health
Istituto Superiore di Sanità
Epidemiology for public health - ISS


 

What is it?

Only recently are gender differences being fully acknowledged in medicine, drug trials and scientific research. Medicine has historically maintained an androcentric bias, and attention to women’s health has solely focused on aspects related to reproduction.

 

The World Health Organization (WHO) defines Gender Medicine, or rather Gender-specific Medicine, as the study of how (sex-based) biological and (gender-based) socioeconomic and cultural differences influence people’s health. A growing amount of epidemiological, clinical and experimental data shows significant differences in the development, progression and clinical signs of conditions that are common to men and women, the adverse events associated with therapeutic treatments, the response to such treatments and nutrients, and in lifestyles. Gender also accounts for major differences in access to healthcare.

 

Some differences

In addition to being socially disadvantaged compared to men, women tend to become ill more often, take more medications and are more likely to experience adverse reactions. Women in the Western world also live longer than men, but healthy life expectancy is similar for the two sexes.

 

It has been clearly demonstrated that several determinants (genetic, epigenetic, hormonal and environmental) account for differences between male and female cells. As a result, guidance has been provided at the global level to ensure that all phases of experimental research are properly conducted. This is because, for a long time, clinical studies enrolled predominantly male subjects, pre-clinical in vitro studies (on cell lines or isolated cells) failed to include information on the sex of the organism from which the cells originated, and in vivo studies (on experimental animals) only used male animals.

 

A gender-based approach to clinical practice can therefore help promote appropriate and personalized care, thus generating a virtuous cycle which translates into major savings for the National Health System. Gender Medicine is not an independent branch of medicine, but its interdisciplinary dimension should permeate all areas of medical science to help understand how sex and gender influence human physiology, pathology and pathophysiology, i.e. the development of diseases and their symptoms, as well as their prevention, diagnosis and treatment in both men and women.

 

A holistic approach to health involves a “patient-centred” focus and “personalized treatments” to provide appropriate care. For the correct diagnosis and management of a condition, the biological sex of the patient should therefore be considered, as well as other parameters, such as: gender identity, age, ethnicity, level of knowledge, religious beliefs, sexual orientation, social and economic conditions.

 

Publication date: 8 September 2021