A Commitment to Women’s Health


A commitment to women’s health and why it matters

In the papers recently was news of the launch by the Scottish Government of the country’s first women’s health plan. The plan, which was informed by the experiences of women, is described as ‘the first stage of a long term commitment to reducing health inequalities for women’. The plan recognises that women’s experience of illness can be different to that of men. For example, the symptoms of heart disease in women can be labelled as ‘atypical’ leading to delays in diagnosis and treatment rather than different symptoms in women being recognised as typical for women. This can lead to poorer outcomes for women with heart disease compared to men.

The plan also recognises and is committed to improving management of the specific health needs of women. These include endometriosis, miscarriage, and menopause as well as care of the pregnant woman. and plans better and targeted services, access to information and research funding to fill gaps in knowledge.

There are examples of the recognition of the unique needs of women particularly for heart disease. A women’s cardiology unit in Kentucky takes ‘a unique, comprehensive approach that provides individualised heart care for women’. 1 However these are the exception and not the rule. The British Heart Foundation is currently half way through a three year plan to tackle the ‘heart attack gender gap’ – in the UK a women is 50% more likely to receive an initial wrong diagnosis for a heart attack and ,even after a correct diagnosis, significantly less likely to receive life saving treatments.’ 2

One of the reasons for this disparity is the adoption of the male body as the standard when developing treatments for conditions and guidelines for medical diagnosis. Women’s bodies are different to men’s from a cellular level upwards and often respond differently to medication. However, much of the medication in use today was developed through research projects to develop drugs for treatment which excluded female animals and humans (because they have hormonal cycles and may become pregnant). This is slowly changing but many of the treatments and drugs in general use today were trialled in this way.

The plan also emphasises the need for ‘cultural competence’ particularly looking at the groups of women who may be put off seeking help due to lack of knowledge about what is available and worries about when seeking help is ‘appropriate’. In the UK black women are four times more likely to die in childbirth than white women.

Alyson McGregor, ED Doctor in the US, co-founder of the Sex and Gender Health Collaborative and author of ‘Sex Matters’ is working to change that from providing advice to women though her book to providing education for training and practicing medics. Her book is intended to empower women to ask the right questions about their treatment. She believes change will happen more quickly from the bottom up than from the top down. In the book she encourages women to ask when a drug is being prescribed ‘Is this the right drug/dose for me as a woman?’ ‘will I have different side effects?’ ‘will this affect my birth control?’ ‘should I take a different dose at different time in my cycle’. She acknowledges that many doctors won’t know the answer to these questions but thinks it should prompt them to go and find out “most people who go to medical school take an oath to lifelong learning. I hope doctors will say ‘Let me look’.

1. Gill Heart and Vascular Institute Womens’ Cardiology
2. The Guardian March 2020.
3. ‘Sex Matters’ Alyson McGregor MD

 

 

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