Women, Men Differ In Health

The more researchers study women's health, the more they are learning about how women differ from men in often surprising ways.

Consider these examples:

Women coming out of surgery wake up faster than men.

Women are more likely to suffer depression, gallstones, eating disorders, high blood pressure and irritable bowel syndrome.

Women produce less of an enzyme that breaks down ethanol in the stomach. Consequently, a female drinker will have a higher blood alcohol content than a man, even after allowing for size differences.

A liver transplant is less likely to succeed if the donor is female, especially if the recipient is male.

"Within the past 10 years, science has uncovered biological and physiological gender differences in virtually every organ and system of the human body," said Phyllis Greenberger, executive director of the Society for Women's Health Research.

Women live longer than men but often have poorer health and suffer more chronic conditions. Women account for about 59 percent of drug prescriptions, 61 percent of doctors' visits and 75 percent of nursing home residents, the health research society said.

But until recently, women were excluded from many medical studies. Researchers believed hormone fluctuations during the menstrual cycle would complicate studies. And they feared experimental drugs could damage fetuses if volunteers became pregnant.

Critics called such policies paternalistic. If a drug isn't tested on women, they said, there's no way to know if it's safe or effective for half of the population. Especially galling to critics were the first studies to show aspirin can prevent heart attacks. Women were excluded, even though heart disease is the leading killer of women.

In 1977, the Food and Drug Administration prohibited women capable of becoming pregnant from early-stage clinical trials. But in 1993, the FDA reversed itself and said such women could participate. The new guidelines included precautions such as pre-enrollment pregnancy tests and contraception.

In 1994, the National Institutes of Health issued guidelines requiring that women and minorities be included in clinical research supported by the federal agency.

Since then, "much progress has been made," said Dr. Vivian Pinn, director of the NIH's Office of Research on Women's Health.

There has been a big increase in published studies about women's health, Pinn said. And about 61 percent of the volunteers in clinical trials are women, according to the NIH's most recent figures from 1997.

"We see more research directed at women's health issues," Pinn said.

Perhaps the best example is the Women's Health Initiative, one of the largest medical studies in history. More than 161,000 women ages 50 to 79 are being studied to find the most definitive answers yet on how to stay healthy after menopause.

Researchers are examining risk factors for heart disease, cancer, osteoporosis and other diseases and investigating such issues as the risks and benefits of hormone replacement therapy.

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