SXSW 2022: Why empowering female patients is key to addressing gender gaps in care

AUSTIN, Texas—While health and medicine have made great, innovative strides in developing new therapies and models of care, there's still plenty of work to be done to ensure those innovations work for women, experts say.

In clinical trials, for instance, men are significantly oversampled, and this can lead to missing evidence on how a drug may interact differently in a woman's body then in a man's, said Alyson McGregor, M.D., a professor of emergency medicine and director for the Division of Sex and Gender in Emergency Medicine at the Warren Alpert Medical School of Brown University, at a panel at South by Southwest this week.

McGregor said an example of this in action is the sleep aid Ambien. Men and women were for decades prescribed the same doses of the drug before it was discovered that women metabolize it differently, leaving them more likely to wake in the morning with levels in their system that could impair driving.

The Food and Drug Administration recommended different dosages for men and women in 2013, she said.

"The gender bias that we're talking about is really systemic," McGregor said.

The knowledge gaps extend beyond drug development, she said. As an emergency physician, McGregor regularly treats patients who are admitted to the ER with symptoms of a potential heart attack. But men and women often present differently, she said.

Men commonly report a sense of a heavy weight on their chests along with pain that shoots down the arm. Women, however, are more likely to describe symptoms such as shortness of breath, indigestion or fatigue. In the latter case, these symptoms can be attributed to anxiety or acid reflux, which could lead lead a physician to potentially miss a heart attack, McGregor said.

One of the challenges in addressing these gaps is a lack of clear ownership for women's health, said Lisa Larkin, M.D., founder and CEO of Ms. Medicine, which aims to educate clinicians on women's health, said during the panel. Younger women receive effective care from an OB-GYN, and women at Medicare age typically transition well into a primary care-led team.

However, there's a significant gap on who should "own" healthcare for women ages 40 to 60, she said. In this age group, many women are no longer thinking about having children but do need be receiving regular screenings as their risk of certain cancers and other conditions is elevated. They may also need appropriate support as they navigate menopause, Larkin said.

"We are just simply failing women, particularly midlife women," she said.

A key solution in addressing these sex-based gaps and biases is to empower female patients to ask questions and take a more active role in their own care. Many women put the health needs of others—a spouse, children, parents or family members who require caregiving—over their own needs.

That's why HealthyWomen launched to put crucial health information directly into the hands of women, CEO Beth Battaglino, R.N., said during the panel. The site offers a slew of clinically backed information on conditions women may be managing, as well as offers a way for them to share their own experiences navigating the healthcare system.

"We are our own best advocates," she said.

Women should be encouraged to ask questions of their doctors and push back if their concerns are dismissed. And, if they can't get the answers they need, they should feel that they have the power to switch to a different doctor if necessary. McGregor said studies have shown that women who are treated by female physicians tend to receive better care.

She added that female patients who bring these concerns up with a doctor may also push them to be thinking about these issues more in the future with other patients.

"I think we all have a sphere of influence," she said. "I really invite you and empower you to bring this topic up."