government allowed unmarried women legal access to birth control. Think about that. If you were a single woman in 1970, it was actually illegal for you to take charge of your reproductive system. In 1989, when I was seventeen, Congress allocated funds specifically for the study of women’s health. By the 1990s, 30 per cent of ob-gyn specialists were women, up from just 7 per cent in the 1960s. Their efforts, along with the efforts of countless other doctors and scientists, increased the focus and attention on women’s health, including the health of older women, setting the stage for the healthcare we will all receive in the years to follow.
A BRIEF HISTORY OF WOMEN’S MEDICINE IN THE UNITED STATES
1916:
Margaret Sanger opens the first birth-control clinic in Brooklyn. Ten days after it opens, the police shut it down and put her in prison. Contraception is illegal.
1916:
Planned Parenthood is founded.
1920:
Women get the right to vote
1960:
The birth-control pill is approved by the Food and Drug Administration (FDA).
1960s:
The women’s health movement begins.
1963:
Congress passes the Equal Pay Act.
1967:
The National Organization for Women (NOW) is launched.
1971:
Ten per cent of medical students are women.
1972:
Eisenstadt v. Baird establishes the right of unmarried women to use the birth-control pill.
1973:
Roe v. Wade gives women the option of a safe and legal abortion.
1989:
The Supreme Court allows states to make abortions in public hospitals illegal.
1990:
Congress passes the Women’s Health Equity Act, and dedicates federal funds to research on women’s health.
1993:
Congress mandates that scientists must include women in clinical trials in order to be eligible for federal funding.
1996:
Perimenopause is defined by the World Health Organization.
2013:
It is reported that women taking the sleep-aid drug Ambien fall asleep while driving. At the urging of the FDA, the manufacturer of the drug cuts the recommended dosage for women in half.
2014:
The NIH mandates that female cells must be included in all federally funded medical studies.
HOW YOUR SEX AFFECTS YOUR DRUGS
During our visit to the NIH, we spent valuable time with Dr Janine Clayton, the director of the NIH’s Office of Research on Women’s Health (ORWH). The ORWH has been around for only about fifteen years. Its mission is to promote women’s health initiatives in the medical community, educate the public about issues related to women’s health, and fund programmes that explore the role of sex and gender differences in medicine. Dr Clayton and her team have been working for years to encourage her colleagues at the NIH to prioritize women’s health issues and needs in their research.
We asked Dr Clayton some questions about sex and drugs, and she told us that your female sex affects the efficacy and the potency of the drugs you take. This is especially important for Americans because, as a nation, we take a lot of drugs. But while women are being prescribed more medications than ever before, not all of those medications are properly tested for use by women. And it has been proven again and again that drugs don’t affect men and women the same way.
When we swallow a pill or get an injection of a vaccine, the medicine travels throughout the body via the bloodstream and is distributed to our tissues and organs. However, medicines affect women differently than they affect men for several reasons:
WE HAVE DIFFERENT ORGANS:
A female liver metabolizes drugs differently than a male liver.
WE HAVE DIFFERENT BODY WEIGHTS:
Men are usually bigger and heavier, and have bigger organs, requiring higher dosages of drugs than a smaller woman does.
WE HAVE DIFFERENT BODY COMPOSITION:
Women store more body fat than men do, and some medications are attracted to fat tissues. When a woman takes those drugs, they linger longer in our bodies, and their effects linger too.
WE HAVE FEMALE HORMONES:
Our hormones influence how our bodies process medications. Factors like oral contraceptives, the menopause, and postmenopausal hormone treatment could also affect how we respond to drugs.
Painkillers and anaesthetic drugs are absorbed and metabolized in a unique way by women, who have a 30 per cent higher sensitivity to neuromuscular blockers and in turn need smaller doses than men. Research has shown that males and females do not respond in similar ways to opioids like OxyContin, Percocet, and Vicodin. Some medications, like Valium, exit our bodies faster than they do men’s bodies. Others linger longer. In animal studies, males and females also react to withdrawal in different ways. It is crucial for us to be aware of these differences, because as a nation we are currently experiencing what the NIH has termed an “epidemic” of women overdosing on painkillers, with a dramatic rise in the number of women dying every year. And the highest risk of death from an overdose of prescription painkillers isn’t found among the young – it is found among women between the ages of forty-five to fifty-four.
But all this information is relatively new, and that’s because for a long time, pharmaceutical companies tested their drugs only on male cells, male animals, and male humans. This practice has led to a mountain of data that isn’t very accurate when it comes to prescribing drugs for women. Many of the studies we rely on today faithfully and obsessively record variables like time and temperature, but overlook the small detail of sex. Even when it comes to animal testing for drugs being developed to treat illnesses that predominantly affect women, sex isn’t always taken into consideration. That goes for human female subjects, too. Since hormones fluctuate over the course of a month, tests that use females can be a lot
