RE: Sex discrimination in your medicine cabinet

[Guest guest]

Sex Discrimination In Your Medicine Cabinet

http://www.intelihealth.com/IH/ihtIH/WSIHW000/333/21291/351688.htmlt

June 24, 2002

(Society for Women's Health Research) -- The safety and

effectiveness of a number of widely used drugs including

antihistamines, antibiotics, and pain relievers varies depending

upon the sex of the user, according to results of an

ever-increasing number of studies.

" While still a fairly new concept, it is becoming increasingly clear

that physicians and patients should consider sex when

choosing a drug therapy, " said Phyllis Greenberger, MSW,

president and CEO of the Society for Women's Health Research

in Washington, DC.

In fact, at least four of ten drugs recently removed from the

market pose greater health risks to women than to men,

according to a 2001 U.S. governmental report. The majority of

these medications put women at an increased risk of

potentially fatal irregular heartbeats or arrhythmias. And other

drugs, still on the market, have also been shown to increase

the risk of arrhythmia in women. Studies have demonstrated

that some antibiotics, heart medications and psychiatric drugs

are associated with an increased incidence of heartbeat

irregularities among women.

For other medications, the effectiveness, not safety, changes

depending upon whether a man or woman is taking the drug.

For example, University of California at San Francisco

researchers led by Jon Levine, MD found morphine-like

painkillers called kappa opiods provide more powerful and

long-lasting relief to women than men. In fact, at some doses

kappa-opiods can actually make the pain worse for men and

afford phenomenal pain relief to women, according to Dr.

Levine.

General anesthesia, drugs that render a person unconscious

during surgery, also can behave differently in men and women.

At least two studies suggest women may be less responsive to

anesthesia than men. The research shows that women wake

up 3 to 4 minutes faster than men after taking the same dose

of medication per pound of body weight and tend to suffer

more side effects.

Why do men and women respond differently?

Exactly why drugs affect men and women differently remains

unclear. And in fact, the answer may turn out to be different for

every class of medication. Nonetheless, research points to a

number of possible mechanisms for these sex-based

differences.

The varying rate at which men and women metabolize drugs

may be involved. Studies show that some liver enzymes

involved in processing pharmaceuticals are more active in

women than in men. In addition, evidence suggests that the

amount of drug that actually gets into the cells of the body may

vary among the sexes partly due to differences in drug-

transport mechanisms.

Anatomy also affects the way drugs are processed. On

average, women have a lower body weight, smaller organ size,

reduced blood flow and a higher proportion of fat compared

with men. Overall differences in hormonal activity between the

sexes affect the way drugs are processed, absorbed and

cleared by the body as well.

In addition, organs seem to function differently depending upon

whether they are inside a male or female body. Evidence

suggests that " female " kidneys are slower to act than " male "

kidneys. In addition, liver functioning, which can influence the

incidence of adverse events, may vary among men and women.

What's more, the rate at which drugs pass through the

gastrointestinal system, which affects how much is absorbed

into the bloodstream, seems to differ among the sexes.

Educate yourself before taking a new drug

According to Sherry Marts, PhD, scientific director of the Society

for Women's Health Research, " Despite mounting evidence

showing that men and women respond differently to the same

drug, most physicians and their patients are still not aware that

sex matters when prescribing medications. "

Why the lack of awareness? One of the reasons is that the

Food and Drug Administration and the pharmaceutical industry,

groups responsible for drug labeling, only recently began to

analyze safety data by gender. In fact, reporting of

gender-based data analysis in medical journals, while

increasing, is still not routine practice, according to Dr. Marts.

This shortcoming of the system keeps gender-specific risks as

well as benefits buried beneath heaps of data.

So what can you do to protect yourself from potentially harmful

drugs? Women must demand that their physicians and

pharmacists fully inform them about the pharmaceuticals they

are prescribed. Before leaving the doctor's office or pharmacy,

make sure you have answers to the following questions:

Are there known sex or gender differences in how the

drug works?

What are the benefits of this drug?

What are the common, rare, and serious side effects?

Are there any safer alternatives to this drug?

Can the prescription interfere with other medications I

am taking?

Does the drug have any serious interactions with other

drugs?