His health, her health

Medications affect women differently than men but you wouldn’t know it from prescribed drugs.

Take the sleep drug Ambien, for example.  After the drug had been placed on the market, it was found to have a dramatically different effect on women. The U.S. Food and Drug Administration found that five times as many women were experiencing driving impairment eight hours after taking the drug. As a result, doctors now prescribe “sex-specific” Ambien which is a lower dose. In Canada the drug is sold under the name Sublinox. But sex-specific prescriptions are the exception rather than the rule.

Doctors prescribe the same drugs for men and women even though they have only been tested on men. Researchers have known about this weakness of drug trials for a long time. Dr. Marcia Stefanick, professor of medicine at Stanford University explains:

“Indeed, drug metabolism, tolerance, side effects and benefits differ significantly between the average man and woman for many widely prescribed medications, with women having a 50 to 70 per cent higher chance of adverse reaction (Scientific American, September, 2017).”

Despite knowing of the difference, few women are included in trials. In a review of 258 trials of cardiovascular treatments, only 27 per cent of the participants were women, and of those only one-third were reported by sex.

Despite years of “Red Dress” campaigns, most people and many physicians still think heart disease is a man’s disease. They are surprised to learn that heart disease is the number-one killer of women, far exceeding deaths from breast cancer. Physicians are less familiar with the symptoms of heart disease in women. In men, the main symptom is chest pain, whereas in women symptoms can include back pain, nausea, headache and dizziness. Women’s symptoms are seen as “atypical” because men don’t report them.

Chauvinistic blindness excludes half the population.

Heart disease also involves the build-up of plaque in the arteries. Men, and older women, tend to suffer from a blockage in one location. Younger women are more likely to have diffuse plaque along the entire artery with the same effect. Because a local block is not found in a younger woman, she could be diagnosed as “free from of heart disease” even though at risk of a fatal heart attack.

The other sex is sometimes overlooked in trials. Men are often neglected in studies for ailments thought to be unique to women. Osteoporosis, characterized by reduced bone strength, is considered a woman’s disease because white women are twice as likely to suffer a bone fracture as white men. As a result, fracture prevention trials include few men. But one-third of hip fractures are in men –and they have worse medical outcomes than women

Men are more susceptible to viral, bacterial, parasitic and fungal infections than women; the exception being sexually transmitted infections such as HIV and herpes which is more prevalent in women. However, women’s resistance to infection comes at a price. Women constitute 70 per cent of cases where a robust immune system attacks her own body in autoimmune diseases.

Professor Stefanick lauds the Canadian Institutes of Health Research for promoting the inclusion of sex and gender in drug trials and wishes the U.S.  Government would do the same. She adds:

“We need further mandates, through policy and funding restrictions, to ensure that female biology makes it into textbooks and testing protocols.”

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Guys, don’t despair when she earns more that you.

The male ego is attached to being the chief breadwinner. It’s a fictitious remnant of the cave man’s role as hunter and provider. The stereotype was perpetuated when men returned from World War II and replaced women in industrial jobs.

  image: Mother Nature Network

With the decline of industrial jobs in North America, and with more women getting a post-secondary education, women are positioned to move into professional jobs. Over the past four decades, full time jobs have increased for women while decreasing for men.

Not just men who have lost industrial jobs worry. Alan, 40, is a successful accountant and his wife, a doctor, earns more than him. At first, Alan was embarrassed by his wife’s breadwinner status. “It was a male ego thing,” he told Levo.com. “There was just something about it that made me feel inadequate. I knew it was illogical.” After simmering for years, the issue came to a head and the couple sat down and talked about the toll that wage imbalance was taking on Alan’s self-esteem. “She helped me gain perspective. There are so many more important things to worry about in life than who makes more money.”

Wage inequity weighs heavily on wives, too. Alyson Byrne and Julian Barling investigated the toll it takes on relationships in their study published in Organization Science. “You have to imagine that a lot of these women, particularly in senior executive or high-status roles, are very smart and very ambitious. We know from management studies that they’ve had to work that much harder and face that many more barriers,” says Dr. Byrne.

Byrne and Barling studied 200 high-achieving businesswomen in Canada in relationships where 44 per cent of husbands made less than they did. Many wives reported a personal loss of status when responding to statements such as “My spouse’s job impedes my future career success;” “I am embarrassed when my spouse accompanies me to work events;” “My spouse’s work makes me look bad.”

This “status leakage” manifested itself in marital dissatisfaction and instability. However, stress was reduced in relationships where the husband was willing to provide an increased roll in child care and household chores.

Frank discussions between partners are critical in reducing martial stress. Men need to lay their own insecurities bare. “The whole time,” said Alan, “I thought I was doing a pretty good job of hiding my feelings, but it turns out she knew and was internalizing my resentment into guilt. That about broke my heart.”

Left to fester, wage disparity can be toxic unless dealt with openly. Unemployed men become confused about their role. They become more violent and controlling. Drug and alcohol abuse increase; so do suicide rates.

Wives need to be frank, as well. Dr. Byrne found that wives are not angry or disgusted, but that they feel a sense of loss. “They are just feeling loss or wishing that they [husbands] were at a similar level to their own, but it creates these long-term impacts on their marriages.”

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I was going to write a column about Omar Khadr’s award of $10.5 million by the Canadian government but I don’t have much more to say than I did in my column, nine years ago, in the Kamloops Daily News.