Gender Medicine: a new therapeutic approach in diseases evaluation

What does Gender Medicine mean? What is the paradigm shift we are moving to which deals with a new gender-specific approach of people’s health?

When it comes to Gender Medicine, we refer to having a new therapeutic approach in diseases evaluation.

The main purpose is to guarantee every human being, man or woman, the appropriateness of the treatment. Indeed, it’s not a medicine about “men or women”, but the term “gender” is considered in a broader sense. It goes further beyond the difference between sexual characters and it includes also and especially many unique features deriving both from men and women’s different anatomy and physiology and from factors concerning environment, society, education, culture and psychology of the individual.

In the last 20 years Gender Medicine aroused increasing interest, after that for a long period of time the difference between men and women had been considered a secondary factor or had been ignored in the development of new pharmacological solutions and in the treatment and diseases prevention techniques identification.

During the last edition of the Trento Economics Festival (1-4 June 2017) on the “Unequal Safety” (La salute disuguale), Dr. Giovannella Baggio held a speech about “Men and women: the unequal treatment” (Donne e uomini: la cura disuguale) where she dealt with this topic.

Gender Medicine means understanding how diseases in all organs and systems occur in both genders, and in particular evaluating gender differences with respect to the symptoms of the diseases, to the necessity of different diagnostic paths and results interpretation, to the differences in drugs response, to the necessity of using different drugs, or even to the differences concerning the prevention of all diseases. Therefore, Gender Medicine is not a new specialty, but a necessary and deserved interdisciplinary dimension of the medicine, which aims at studying the influence of sex and gender on physiology, physiopathology and human pathology.

Dr. Giovannella Baggio is the founder of the first National Study Centre for Health and Gender Medicine, full professor with a Chair in Gender Medicine at the Department of Molecular Medicine of the University of Padua and Director of the UOC of General Medicine of the Padua Hospital.

Dr. Baggio is one of the main Italian experts in the sector and member elected of the International Society of Gender Medicine Executive Committee and claims that it’s necessary to study again the diseases that daily affect men and women: cardiovascular and infectious diseases, tumours, metabolic and neurological disorders and all the specializations, even surgical, because Gender Medicine deals with all medical branches.

In the paper “From Gender Medicine to gender-specific medicine” some emblematic examples that clarify what we are talking about and give concrete expression to the necessity of a new medical approach are provided.

Life expectancy:
In Italy life expectancy is 79.9 years in men and 84.6 in women (ISTAT, 2014). Actually, healthy life expectancy is equal in both genders: the five years of difference are a period of a sick and disabled life, especially for the consequences of the cardiovascular, osteoarticular and neurological diseases (dementia and depression).

Heart attack:
In the last 40 years mortality by cardiovascular diseases (myocardial infarction, stroke) decreased sharply in men but today heart attack is the main cause of death in women. Paradoxically, it is thought that these diseases mainly affect men so feminine gender is nearly absent in epidemiological trials used to describe risk factors and prevention, but also heart attack and therapy symptoms. Furthermore, women can have very different symptoms from men when they are affected by a heart attack such as neck pain or back pain. Some of them have no pain, but they feel nervous, anxious and have light dyspnoea.

These atypical symptoms lead rescuers not to hospitalize patients and not to send them to the First Aid Red Zone; so mortality rate in women is always higher than in men.

Where are we today with gender medicine in Italy and abroad?

The World Health Organization (WHO) has included Gender Medicine in the Equity Act.
Cardiology is the most advanced branch in this sense, so much so that the American Heart Association published the guidelines for the prevention of cardiovascular diseases in women. However, this is the first and sole example.

At the European level and even more in Italy, there is still a long way to go. Indeed, the Italian National Institute of Health has a Department of Gender Medicine that is continuously engaged in research activities and many regions inserted Gender Medicine in their Regional Health Plan.

The Italian Parliament voted unanimously a motion on Gender Medicine and two proposals that state the necessity for Gender Medicine to enter the Core Curriculum of the Italian Medicine School and also the Specialization Schools.

Dr. Baggio ends her paper by claiming that: “It’s incredible that at the beginning of the third millennium we are called to change our mind about medicine: we must complete our knowledges and we must apply in all branches a gender-specific medicine.
The term Gender Medicine is misleading and it has to be avoided because it seems to refer to a parallel medicine system. We all must found and put into practice a gender-specific medicine.”

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