Passionate About Sex

Jun 02

Recently, I gave the commencement address for the Wayne State University School of Medicine. Soon after I received this invitation, I asked some of my colleagues if they could recall their commencement speakers and their speeches. Uniformly, none could remember! So, in order to not join that esteemed collection of forgotten addresses, they suggested that I highlight what I am passionate about, such as SEX.  Of course, when I first mentioned “sex” in my speech, I knew what most people were thinking, and that it would have made for a most entertaining and memorable speech. However, I had something else in mind that I hoped would be equally intriguing.

I’ve been interested in the impact of “sex,” which connotes the biological and physiological characteristics that define men and women, and “gender,” which refers to the psycho-social component of health, ever since the NIH Revitalization Act was passed in 1993. This law requires the inclusion of women and minorities in phase 3 clinical trials and analyses by sex, gender and race.

It literally took an act of Congress to begin to address the inequities in biomedical research and health care that have harmed the lives of women through incorrect diagnoses and misguided treatments. For example, women present with different symptoms for cardiovascular disease compared to men. Women may also have microvascular or small coronary artery blockages that could be missed by angiography, and they even have higher mortality rates in the hospital and during the first year after a heart attack. In regard to Alzheimer’s disease, two-thirds of 5.1 million people suffering from this devastating disease are women, and it is not just because women live longer. The impact of sex differences in gene expression may be a potential explanation.

During the week of May 12, 2014, the NIH announced that it will now expand its policy to include analyses by sex during the pre-clinical phase, which includes animal studies and basic research involving cell cultures. This is important for understanding the safety and efficacy of drugs, as well as how and why diseases manifest differently in men and women.

All of this leads us to the exciting world of precision or personalized medicine. Sex and gender can serve as the building blocks for this dynamic evolution in health care. It is the new frontier of medicine where genetic profiling will lead to improved diagnosis and targeted therapies. This will increasingly transform how we practice medicine on Earth and in space.

This entry was posted on Monday, June 2nd, 2014 at 9:44 am and is filed under Policy, Social Marketing. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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