“Second Opinions- Why it’s high time U.S. focused on women’s health research and funding
by Stacey E. Rosen, MD November 26, 2023
Rosen is a professor of cardiology.
Comics aren’t typically my go-to source for making an expert point. A searing insight from Amy Schumer has me reassessing. In her newest comedy special, Schumer discusses her complex 2019-2020 pregnancy.
“I had this dreadful condition while I was pregnant called hyperemesis gravidarum, severe nausea and vomiting the entire pregnancy,” she describes. “I was so relieved when I was diagnosed … 6 months in I was like, ‘Okay, we know what it is. What do we do?’ And they explained to me, ‘Well, we haven’t been able to study it since it only happens to women.'”
In one mic-drop moment, Schumer nailed both the laugh and the serious medical issue. Her bit also made me question: Did men hear the punchline or is this an echo chamber?
Fortunately, it seems President Joe Biden heard it. With First Lady Jill Biden beside him, the president established the “first” White House Initiative on Women’s Health Research. It will bring together experts from the entire administration, the private sector, research institutions, and humanitarian organizations “to drive innovation in women’s health and close research gaps.”
Those gaps exist at the most fundamental level: women have been historically under-represented in clinical trials, and research focused on women’s health has been significantly underfunded. I’m not talking about reproductive organs: what we call “women’s health” goes beyond that.
Women have been neglected or underrepresented in a wide range of studies. Consider the health conditions that are more common in women, such as Alzheimer’s disease, rheumatoid arthritis, and even adenocarcinoma. Clinical presentation in many conditions is different for women too, especially with heart disease. For too long and for too many women, these differences- and lack of targeted studies- have led to misdiagnoses, mistreatment, and poor health outcomes.
I want this White House effort to transform how women’s health research is funded and conducted. That can only happen by starting with the basics- understanding that men and women are different at the cellular level. About a third of the genes that people carry are expressed differently in men and women. As a result, medical presentation, treatment options, and health outcomes often differ.
It is why Erica Ollmann Saphire, PhD, MBA, president and CEO of the La Jolla Institute for Immunology, stated: “Studying sex-based differences in a systematic way will help uncover the causes and enable treatments that are in tune with biology.”
My expertise comes from cardiology, where not taking this approach meant we didn’t learn until the mid-1980s that women were dying from heart disease at higher rates than men.