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New frontiers: gender medicine

November 27, 2018

The cure depends on the sex. Gender medicine is the last frontier of medical science and, within a decade, it is destined to revolutionize the approach to care depending on whether the patient is a man, a woman or a child. The physiological differences between men and women are intertwined with those of age and lifestyle in an increasingly decisive way when it comes to effective and appropriate therapies, so much so that the symptoms can be very different in both sexes.

We talked about the medicine of the future with Dr. Patrizia Presbitero, Senior Consultant of the Clinical and Interventional Cardiology Unit of Humanitas.


The new medicine will be “tailored” to measure

The medicine of the future will always be tailor-made for each patient. Most diseases in fact manifest themselves in the two sexes with different shades and the way in which they evolve and respond to treatment is also different. Italy is one of the first countries in Europe to have taken action on this front, a sign that the time has come to address this field of health, as stressed by experts at the conference organized by Onda (Observatory on Women’s Health), where the objective is already clear from the title: “Gender medicine: from evolutionary paths to clinical practice. Behind this definition there is an approach that is concerned with treating diseases taking into account all differences, including those related to age. Older women, for example, are at a greater risk of developing cognitive deficits than men. The cause could be hormones.


Women and men have different hearts

The one area in which men and women differ is precisely that of cardiovascular disease. From the 1970s to 2000, mortality from heart attacks and strokes declined significantly in men, who were very responsive to numerous prevention campaigns. The same has not happened in women who tend to neglect the problem, mistakenly believing that it does not concern them. Seven out of ten women are convinced that heart attack does not affect them; although after the age of 50 cardiovascular disease is the leading cause of death in the “fair sex”. Moreover, in women the heart attack often occurs with atypical symptoms and serious complications such as malignant arrhythmias, ruptures and coronary dissections are more frequent.


“When she has a heart attack, the woman often does not have the same symptoms as the man – points out Patrizia Presbitero, clinical and interventional cardiology at the Humanitas Institute in Milan: often the woman does not have the typical heart pain. Instead, there may be atypical symptoms such as paleness, weakness and asthenia, which is why the heart attack is recognized and treated late compared to the male one. The age of onset is also higher than in men, because up to menopause there is the protective effect of estrogen.

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Osteoporosis is not just a female problem

Osteoporosis is not just a female problem, as often believed. It can also affect men in whom it appears late and in a more subtle way. It does not take the form of rapid bone decay typical of menopausal women, yet it can be a serious threat.


“As for women, the mortality rate after a fractured femur increases with age and is higher in the twelve months after the event – continued the specialist. In the first six months, the risk of death in men is about double that of women of the same age: men are more likely to report serious or fatal consequences. This is because most osteoporosis studies have been performed on women’s cases. Moc is proposed as a screening test for all women, while it is rarely done in men.


Bikini syndrome

For many years, women’s studies have focused on everything related to the reproductive system, so much so that there has been talk of “bikini syndrome”, namely the uterus, breast and ovaries. However, the female body is not identical to the male body, even as far as the other parts of the body are concerned.


Since the 1980s, the gap between the two sexes has narrowed, mainly due to the significant increase in smoking habits.

Today, there are more deaths in the female population as a result of this neoplasm rather than breast, ovarian and uterine cancer taken together. This is because a cigarette is more harmful in a woman than in a man and because a woman has less capacity to repair her DNA. Another cancer in which there are obvious gender differences is colorectal cancer, which occurs on average five years later in women compared to men.


Gender and sport

Men and women have a different susceptibility to sports injuries as well. Suffice it to say that the lesion of the anterior cruciate ligament is much more frequent in athletes or that young sportswomen are more prone to distorting traumas due to a greater laxity of the ligaments, which at certain times is more evident due to hormonal fluctuations. The female body, in short, requires different forms of training and risk prevention compared to male athletes.

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