Medicine and Gender: How Men and Women are Different
© Webcast Transcript © 2001 Healthology, Inc.
DAVID R. MARKS, MD: Welcome to our webcast. I'm Dr. David Marks. Men may be from Mars and women may be from Venus, but are they different medically? It's the age-old question. Joining me to help discuss this question are two guests. First is Dr. Marianne Legato. She is professor of clinical medicine and director of the Partnership for Women's Health at Columbia. Welcome.
MARIANNE LEGATO, MD: Thank you.
DAVID R. MARKS, MD: Next to her is Dr. Benjamin Lewis. He is assistant professor of clinical medicine and a scholar at the Partnership for Women's Health, also at Columbia. Welcome.
BENJAMIN LEWIS, MD: Thank you.
DAVID R. MARKS, MD: Why do we have this question to begin with after all of these years?
MARIANNE LEGATO, MD: Ever since the 20th century began, we assumed that women were really small men and did research almost exclusively in men, partially as a desire to protect women from the consequences of clinical investigation, particularly women who were still in their reproductive years. That all changed with the advent of feminism after World War II, and finally Congress listened to the wishes of women to have more attention to their health and legislated in the early 1990s that women were to be included in federally funded research grants. To our amazement, we find that there are significant and important differences body-wide between men and women.
DAVID R. MARKS, MD: But this is all just recent information.
MARIANNE LEGATO, MD: Yes.
DAVID R. MARKS, MD: So probably all of the results are not in, and we're going to find out even more down the road, I would think.
MARIANNE LEGATO, MD: That's right. But a significant number of interesting differences are already very much apparent.
DAVID R. MARKS, MD: Why don't you tell us, Dr. Lewis, about some of the differences that we're finding?
BENJAMIN LEWIS, MD: Some of the differences that are significant are, for example, how we test for coronary artery disease. The testing where we do the conventional stress testing with an EKG has a fairly good track record for reliability in men, but when you apply those same criteria to women, there are a number of false positives. That concept led to using nuclear scans for women that continue to have problems because of artifacts in the nuclear scan. As a result there became a bias against the truth, which was that women do get heart disease, and women really had to present with heart attacks or manifest heart disease before it was taken more seriously. I think now we understand that there are ways to look at the technology and find people earlier. One of the key advantages has been in terms of using ultrasound, using exercise echo.
