Health has gender, which is why we must integrate it into public health. According to the World Health Organization (WHO), "the different needs of men and women in all phases of policy and program development" must be taken into account. In Lanzarote, health education based on these differences is still very poor, and women suffer the most from this deficiency.
Sex influences through the effect of hormones, and gender through assigned social roles that predispose us to certain behaviors. However, it's not just that; historically, medicine was based on the study of diseases in men (mainly because women were not supposed to undress before male doctors, and they were the ones who had access to studying that discipline). Today, it is known that some diseases have a higher incidence in one sex than in the other, and that the effects of medications and even the symptoms of the same disease are different in men and women. However, education about these differences in society is still lacking.
Experts warn us that taking diseases in a generalized way, without appreciating gender differences, can lead to a delay in diagnosis and, consequently, in recovery. For example, the symptoms of a heart attack popularly known are those of men, so women do not go to health services quickly, thus hindering their recovery, or a man does not know that he can suffer from breast cancer since the known self-exams are for women and do not give importance to lumps in their chest.
As in every aspect of life, gender differences negatively influence both women and men.
Medications
There are differences in the effects of some medicines between men and women, in how they act, in their side effects, and in the absorption times in the body. This is due to hormonal differences between both sexes and to the fact that most clinical trials of drugs are performed on men. Did you know that women eliminate paracetamol more slowly?
Therefore, for the prescription of doses and the duration of treatment, it should be taken into account whether the patient is a man or a woman before medicating them.
Diseases and symptomatology
Many diseases present different symptoms if they appear in men and women, and the ones most socially known are not always the ones related to our sex.
Heart attack: We popularly associate it with an oppressive pain in the center of the chest that radiates towards the left arm, sweating, or breathing problems, but in women, it presents other symptoms such as unusual fatigue, nausea, and pain in the lower abdominal part. The lack of knowledge of these symptoms causes women to take longer to seek medical help and are even not examined properly by medical professionals. Thus, the prognosis is worse in women than in men - 52% die before reaching the hospital, compared to 42% of men.
Chronic Obstructive Pulmonary Disease (COPD): It is a traditionally male pathology that causes cough, fatigue, shortness of breath, and muscle problems, but the increase in tobacco consumption among women has caused more and more female cases, and their symptomatology is different since they present a greater sensation of shortness of breath and injuries caused by the disease.
Anorexia: To detect the pathology, it must be taken into account that men and women do not carry out the same strategies to lose weight. They resort to vomiting and extreme diets, while they develop an obsession with exercise. It should be noted that men also react earlier and better in the first phases of treatment.
Anxiety Disorder: Presents symptoms in women such as panic and breathing problems, while in men, gastrointestinal symptoms and excessive sweating appear.
Depression: They are more tired and irritable than women and tend to lose interest in work, their family, or their hobbies. In addition, men often have more physical problems linked to depression, such as sleep problems or headaches.
Gender roles
But beyond genes and hormones, the health inequalities between men and women have much to do with social issues.
Some data left by the so-called "Gender Medicine":
- Between 15% and 71% of women have suffered physical or sexual violence at some point in their lives, which has left consequences on their health: low self-esteem, depression, or chronic diseases. Taking into account the delay in the waiting lists for mental health in the health area and that on the island there is only one psychological assistance service specialized in women victims of gender violence (CIAM), our future is discouraging.
- Women dedicate themselves to taking care of others but little of themselves, and when they go to consultations with nonspecific discomforts, they are given less attention. Dr. Valls-Llobet, author of Invisible Women, explains that iron deficiency in women of reproductive age is known, without taking into account that anemias can produce fatigue, discomfort, and difficulties in memory or concentration, so that when women go to the doctor with these discomforts, there is a predisposition to think that they respond to psychological issues and to prescribe anxiolytics or antidepressants. Do we suffer it daily in our primary care consultations?
- According to Santiago Palacios (Spanish gynecologist), there are female pathologies related to lifestyle and social conditions: "The feeling of aggressiveness that women have at work and the stress it entails, added to the stress of combining it with domestic and family tasks, has a lot to do with headaches, constipation, or gastritis" and other ailments they suffer more.
It sounds encouraging to know that we are neither crazy nor weak, but what sounds more encouraging is to know that people are starting to talk about women and health because our grandmothers did not have that advantage.
The time has come to demand that our health personnel also train in it, mainly because our lives depend on it.
