Sex-based discrimination in medicine costs lives | Letters

As head of pharmacovigilance at a clinical trials technology company, I was not surprised that a review of global research found that women are less likely than men to be offered active treatment for the same conditions (Women with same health conditions as men ‘less likely to be offered active treatment’, 16 September).

This inequality costs lives. A British Heart Foundation-funded study found that women were less likely than men to receive recommended care after a heart attack. Research in 2018 estimated that more than 8,000 women’s deaths may have been prevented over 10 years had they received the same standard of care as men.

The problem starts long before a patient reaches the hospital, however. For years, women have been woefully underrepresented in clinical trials, initially because policy excluded women who might become pregnant. However, women also have busy lives, typically managing home and work, which makes taking time off a challenge that many find impossible.

Yet without representation in the trials that give us safer, more effective medication, women’s specific needs are sidelined – which is unacceptable given that women experience 50%-70% more side-effects from drugs than men. Including women in more trials would go a long way towards addressing the health inequality between women and men.
Claire Williams
NorthWest EHealth

Sex-based discrimination is not new, but the fact that women with the same health conditions as men – from kidney to heart to liver problems – are less likely to be offered treatment continues to shock us. These are not just men’s issues, as they have historically been treated, but conditions that significantly affect women.

This new research is significant because it goes beyond gynaecological conditions. It illustrates that medical misogyny is not just rife in “women’s specialities”, where conditions are dismissed as “women’s problems”, but across fields, contributing to women receiving less treatment and less help for their health problems.

A fundamental shift in attitude is needed. Addressing this requires mandatory education in women’s health and in sex- and gender-sensitive medicine to eliminate bias throughout the training and continuing professional development of all healthcare professionals. Education must also begin in schools, with stronger sex and health education to challenge stereotypes and improve understanding of women’s health.

The renewed women’s health strategy and the 10-year health plan for England provide an opportunity to act. Women are not asking for preferential treatment; they need equal access to timely diagnosis, appropriate investigation and effective care.
Prof Geeta Nargund
Health Equality Foundation

I was delighted to see more discussion of endometriosis and other women’s health issues (‘It makes you feel helpless’: patients and doctors cast doubt on standard treatment for endometriosis, 15 September). However, there remains a woeful disregard of many of the issues women face.

Pelvic pain is experienced by many women, as the article pointed out. In my case, as extreme pain came to dominate my life, I saw several top (male) professors of gynaecology and urinary disease before – thanks to a Guardian article – I saw a female gynaecologist who pointed me to a solution. This was physiotherapy specifically directed to dealing with women’s health issues, and pain in particular. These techniques need to be far more widely available and known.
Prof Sophie Watson
The Open University