Adverse Drug Reactions Overly Affect Women. The Reason Why Is Starting to Emerge

[Warpy]

(from the "it took you long enough" files)

Biomedical research helps us understand the timeline of diseases and how we can treat them. In the past, most of it has been conducted on male cells and experimental animals, such as mice. It has been assumed the results from such "pre-clinical" research on males apply to females too.

Yet men and women experience disease differently. That includes how diseases develop, the length and severity of symptoms, and the effectiveness of treatment options.
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The US Food and Drug Administration (FDA) has already recommended dosage changes for women for some drugs (such as the sleep drug zolpidem). Additionally, weight-adjusted dosing for some antifungal drugs and antihypertensive drugs appears to work.

On the other hand, drug reactions are strongly linked to what the drug does in the body in women, and less so in men. There are also many documented differences in physiology between men and women that relate to how drugs are absorbed and cleared by the body, and not to body weight.

https://www.sciencealert.com/adverse-drug-reactions-overly-affect-women-the-reason-why-is-starting-to-emerge

Good discussion on how the study was desugned and if I lived another 100 years, I might live to see it penetrate the rock headed prejudice of drug researchers that women are not just small men.

[MOMFUDSKI]

1. I have to tell every doc that I am extremely sensitive to drugs.

I always get 'the look' like I know better than you do. But if you bother to read the literature that comes along with the script it invariably says, "Women over 60 may have adverse effects". Well, kids, I can tell you that is true and correct. So I always start with a lower dose than advised. Given Gabapentin recently and I lasted 7 doses. Couldn't focus my eyes for first hour in the morning and then felt really crappy and checked my blood pressure which was 112/55. So I am done with that stuff. I will get 'the look' from the doc in 10 days when I tell him I am off that train.

[Warpy]

2. I am to some, not to others

Most blood pressure pills will put me on the floor but I'm strangely resistant to benzodiazepines, Back in the 60s, I could fall asleep on dexedrine and stay wide awake on Seconal. It's probably why I never did find my drug of choice and just wandered away from the whole thing when the 60s ended. Mostly, it was "is this supposed to do something? When?"

Studies on sex differences to drug effectiveness and toxicity definitely need to be done on female subjects. They haven't been because females under the age of 55 are assumed by drug researchers to be continuously pregnant and/or lactating.

Women in prisons would be ideal test subjects, and most would jump at the chance to earn a little cash and rack up some brownie points when their parole hearings come up. Other than that, they're going to have to rely on subjects with non hormonal IUDs and those taking frequent pregnancy tests.

We've been ignored for too long.

[halfulglas]

3. They've known this for almost 50 years but they just want to tweak things.

They should really have equal numbers of men and women in the research but the models for the research are set up for the men. Also, when women complain to their doctors of side effects, they are more often brushed aside, at least until the men start complaining, because most doctors assume that women are complainers. Sometimes they aren't even in the patient notes that the patient complained (I know, ex-medical transcriptionist here). I had reactions to every statin I have ever been on and registered complaints and what they were, but going over them with a new provider, the notes of what the complaints were are not specific at all in my records - and before my old doctor left the area I really liked him.

[Warpy]

4. They just stuffed their heads farther up their butts

and pretended it was all weight based, something this particular study disproved very handily, one reason I posted it.

Old retired RN here, I've seen the same things you have. I've also been involved doing a lot of clinical trials, most of them on male patients and exactly none of them looking at the differences between male and female responses to study drugs.

[mercuryblues]

5. The same can be said about seatbelts

And the actual design of a car's interior. All of them are designed and tested for the average sized male.

The list is endless on things designed for men that are intended to be used for both sexes. From tools, PPE, to office equipment...

[Warpy]

6. Air bags were the worst

and early ones managed to kill children and very small women.

I never minded the seat belts, contusions and possibly a cracked pelvis were better than death. I just wish they'd designed a shoulder strap that wouldn't make me feel like I was being hanged. That's where the piss poor, manly man design flaw came in.

[MOMFUDSKI]

7. Good stuff there, Warpy.

As an example, we had my brother-in-law redo our shower while we were gone. He is about 5'10" and his ex was about 5'7". I am 5'3" on a good day and he hung the shower pipe where I had to get on my tippy toes to even reach it. So my husband went and bought a separate shower holder in which to put the hand-held shower thingy so now I can reach it. I also found that the boys always put the viewer thingy in the door at a height that the small women can't even peer out of. None if this is earth shattering but still . . .

[halfulglas]

8. For the seat belt I buy those snap on cushion tubes and position it so I don't

Get rope burns on my neck. I keep one on my own car and have a spare, which I sometimes forget if I'm riding in someone else's car and can't control where I'll sit. If they designed our cars with harnesses instead of seat belts it would be a lot safer because the fit would be better.

[Warpy]

10. All they had to do was mount the shoulder harness about 6 inches lower

It would go over the shoulder of the 6'4" manly man but it would fit the 5'4" average woman, as well. Designers just don't consider ergonomics, especially when they concern women.

My pet peeve is with kitchens. A 30-32" counter height would be ideal for me. But NO, they have to be 36" so that 6' tall man who pushes all the cooking off on his wife could theoretically use them comfortably.

Everything we use is designed for that 6' man, from office furniture to step ladders to cars and nobody wants to think about how uncomfortable and downright dangerous that is for women. If they want to design something for women, they take a men's item, produce it in pink, and charge more for it.

[SorellaLaBefana]

9. If you are a woman, or know a woman, or suspect your mum may have been a woman...

The issue is NOT just with medicines. Women are invisible in many ways.

Nowhere is this more eloquently put than in "Invisible Women" by Caroline Criado Perez.

I first heard of her work on the SETI podcast "Big Picture Science" in 2019. Here is the blurb for that episode which was examining data collection biases in general

Sexist snow plowing? Data that guide everything from snow removal schedules to heart research often fail to consider gender. In these cases, “reference man” stands in for “average human.” Human bias also infects artificial intelligence, with speech recognition triggered only by male voices and facial recognition that can’t see black faces. We question the assumptions baked into these numbers and algorithms.
https://radio.seti.org/episodes/skeptic-check-data-bias

The gendered effects of snow removal were first studied in Sweden. This started basically as a joke since officials were tasked with looking at gender equality in the town. Someone suggested that they should look at snow removal, since that certainly was safe from sexism.

Turned out, wasn't true. The town followed the common snow plowing plan of clearing main routes to city center and only then the secondary streets. The study reversed this order to see if there were any gender specific effects. There were. They were massive!

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It was found that by reversing the plowing order that injuries among women decreased dramatically, without any increase in injuries among men. The reasons for this are fascinating. Primarily resulting from the different social roles and the resulting difference in travel patterns of the two sexes.

The SETI podcast also discusses more hidden data biases, several of which (design of cars) can be immediately lethal to women, since the design (especially for the driver!) is optimized for men. It is also discussed how poorly facial recognition performs with dark skin—frightening as TSA is introducing such tech for screening. These biased actions are not done nefariously, just thoughtlessly.

Then there was the NASA all female spacewalk fiasco

What should have been a giant leap for womankind has turned into a stumble after Nasa said on Monday night that they will only have access to one correctly sized spacesuit top by Friday when the walk was scheduled. One of the two women on the mission, Anne McClain, will now have to give up her place to a male colleague.

https://www.theguardian.com/science/2019/mar/25/nasa-all-female-spacewalk-canceled-women-spacesuits

Women are NOT just small men.

[Warpy]

11. I know a lot of women who are ex military

and their language is at its most pungent when they start talking about protective gear for soldiers on or near the front. Women are at their most invisible in the military and even men who aren't northern European 6 footers have problems with it, even without tits getting in the way.