Gender medicine: looking at women and men differently in healthcare

Are women and men different? Do women and men get different illnesses? Absolutely! In recent years and decades, it has become clear how fundamentally differently the male and female bodies work. The biological differences go far beyond sex organs and hormones: they can affect metabolism, pain perception and the immune system, for example.

Women and men often react very differently to medicines and therapies, and symptoms and disease progression can be completely different. There are also socio-cultural factors and role attributions.

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Typically female, typically male

Studies show, for example, that certain diseases are more common in women or progress differently than in men. Take autoimmune diseases, for example; four of every five people suffering from an autoimmune disease such as rheumatism or MS are women. Depression and osteoporosis also affect women in particular. Broken heart syndrome, a heart condition triggered by severe stress, occurs in women in 90% of cases. Cardiovascular diseases and diabetes differ significantly between the sexes. In all, women bear a high incidence of disease: the World Economic Forum’s Gender Health Gap Report 2024 showed that, on average, women worldwide live 25% fewer years in good health than men.

Women also react differently to medication than men. For example, high blood pressure medication causes stronger side effects in women. ASA prophylaxis to prevent a heart attack works primarily in men. Certain sleeping pills can cause a hangover in women and increase the risk of accidents during the day – but do not have this effect in men. One of the reasons for this is that women metabolise medication differently; men usually break down medication faster.

Breaking down barriers around men’s physical and mental health

For a long time, the fact that women feel pain differently was not known. Experts speak of the gender pain gap. Today we know that women react more sensitively to pain than men, and their pain perception often fluctuates depending on their cycle. For example, they suffer from migraines three times more often than men and experience more severe symptoms of chronic pain. Their pain is often interpreted as being psychological, which in turn means that women are less likely to receive appropriate diagnosis and treatment in an emergency. For example, a British study showed that female patients systematically receive less pain medication than male patients.

The aim of gender medicine, which has been gaining momentum in recent years, is to ensure that the differences between men and women are taken into account in research, prevention and treatment. This is understood to mean gender-sensitive medicine, which assumes that the frequency of illnesses, their development mechanisms, symptoms, progression and therapeutic success are also influenced by gender.

A major problem: lack of data

The main problem is the attempt to close the existing data gap – the “average person” is still male. For a long time, only the male was considered the standard in medicine, with women excluded from studies. As a result, the needs of women are still often not sufficiently taken into account to this day: menstruation, childbirth and painful illnesses such as endometriosis are either not taken into consideration at all, or only from a certain point of view. As a result, there is a lack of knowledge about women’s diseases. For example, analyses show that women with endometriosis wait an average of ten years for a diagnosis. The disease, in which tissue similar to that of the uterine lining proliferates in the abdominal cavity, affects about one in ten women, with 190 million people worldwide suffering from it.

An EU directive has been in place since 2017 to promote gender equality in clinical research. However, despite progress that has been made, women are still often underrepresented in clinical studies. Gender experts warn that the growing use of AI applications in medicine could further widen the gender health gap due to the existing data shortage – as artificial intelligence learns from the data available, which is primarily male. The current conclusion: there are new findings as well as questions that remain unanswered – so there is still much to be done in the field of gender medicine.