Biology of Women: WHY

1
Biology of Women WHY?

• Female physiology is unique, not a deviation from
  male norm
• Historically, womens biology has received
  negative treatment
• Women are underrepresented in medical trials
• Women are underrepresented in the sciences

2
How Things Were

• Early ideas re womens nature still influence
  perceptions today
• Plato males are reincarnated as females if they
  fail to live good life
• Aristotle just as the young of mutilated
  parents are sometimes born mutilated and
  sometimes not, so also the young born of a female
  are sometimes female and sometimes male instead.
  For the female is, as it were, a mutilated male,
  and the catamenia menstrual discharge are
  semen, only not pure, for there is only one thing
  they have not in them, the principle of soul.

3
How Things Were, Contd.

• Hippocrates prescribed intercourse and pregnancy
  as cures for female illnesses
• Medieval physicians
• Menstruation channels energy to womb, leaving
  little for intellect
• Mental illness (hysteria) caused by
  disturbances of womb rx hysterectomy
• Failure to expel blood during menopause
  negatively affects brain
• Result negative aura surrounding womens
  biology (examples menstruation, vaginal region,
  menopause)

4
Other Historical Influences

• Descartes women are influenced by passion, not
  reason
• Charles Darwin sex differences in natural
  selection
• Sigmund Freud portrayal of women as men without
  penises

5
How Things Are I.Underrepresentation of Women
in Clinical Trials

• NIH has been remiss about including women in
  clinical trials of drugs
• Reason female hormonal fluctuations too
  cumbersome

6
Reasons cited for exclusion of women from
clinical research studies

• concerns about liability for effects on
  conception, reproduction and fetal development
• confounding variables (e.g. cyclic hormonal
  variation)
• low disease prevalence
• difficulty with subject recruitment
• study cost
• lack of regulatory authority or granting agency
  requirements for inclusion of women

7
I. Underrepresentation, contd.

• Result sub-par health care for half the
  population
• Examples
• Lack of research on heart disease prevention in
  women
• AIDS research
• Viagra

8
How Things AreII. Lack of Women in Field of
Biology

• Fewer women with Ph.D.s in biology than men
• Many with Ph.D.s hold nontenure-track positions
• NIH awards 20 of grant money to women
  investigators
• Few female mentors in the field

9
How Things AreIII. Lowered Expectations for
Women

• Findings of Sadker and Sadker (1994)
• Boys get more eye contact, attention from math
  and science teachers
• Females rewarded for being quiet, cooperative
• Boys more likely to receive probing follow-up
  questions
• No data to support idea that females are inferior
  to males re analytical skills
• By high school, only 28 of females have taken 3
  years of math and science (compared to 40 of
  males)

10
How Things Are III. Lowered Expectations,
Contd.

• Womens SAT math scores slightly higher than
  mens
• Female professional scientists continue to face
  sexism in this regard
• Reviews of research papers
• Applications for teaching positions at
  universities
• Student assessments of professor performances

11
How Things AreIV. The Culture of Science

• Evolved when most scientists were male (single or
  with stay-at-home wives)
• Result women have to choose between family,
  career higher loss of women from science
• Two-body problem
• Other gender-related difficulties peer review
  (Swedish study)
• Competitive nature of field, language
• Lack of mentors

12
The Womens Health Movement

• began in late60s, early 70s with rise of
  feminism
• formed local grass roots health collectives
• educate women re their anatomy, physiology
• improve doctor/patient relationships
• share health experiences
• provide advocacy services (National Womens
  Health Network)
• demystified female body empowered women
• traditional medicine still must be transformed
• women still excluded from clinical trials

13
Womens Health Initiative

• recent milestone (1990) passage of Womens
  Health Equity Act
• generated first federal dollars for womens
  health research
• result creation of Office of Research on Womens
  Health (ORWH) in 1990
• implemented Womens Health Initiative (WHI) in
  1992
• coordinated by ORWH carried out by 7 NIH
  institutes
• 14 year study funded annually by Congress

14
WHI Studies

• objective reduce prevalence of three major
  causes of death and disability in middle-aged and
  elderly women
• major foci cardiovascular disease, cancer, and
  osteoporosis
• impact of diet, lifestyle, hormone replacement
  therapy (HRT), obesity on risk examined
• efficacy of clinical interventions also examined
• examples of ongoing studies
• effects of HRT on colon cancer, breast cancer
• influence of Ca and vitamin D intake on risk of
  osteoporosis and colon cancer

15
Other ORWH activities

• identifying opportunites for research on womens
  health (WHI)
• promoting participation of women in clinical
  trials by identifying and overcoming barriers to
  participation
• increasing the number of professional women in
  biomedical research