Why Medicine Often Has Dangerous Side Effects for Women | Alyson McGregor | TED Talks

Why Medicine Often Has Dangerous Side Effects for Women | Alyson McGregor | TED Talks


We all go to doctors. And we do so with trust and blind faith that the test they are ordering
and the medications they’re prescribing are based upon evidence — evidence that’s designed to help us. However, the reality is that that hasn’t
always been the case for everyone. What if I told you that the medical science discovered
over the past century has been based on only
half the population? I’m an emergency medicine doctor. I was trained to be prepared
in a medical emergency. It’s about saving lives. How cool is that? OK, there’s a lot of runny noses
and stubbed toes, but no matter who walks
through the door to the ER, we order the same tests, we prescribe the same medication, without ever thinking about the sex
or gender of our patients. Why would we? We were never taught that there were
any differences between men and women. A recent Government Accountability study
revealed that 80 percent of the drugs withdrawn from the market are due to side effects on women. So let’s think about that for a minute. Why are we discovering
side effects on women only after a drug has been
released to the market? Do you know that it takes years
for a drug to go from an idea to being tested on cells in a laboratory, to animal studies, to then clinical trials on humans, finally to go through
a regulatory approval process, to be available for your doctor
to prescribe to you? Not to mention the millions and billions
of dollars of funding it takes to go through that process. So why are we discovering
unacceptable side effects on half the population
after that has gone through? What’s happening? Well, it turns out that those cells
used in that laboratory, they’re male cells, and the animals used
in the animal studies were male animals, and the clinical trials have been
performed almost exclusively on men. How is it that the male model became
our framework for medical research? Let’s look at an example that has been
popularized in the media, and it has to do
with the sleep aid Ambien. Ambien was released on the market
over 20 years ago, and since then, hundreds of millions
of prescriptions have been written, primarily to women, because women
suffer more sleep disorders than men. But just this past year, the Food and Drug Administration
recommended cutting the dose in half for women only, because they just realized
that women metabolize the drug at a slower rate than men, causing them to wake up in the morning with more of the active drug
in their system. And then they’re drowsy and they’re
getting behind the wheel of the car, and they’re at risk
for motor vehicle accidents. And I can’t help but think,
as an emergency physician, how many of my patients
that I’ve cared for over the years were involved in a motor vehicle accident that possibly could have been prevented if this type of analysis was performed
and acted upon 20 years ago when this drug was first released. How many other things need
to be analyzed by gender? What else are we missing? World War II changed a lot of things, and one of them was this need
to protect people from becoming victims of medical research
without informed consent. So some much-needed guidelines
or rules were set into place, and part of that was this desire
to protect women of childbearing age from entering into any
medical research studies. There was fear: what if something
happened to the fetus during the study? Who would be responsible? And so the scientists
at this time actually thought this was a blessing in disguise, because let’s face it — men’s bodies
are pretty homogeneous. They don’t have the constantly
fluctuating levels of hormones that could disrupt clean data
they could get if they had only men. It was easier. It was cheaper. Not to mention, at this time,
there was a general assumption that men and women
were alike in every way, apart from their reproductive organs
and sex hormones. So it was decided: medical research was performed on men, and the results were later
applied to women. What did this do to the notion
of women’s health? Women’s health became synonymous
with reproduction: breasts, ovaries, uterus, pregnancy. It’s this term we now refer
to as “bikini medicine.” And this stayed this way
until about the 1980s, when this concept was challenged
by the medical community and by the public health policymakers
when they realized that by excluding women
from all medical research studies we actually did them a disservice, in that apart from reproductive issues, virtually nothing was known
about the unique needs of the female patient. Since that time, an overwhelming amount
of evidence has come to light that shows us just how different
men and women are in every way. You know, we have this saying in medicine: children are not just little adults. And we say that to remind ourselves that children actually have
a different physiology than normal adults. And it’s because of this that the medical
specialty of pediatrics came to light. And we now conduct research on children
in order to improve their lives. And I know the same thing
can be said about women. Women are not just men
with boobs and tubes. But they have their own
anatomy and physiology that deserves to be studied
with the same intensity. Let’s take the cardiovascular
system, for example. This area in medicine has done the most
to try to figure out why it seems men and women have
completely different heart attacks. Heart disease is the number one killer
for both men and women, but more women die within the first year
of having a heart attack than men. Men will complain
of crushing chest pain — an elephant is sitting on their chest. And we call this typical. Women have chest pain, too. But more women than men
will complain of “just not feeling right,” “can’t seem to get enough air in,” “just so tired lately.” And for some reason we call this atypical, even though, as I mentioned,
women do make up half the population. And so what is some of the evidence
to help explain some of these differences? If we look at the anatomy, the blood vessels that surround the heart
are smaller in women compared to men, and the way that those blood vessels
develop disease is different in women compared to men. And the test that we use to determine
if someone is at risk for a heart attack, well, they were initially designed
and tested and perfected in men, and so aren’t as good
at determining that in women. And then if we think
about the medications — common medications
that we use, like aspirin. We give aspirin to healthy men to help
prevent them from having a heart attack, but do you know that if you
give aspirin to a healthy woman, it’s actually harmful? What this is doing is merely telling us that we are scratching the surface. Emergency medicine
is a fast-paced business. In how many life-saving areas of medicine, like cancer and stroke, are there important differences between
men and women that we could be utilizing? Or even, why is it that some people
get those runny noses more than others, or why the pain medication that we give
to those stubbed toes work in some and not in others? The Institute of Medicine has said
every cell has a sex. What does this mean? Sex is DNA. Gender is how someone
presents themselves in society. And these two may not always match up, as we can see with our
transgendered population. But it’s important to realize
that from the moment of conception, every cell in our bodies — skin, hair, heart and lungs — contains our own unique DNA, and that DNA contains
the chromosomes that determine whether we become
male or female, man or woman. It used to be thought that those sex-determining
chromosomes pictured here — XY if you’re male, XX if you’re female — merely determined whether you
would be born with ovaries or testes, and it was the sex hormones
that those organs produced that were responsible for the differences
we see in the opposite sex. But we now know that
that theory was wrong — or it’s at least a little incomplete. And thankfully, scientists like Dr. Page
from the Whitehead Institute, who works on the Y chromosome, and Doctor Yang from UCLA, they have found evidence that tells us
that those sex-determining chromosomes that are in every cell in our bodies continue to remain active
for our entire lives and could be what’s responsible
for the differences we see in the dosing of drugs, or why there are differences
between men and women in the susceptibility
and severity of diseases. This new knowledge is the game-changer, and it’s up to those scientists
that continue to find that evidence, but it’s up to the clinicians
to start translating this data at the bedside, today. Right now. And to help do this, I’m a co-founder
of a national organization called Sex and Gender
Women’s Health Collaborative, and we collect all of this data
so that it’s available for teaching and for patient care. And we’re working to bring together
the medical educators to the table. That’s a big job. It’s changing the way medical training
has been done since its inception. But I believe in them. I know they’re going to see the value
of incorporating the gender lens into the current curriculum. It’s about training the future
health care providers correctly. And regionally, I’m a co-creator of a division within
the Department of Emergency Medicine here at Brown University, called Sex and Gender
in Emergency Medicine, and we conduct the research to determine
the differences between men and women in emergent conditions, like heart disease and stroke
and sepsis and substance abuse, but we also believe
that education is paramount. We’ve created a 360-degree
model of education. We have programs for the doctors,
for the nurses, for the students and for the patients. Because this cannot just be left up
to the health care leaders. We all have a role in making a difference. But I must warn you: this is not easy. In fact, it’s hard. It’s essentially changing the way
we think about medicine and health and research. It’s changing our relationship
to the health care system. But there’s no going back. We now know just enough to know that we weren’t doing it right. Martin Luther King, Jr. has said, “Change does not roll in
on the wheels of inevitability, but comes through continuous struggle.” And the first step
towards change is awareness. This is not just about improving
medical care for women. This is about personalized,
individualized health care for everyone. This awareness has the power to transform
medical care for men and women. And from now on, I want you
to ask your doctors whether the treatments you are receiving
are specific to your sex and gender. They may not know the answer — yet. But the conversation has begun,
and together we can all learn. Remember, for me
and my colleagues in this field, your sex and gender matter. Thank you. (Applause)

100 comments

  1. Me: "Doctor, will these percocets I'm being precribed be specific to my gender?"

    Doc: blank stare
    "Get the f*** out my office"

  2. wow everyone hates this………… that's not right. If there's a message to be given, let it be heard? Why are so many negative comments necessary about generalizing it into a "gender issue". The general public is strange.

  3. This talk has nothing to do with feminism. It's a large step in the future of medicine which is personalized health care. Excellent talk. Very eye opening.

  4. Downvotes, because god forbid we ever EVER admit that male and female are scientifically different on a cellular level. That's just politically incorrect.

  5. It's a good talk, just an unfortunate title. ''Gendered'' titles make bad 1st impression. Unfairly disliked by association…

  6. TOTALLY thought this was gonna go in a different direction when I clicked it…

    Men and women are biologically different? Blasphemy!

  7. The information I know of tells me: women are excluded from first trials because they can pregnant and nobody wants to endanger their ability to reproduce! Later studies, shortly before the market introduction, include women! So where is the problem? The pharmacytical industry knows all this and does act accordingly.

  8. I was about to comment that I was not surprised that this has so many down votes, as it has the word women in the title and people on YouTube tend to be rather sexist. But then I realised how badly the talk was delivered.

  9. Get real and tell the truth. The reason medicine has dangerous side effects is that it is full of chemicals and unnatural for the body. Big pharma is only interested in money and not the health of the public. For example chemo was derived from gas which was used in world war two. I do agree with you that a lot of people(not all), trust their doctor but a lot of people are waking up and exposing the fraud. See The Truth About Cancer which is on you tube. Episode 1 deals a lot about these untruths and will open peoples eyes.

  10. I think what this doctor is saying is is important. Not least the point she makes about drugs remaining in the female system for longer than in males due to slower metabolism, and especially If you consider the build up of drugs within a system (like anti depressants and side effects, for example). Simply to draw an analogy, One Size Fits All clothing is simply preposterous, and we all know it. Shared to Google+.

  11. an excellent and very factual approach that l personally experienced after a bypass operation when l was treated with the standard medicine that gave an averse affect and with persistent argument l got them to change the type of management to my specific case l am sure you are in the right track God bless you you could make the difference in many sick people and their recovery program management

  12. Some drugs have different or worse side effects for women, why are they removed from the market when they can still be used by men?

  13. "We were never taught that there were any differences between men and women". Thank you, cultural Marxists. Thank you, Regressive Leftists.

  14. Why the downvotes? We know that chemical balances in men and women can be significantly different. I learned about this in AP Biology. The example given in class was sleeping pills.
    Okay, I'm good, the example she gave was the same I learned about.

  15. I/m a physician and I've read a lot of RCT papers (randomized controlled trials). these are the studies that FDA uses to approve medications. and they all list female/male ratio. and I can tell you they all have ~50% females to males. I have not come across a study yet that excluded women. this talk might have some truth in some incidents but for the most part it is very generalized and lacks evidence.

  16. Thanks TED… Sat through 14 minutes of divisive bullshit to hear her admit that individualized medicine is the new goal anyhow… Seriously?

  17. I've actually seen old (as in a few decades old) medical textbooks which teach that women's complaints are mainly "hysterical" and that menstrual pains and menopause symptoms are imaginary. There is still some of that underlying attitude in some medical professionals. That's beside the facts these speaker is talking about – that most medical studies were done on men and the assumption that women will have the same result is detrimental.

  18. what if i told you that everyone is unique, not just in DNA but also in gut flora, in retroviruses, in diet, in environment. what if i told you that even identical twins will have mild differences in medication effect? this men vs women is easy, but it is also a false narrative. the same things could be seen between people who are vegetarians vs. heavy meat diet people. the same thing is true of white people living near the poles vs dark skinned people living near the equator. to focus on gender is to lose sight of the reality, that people are unique, and that drugs do not work the same on all people.

    there is a real reason to focus medical trials on extending the health of males. men die much earlier than women, and are responsible for the majority of the production of real wealth. extending the working lives of males increases production, and benefits women as well as men.

  19. @thewallofsilence Even the FDA acknowledges (on their very website) that historically the vast majority of trials were conducted not just on males but white males. The inclusion of others in clinical trials is relatively new.

  20. It would be pretty obvious if "every drugs" are tested by male testers only. Any drug reaching the hospital for final tests would be so far out of the way. Also, it would be insanely cost INEFFECTIVE if most drug companies tests their drugs with a "bias" test, they would spend millions investing in a drug, just to find out it has ridiculous side effects on females. Even basic salesman understand this kind of logic.
    If every drugs were tested by male testers only, I am pretty sure even the most powerful pharmaceutical companies won't be able to cover them all up.
    She does look very convincing though, and very attractive as well.

  21. Why are there so many dislikes? I mean this is one of the most mind-opening TED talk I've ever seen, and something I've never even thought of, like at all!

  22. "THERE IS NO SEXISM, NO NEED FOR FEMINISM, MEN AND WOMEN ARE TREATED EQUALLY"

    Yet a mass of men mindlessly dislike ANY Ted Talk with the word "women" on the title before listening to it.

  23. This video is actually really interesting, I trust that her science is correct, and I'm actually unaware that they tested most "unisex" drugs only on one gender. But it makes sense where the current status quo stems from, considering the complication with a gender that has hormone fluctuation, it's like trying to do a science experiment on a boat in a storm vs still ground.

    This also opens up an interesting can of worms, on one hand she's getting hate for suggesting there needs to be more focus on women in the West, in 2015, which can infuriate a lot of people thanks to the work of gender politics pushers who have taken legitimate issues to infantilise to a point where even when serious issues are raised, people roll their eyes, it's like the boy who cried wolf, the variant cover version featuring the privileged girl who cried patriarchy.

    On the other hand, she's getting hate from the current wave feminists, how dare she suggests there are physiological differences between men and women other than reproductive organs, next thing you know she'll be saying women make difference choices due to those differences!

  24. This is the kind of things wester 'third wave' feminists should be talking about, not their nonsensical imaginary conspiracies like 'patriarchy' and 'rape culture'.

  25. We don't need more drugs that give us more side effects than what its proposed to be treating. How about we all just try to focus on prevention rather than treating a symptom. Most people are on a poor diet from lacking any alkaline foods, exercise to promote oxygen flow within the body, a overload of acidic foods and poisonous water being pumped from just about every city in America. we shouldnt personalize medicine down to every detail nor gender unless disease or injury (ect.) is gender based as long as we make it healthy for the body to begin with.

  26. The stupidity in a YouTube comments sections never ceases to amaze me. Bunch of uneducated American fucktards. Go to school instead of bitching about "SJWs" and "feminazis"

  27. Gender is a start at addressing the present criminality of the status quo.
    Imperative to go beyond gender re Leroy Hood P4 model : Personalized; Predictive; Preventive; Participatory.
    Each person is biochemically unique.
    "Side-effect" is an oxymoron. All drugs have adverse effects = Russian roulette.

  28. Is a shame so many women are bad talkers. I wonder why. It feels is mainly about body language, tone of voice and lack of humor. I am not saying that all men are good talkers, not at all. But it feels that there are already such a little % of women in those talks, that is more evident when there are female bad talkers.

    May the shitstorm begin.

  29. good point at the end. from a socialist pov, there are so many diversities between different races and people in general. simply dividing males and females are not nearly enough

  30. Good presentation. I wonder if such a distinction is also useful to make between people of different racial backgrounds.

  31. For all the people who are dislking this because it's "just a feminist rant" obviously haven't watched till the end because clearly this is about personalized healthcare for everyone. She is focusing on women because they are the ones which have been lumped in with men. She's not suggesting we take away men's research, only add women't research.

  32. Started off strong, but the "Gender" problem seemed to be a issue against "women." I would have liked it to be both, and the "racial factor." If you ever see labs they'll tell you to base results in Latino or African Americans, this can be an issue as well. Just a thought.

  33. Why all the questioning of gender anger here? Why not get to the facts instead of just ranting and venting, as we see most reader/commenters over exercising this attitude? The most overprescribed drug for women in America, is valium. It is also a choice of suicide for many of the same. Yet their doctors and pharmacologists go free of any guilt for causing this. Why are these patients not asking their doctors this?

  34. It's because of the chronic neglect of the special needs of women in medicine, that in developed countries women only live 5 years longer on average than men.

  35. Oh god this is full of plainly wrong things! Syntom presentation by the patient compared to symptom? Confounding total population and affected population? Declaring that women suffer from an higher mortality in the 1 year period after infarction while conveniently not mentioning that they usually develop infarction much later in life than men?

    Gosh this is simply bad science.

  36. I feel that when I was in the hospital suffering from a migraine that indeed I was given a drug that is not commonly used. The doctor even told me this! As a female i feel like i can relate to this video.I was given a medication that sent me into a reaction that was probably the worst of my life. I was restless beyond anything that I had ever experienced. This video showed many ethical situations.One in particular is that when the drugs are being made, the testers are not looking at the community as a whole. Everyone knows that the male body is a lot different than females and that our society has both male and females in it. It baffles me that when making these drugs, they only looked out for the males in this community. Also what about beneficence? This states that anyone in the medical field EVEN the ones making these drugs and testing them are supposed to look out for others in that it benefits them. By testing mainly males, I don't see how this is looking out for the benefit of females. Obviously changes are being made. I just had a first hand experience with this and I know it could have been prevented!!!

  37. So, this Talk has nothing to do with feminism, and she explicitly states that this is about both men and women.

    Why is she getting so much flack?

  38. sad little mras go every video with the word women in the title and down vote it as if that means something. get a life, idiots.

  39. wahhh waaaahhh i am a feminist woman i need to victimize myself forever waahhhhh NOTICE ME OR I WILL SUE YOU FOR PSYCHOLOGICAL ABUSE

  40. I like the video for its subject matter, it's compelling and offers great information we otherwise wouldn't have known or considered. There is no need for a gender debate. This video is about getting PEOPLE the care they need and, last I checked, women were included in that category.

  41. big pharma is trying to kill us. all this chemical medicine with a million side effects. make some drugs without the side effects. it's not that hard people.

  42. Dumb male-rights chodes refuse to believe that there's ANY form of discrimination against women, no matter how known it is.

  43. How does the transgender patient alter this dynamic. Do providers treat the gender or DNA of a patient and how much does hormone therapy change the cell DNA if at all? Do I dose my transgender male like the female he was born as or as the man I am trying to transition her into?

  44. The most obvious reason is that drug trials have a problem attracting women to take part. Makes sense, because women have the sense not to take part in a trial involving a previously untested drug.

  45. I don't actually understand why we don't have gendered medicine. There's no shame in it. Let's not pretend men and women are the same apart from genitals.

  46. Men don't have hormones that fluctuate like ladies, so they're easier to study. Drug companies are also becoming afraid to test on ladies because they could become pregnant and it causes liability issues.

  47. you only need to spend a few hours to see how dangerous birth control pills are for women – but no one will come out and say it, too much money at stake, and too politically charged

  48. When I was in 5th Std, our teacher told us that women is complex just like her reproductive system, so handle with careXD

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