IS IT IN THE GENES? BATTLE OF THE SEXES
Women are 4-times as likely to develop arthritis, 9-times as likely to have lupus and twice as likely to have multiple sclerosis. Men, on the other hand, are 4-times as likely to develop autism and twice as likely to develop parkinson's. Why do these diseases affect men and women differently? Take a closer look in our special report.
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Arthritis. Depression. Heart disease. Three of many diseases that discriminate.
Marianne Legato, M.D.
Founder/Director
Partnership for Gender Specific Medicine
Columbia University
New York, NY
"The clinical observation that some diseases are more frequent in men and women is not news to us. The real news is that we're beginning to understand the reasons why that's the case."
One reason for the years of misunderstanding is that research has mainly involved men.
Marianne Legato, M.D.
"Men were considered simpler to study because they don't have hormonal fluctuations. They were considered cheaper, therefore, because we needed smaller groups to study."
In fact, 83 percent of all humans in stress studies were men.
When they started to look at women, Shelley Taylor and colleagues found a difference they didn't expect.
Shelley Taylor, Ph.D.
Psychologist
UCLA
Los Angeles, CA
"Humans, but especially females, cope with stress in large part by caring for their offspring, getting them out of harm's way, ensuring that nothing bad happens to them and by affiliating with a social group."
Taylor calls this "tend and befriend" and says it may be one reason why women live longer.
Shelley Taylor, Ph.D.
"When people give or get social support in response to stress, it downregulates stress hormones. What that means is that there's lesser wear and tear on the body."
Marianne Legato is director of The Partnership for Gender Specific Medicine. She is spearheading a push to learn even more about how diseases affect men and women differently.
Marianne Legato, M.D.
"The way disease affects them can be different in terms of symptoms, risk factors, the treatment options available, and the outcome from the disease."
This includes everything from heart disease to depression, adhd and autism. One explanation Legato gives is where a gene comes from.
Marianne Legato, M.D.
"There is something called imprinting in which certain genes are silenced by virtue of whether they come from the father or the mother."
Another reason has to do with back-up genes. With two X chromosomes to a man's one, women are protected against mental disorders from autism to schizophrenia. UCLA's Art Arnold says men's Y chromosome can also cause trouble. It produces excess levels of the pleasure hormone dopamine -- a characteristic of Parkinson's disease.
Marianne Legato, M.D.
"There is tremendous difference in the genetic equipment of men and women. The impact of how those genes modify our normal function and how immutable those characteristics are, are really a matter of great discussion now."
And with a better understanding, researchers expect gender will play a big part in the future of medicine -- in a positive way.
Doctor Legato says the next step is to educate physicians to consider different ways to treat a condition, depending on whether they're treating a man or a woman. If you're interested in getting involved in a clinical trial, you can visit www.Clinicaltrials.Gov to find out about ongoing research.
BACKGROUND: A new area of medicine is developing and it's dividing men and women. It's known as gender-specific medicine and it's the "science of how normal human function differs between men and women and how the different genders experience the same disease differently." Until recently, researchers falsely assumed that whatever they learned about men could be transferred to women without separate testing or modification.
GENDER DIFFERENCES
HEART -- Doctors now know that men's and women's hearts differ in many ways. Each year 478,000 women die of heart disease compared with 453,000 men. When a woman reaches menopause, her risk for heart disease increases four-fold. The appearance of coronary artery disease is 10 years earlier in men than in women. In general, women's hearts are only two thirds the size of men's and women have smaller coronary arteries. Women's heart rates are also higher than men's, even during sleep.
IMMUNE SYSTEM - The relationship between sex hormones and immunological processes is a close one. Women have the ability to fight off viruses better than men because of higher immunoglobulin levels. Women's cell-mediated immune response is less vigorous than men's but women mount a more vigorous response to viral illnesses and parasitic infestations. Autoimmune diseases are more prevalent in women than in men. Pregnancy dampens the intensity of the female immune response.
BRAIN - Migraine headaches affect 15 percent to 17 percent of women and only 3 percent to 6 percent of men. Women experience depression two to three times more often than men and the number of women's with Alzheimer's disease outnumbers men. More women die of stroke each year than men, even though the stroke rate among men is higher. In the part of the brain associated with language skills, women's brains contain up to 11 percent more brain cells than men. Male brain neurons are about a third larger than female neurons. Male and female neurons take up significantly different amounts of dopamine - a brain chemical that acts as a mood enhancer, relieves pain and regulates motion.
BONE - Women establish less bone mass at peak maturity than men. Women have a higher incidence of osteoporosis than men. Women experience accelerated bone loss immediately after menopause, which can result in osteoporotic fractures. Eighty percent of the roughly 210,000 hip fractures each year occur in women.
SKIN - Because women have thinner skin than men, the sun's UVA rays damage female skin to a greater degree. Women develop melanoma on different areas of the body than men. As estrogen levels drop in women, the epidermis becomes thinner. Delayed skin maturation in males may contribute to increased mortality and morbidity in male infants. Lupus, an autoimmune disease typically associated with the skin, occurs in women more than men, at a ratio of 10 to 1.
Partnership for Gender-Specific Medicine
http://partnership.hs.columbia.edu
Copyright © 2004 Ivanhoe Broadcast News, Inc.
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