Tuesday, February 11, 2014

It May Not be Politically Correct, but There are Gender Differences

It shouldn't come as a surprise to us that men and women are physiologically different. Come on now, I know my readers are smart. All of you worked this out before I said anything. But, lots of people have been surprised by this article and the FDA recommendations in it.

The FDA, for the first time, is recommending a different drug dosage for women than for men, although they go on to say that perhaps the reduced dosage is appropriate for men as well.  What surprises me is not that this happened, but that it took so long to happen.

Let's consider why.

Before drugs go on the market in the US, the FDA requires that they go through extensive research and clinical trials. Those are done almost exclusively on men. Why? To quote an FDA official whose name I cannot remember, "Women are hormonally inconvenient." In other words, because women monthly have significant hormonal swings, it is much more difficult to filter out the noise in the data.

Unfortunately, this means that much of the data that we actually have collected on drug efficacy and drug interaction may be somewhat accurate for men, but it's probably less accurate for women. And, as long as I am being politically incorrect, I would hypothesize that the same efficacy and interaction deficiencies that result from gender specific studies also result from the fact that studies have generally not been filtered by data such as ethnicity and blood type.

I've not done the research, so I am just guessing. But, my guess would be that people of different ethnicities and people of different blood types (among other differences) handle different drugs differently. It just makes sense.

So, what's in the future?

I don't really know, but this is my blog, so I get to hazard a guess.

Today, one of the current trends is genome mapping. Without having any particular expertise in the field, I understand that each of us has our own individual genetic map (perhaps monozygotic twins (identical) have the same genetic map, I just don't know). Surely then, the ideal medical treatment of each of us for a specific condition is different than for anyone else and those differences are based on our genetic maps. The data to develop these new medical plans of action will be here soon. Are we going to let hormonal inconveniences get in the way of better treatment plans?

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