Specific Needs of Women
By Elizabeth Lipski, PhD, CCN

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Historically women's maladies were often discounted as hysteria, depression, and psychosomatic. Even today women's complaints aren't always taken as seriously as men's. A new study from the Netherlands reported that women with Rheumatoid Arthritis (RA) were more likely than men to have a delay in referrals to specialists, even though disease activity was similar in both sexes (Badley, 2001; Lard LR, 2001). An Austrian study stated that women take longer to access coronary angiogram than men despite free access to services (Hochleitner, 2000). In 1984 the National Institutes on Aging published a study using data derived only from men and called it "Normal Human Aging" (Lamberg, 1998).

Prior to 1990 women were rarely subjects for research, although results were widely extrapolated for women's treatment. Women were largely excluded from studies to prevent possible birth defects and "not to confound results with the normal cyclic variations in many functions that occur over the estrus cycle". The impact of this is that the impact of cyclic changes on diagnosis and treatment of women has been largely ignored (Lamberg, 1998). In 1990 the NIH issued guidelines requiring the inclusion of women and minorities in all NIH funded clinical research to address the issue of gender/minority inequities in medical research and funding. A recent study that surveyed research articles in major medical journals in the years 1993, 1994, 1997, and 1998 found that over this 5-year period, only 80% of NIH non-sex-specific studies included women. Only ? to 1/3 of the studies analyzed data or results by sex of the subjects. These numbers did not improve significantly over time (Vidaver RM, 2000). Women are different!

  • 80% of the population with Osteoporosis are women.
  • 75% of people with Lupus are women
  • Twice as many women as men have arthritis.
  • Hypothyroidism is 10 times more prevalent in women than in men.
  • Fibromyalgia (FM) is 9 times more prevalent in women than in men.
  • Chronic Fatigue Syndrome (CFS) is three times more common in women than in men.
  • Migraine headaches affect women three times more than men (Lamberg, 1998).
  • Women experience more severe and more pain overall than men (Lamberg, 1998).
  • Interstitial cystitis is almost exclusively found in women.
  • Multiple sclerosis occurs more in women than in men.
  • Endocrine imbalance affects women more than men.

Women with auto-immune conditions often have food and/or environmental sensitivities, heavy metal toxicity, dysbiosis and/or leaky gut syndrome. Depending on the genetics, lifestyle, and environmental affects, each person's unique biochemistry will determine which tests are of highest priority. For example: Osteoporosis is of major concern for aging women. Bone mineral density testing is necessary to determine bone health. Solomon and colleagues reported that bone mineral density testing (BMD) is under-utilized by a majority of health care professionals [Solomon, 2000 #5]. BMD is an important test for assessment of bone density. Urinary bone resorption assessment is a useful test to monitor whether treatment is preventing further bone loss.

Thyroid dysfunction was reported to be three times as high in women with Rheumatoid Arthritis (RA) than in women with non-inflammatory rheumatic diseases such as osteoarthritis and fibromyalgia [Shiroky , 1993 #13]. Some RA patients have food and environmental sensitivities (Darlington, 1993; van de Laar, 1992). And others have dysbiosis. RA has especially been linked with a genetic predisposition and Proteus bacteria as a trigger for the illness (Ebringer, 2000; Rashid, 1999; Rashid, 2001).

Bairey-Merz reports that about 50% of women and 17% of men who have diagnostic cardiac catheterization have normal coronary arteries. So, 50% of the time chest pain in women is due to some other cause(s). Assessment of mineral status, and of other cardio risk factors such as homocysteine, fibrinogen, and C-reactive protein can be used to detect other contributors to chest pain. These tests and others are included in a comprehensive cardiovascular assessment. Magnesium deficiency often mimics angina and arythmias.(Sueda S, 2001; Topalov V, 2000; Yoshimura M, 1998) Serum minerals testing would be of benefit. Higher levels of estradiol also are associated with increased risk of chest pain (Lamberg, 1998) so a hormone panel would be indicated as well.

Although CFS and FM are distinct, they have many common characteristics in symptoms, diagnosis, and treatment. Several studies have reported a high incidence of food sensitivities, leaky gut syndrome (Mercola, 2001) (Jaffe, 1996), and thyroid autoimmunity (Aarflot, 1996) in fibromyalgia and CFS.
So, it's important for health care practitioners to really listen to women's concerns. They are not plagued with psychosomatic illness, but rather clues to their distress lie in functional analysis and an integrative medicine approach to their healing.

Resources:

Aarflot, T., Bruusgaard D. (1996). Association between chronic widespread musculoskeletal complaints and thyroid autoimmunity. Results from a community survey. Scand J Prim Health Care, June(14(2)), 111-5.

Badley, E. (2001). Gender Differences in Access and Use of Health Care Services. J of Rheumatology, 28:10, 2145-6.

Darlington, L., Ramsey, NW. (1993). Review of dietary therapy for Rheumatoid Arthritis. Br J Rheumatol, June(32(6)), 507-14.

Ebringer, A., Wilson C. (2000). HLA molecules, bacteria and autoimmunity. J Med Microbiol, Apr(49(4)), 305-11.
Hochleitner, M. (2000). Coronary heart disease: sexual bias in referral for coronary angiogram. How does it work in a state run system? J Womens Health Gend Based Med, Jan-Feb(9(1)), 23-34.

Jaffe, R. (1996). A Novel Treatment for Fibromyalgia Improves Clinical Outcomes in a Community-Based Study. Paper presented at the American Association for the Advancement of Science, Baltimore, MD.

Lamberg, L. (1998). Venus Orbits Closer to Pain than Mars, RX for One Sex May Not Benefit the Other. JAMA, 280(2).

Lard LR, H. T., Hazes JMW, Vliet Vlieland TPM. (2001). Delayed Referral of Female Patients with Rheumatoid Arthritis. J of Rheumatology, 28(10), 2910-2192.

Mercola, J. (2001). Diet helps Fibromyalgia, [electronic newsletter]. Annual Meeting of the American College of Nutrition in Orlando Florida, October 2001, as reported in the Mercola Newsletter [2001, 11-7-01].

Rashid, T., Darlington G, Kjeldsen-Kragh J, Forre O, Collado A, Ebringer A. (1999). IgG antibodies and C-reactive protein in English, Norwegian and Spanish patients with rheumatoid arthritis. Clin Rheumatol, 18(3), 190-5.

Rashid, T., Tiwana H, Wilson C, Ebringer A. (2001). Rheumatoid Arthritis as an auto-immune disease caused by Proteus urinary tract infections: a proposal for a therapeutic protocol. Isr Med Assoc, Sept(3(9)), 675-80.

Sueda S, F. H., Watanabe K, Suzuki J, Saeki H, Ohtani T, Uraoka T. (2001). Magnesium deficiency in patients with recent myocardial infarction and provoked coronary artery spasm. Jpn Circ J, July(65(7)), 643-8.

Topalov V, K. D., Topalov A, Kovacevic D. (2000). Magnesium in cardiology. Med Pregl, May-June(53(5-6)), 319-24.

Van de Laar, M., Aalbers M, Bruins FG, van Dinther-Janssen AC, van der Korst JK, Meijer CJ. (1992). Food intolerance in Rheumatoid Arthritis II. clinical and histological aspects. Ann Rheum Dis, Mar(51(3)), 303-6.

Vidaver RM, L. B., Tong C, Bradshaw R, Marts SA. (2000). Women subjects in NIH-funded clinical research literature: lack of progress in both representation and analysis by sex. J Womens Health Gend Based Med, June(9(5)), 495-504.

Yoshimura M, O. T., Hiraga H, Nakano Y, Matsuura H, Yamagata T, Shiode N, Kato M, Kambe M, Kajiyama G. (1998). Increased cytosolic free Mg2+ and ca2+ in platelets of patients with vasospastic angina. Am J Physiol, Feb(274(2 Pt 2)), R548-54.

© Elizabeth Lipski, PhD, CCN

 

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