More MS news articles for April 2001

Sex Differences Called Key in Medical Studies

http://www.nytimes.com/2001/04/25/health/25HEAL.html?searchpv=site01

April 25, 2001
By ROBERT PEAR

WASHINGTON, April 24 The National Academy of Sciences said today that biomedical researchers should pay much more attention to the different ways in which women and men are affected by diseases and various treatments for disease.

Researchers should "study sex differences from womb to tomb," because such differences are pervasive, the academy's Institute of Medicine said in a report commissioned by the federal government and several private sponsors.

"Sex that is, being male or female is an important basic human variable that should be considered when designing and analyzing the results of studies in all areas and at all levels of biomedical and health-related research," the 16-member panel said. "The cells of males and females have many basic biochemical differences, and many of these stem from genetic rather than hormonal differences."

For many years, the panel said, researchers tended to view men as the norm or the standard, and scientists tended to "underreport rather than highlight sex differences." This habit, it said, "can still be found in the current medical literature."

The report catalogs dozens of ways in which "sex affects health," documenting differences in the incidence and severity of heart disease, obesity, rheumatoid arthritis, multiple sclerosis and other illnesses.

In addition, it said, women are more sensitive to certain types of pain, and a woman may feel more or less pain from the same stimulus at different stages of the menstrual cycle. These differences have important implications for the treatment of illnesses, the panel said.

The panel urged scientists to investigate sex differences at the level of cells and molecules, not only in the reproductive system, but also in other parts of the body, for, it said, "every cell has a sex" every cell contains a full set of chromosomes, including the sex chromosomes.

The conclusions, based on a large body of scientific data, place the imprimatur of the scientific establishment on arguments that have been made by some advocacy groups and women's organizations.

Phyllis E. Greenberger, president of the Society for Women's Health Research, said: "We are delighted. This report substantiates everything we've been saying for six years. Many scientists see the emphasis on sex and gender differences as a passing fad, reflecting some kind of political agenda. But the Institute of Medicine has validated this as an important field of research."

Senator Olympia J. Snowe, Republican of Maine, said: "This watershed report will change the way we approach research and medical science. It underscores the imperative of including women and men in every aspect of health research, testing and trials."

The panel was headed by Mary- Lou Pardue, a professor of biology at the Massachusetts Institute of Technology.

"Sex does matter," Ms. Pardue said. "It matters in ways that we did not expect. Undoubtedly, it also matters in ways that we have not begun to imagine."

The panel made these recommendations:

The panel acknowledged the ethical difficulties of conducting research in pregnant women. The American College of Obstetricians and Gynecologists has said that "pregnant women should be presumed to be eligible for participation in clinical studies," with full disclosure of the risks so women can give informed consent if they wish.