Like a lot of other people, I thought it was interesting how the Sex Differences article began by articulating the difference between gender and sex. I think gender is definitely a weaker word to use in the realm of medicine because it implies something that is culturally constructed and variable according to social values. However, sex refers to the physiology of the human body and the way in which it functions. I had never before thought that sex could affect something as significant as the immune system.

The New York Times article was extremely frightening because I consider myself healthy and the thought that I could be predisposed to something as serious as heart disease seems difficult to accept. This is a major reason why such research should continue and be communicated to the public. If it hard for people to swallow themselves, I can see how it could lead Kachmann-Geltz to be treated like a crazy woman.

Week 4 Readings

I found it interesting that the article Sex Difference in Autoimmune Disease noted the difference between the terms “gender” and “sex” and how gender cannot be used to accurately describe the physical and biological differences between men and women. The article also showed the interdisciplinary nature of women’s health, as the attendees of the National Institutes of Health Office of Research on Women’s Health conferences didn’t just include scientists and researchers but also social scientists, public policy makers, legislators, and advocates.

The New York Times article, which seemed to be in favor of the term “gender differences” even when they more closely associated with sex differences, talked about how sometimes women’s symptoms don’t reflect the urgency and extent of their condition. The main subject of the article said she was “treated like a crazy woman” because her symptoms didn’t match the severity of her condition. It makes me wonder how this fact is going to affect the quality and amount of care that women receive, even if tests don't accurately show what is going on.

Both articles were uplifting in showing the efforts that have been made, even though initiated only recently, towards understanding and improving diagnosis and treatment for women. It was surprising to learn that autoimmune diseases are more prevalent in women, with some diseases, like Sjogren’s syndrome, SLE, autoimmune thyroid disease (Hashimoto’s thyroiditis and well as Graves’ disease) and scleroderma, occuring > 80% in women. In regards to the physiological aspects described, I thought it was interesting that there were post-partum flares of disease activity. Does this indicate that women's bodies were not as adequately prepared after pregnancy as they were during the period (perhaps because they used much of their resources to supply the proper nutrients and defenses for the fetus)?
The NYT article illuminated gender differences in heart disease, pointing out that tests are less likely to pick up signs of heart damage in women (which has huge implications for the way diagnoses should be made). The fact that many women (some unknowingly) suffer from microvascular disease pushes further for more research and focus in this area.

Week 4 Readings

Sex differences in autoimmune disease:

I thought the explicit clarification of gender vs. sex was a really important statement to make. Often, medical professionals shy away from a statement of social construction in favor of not discussing what is not completely biological. When I first read the title, I wondered whether the author would make a distinction, and I was actually surprised by it.

I was surprised that so many diseases have such high prevalence among females. Usually, you only hear the common "female" diseases like reproductive-related cancers, but I had no idea that diseases like MS and thyroid diseases had such high female-to-male ratios.

I think information like this should be disseminated to the general public because if we don't know some of this info, chances are most people know even less.

I had never heard that diseases like RA and MS are mitigated by hormones in pregnancy and flare during the post-partum period.

[on an unrelated note, I thought the experimental method of testing hormones in mice by castration was particularly cruel]

The sentence "Never has there been greater interest and funding opportunities in the are of sex difference in autoimmune disease than now" was hope-instilling :)

In Heart Disease, the Focus Shifts to Women:

I was surprised to see that heart conditions have worse results in women than men. Popular media usually sends the message that heart problems are a problem mostly for males.

It's a little disappointing that so little is known about many of the differences in stress related responses, etc., but I'm glad people are discussing it. I, too, was angered by a common response by doctors to symptoms from women. Obviously, they aren't aware either that heart conditions are common among women.

Week Four Readings

The NY Times article raises some interesting points about the impact that disease can have on women's lives, especially if women are naturally more likely to acquire these diseases. Something that became apparent to me while reading this article was the structure of how it was written. I feel like this article was "womanized" in that they appealed to the femininity of the woman, her feelings, her motherhood, where as if this article was written about men's diseases, perhaps some of the concepts would have been presented differently. Just a thought.

I never realized that there was an actual difference between the words "gender" and "sex". This article is very interesting because they take both the research and analytical approach of figuring out why there are differences between men and women in health while also creating distinguishing exactly where in medicine men and women differ. I always knew that because of our physical differences and hormone differences that men and women functioned differently, but I never thought that our differences would affect us so much to differ the rate at which we are susceptible to autoimmune diseases. Taking both of these actions is important so as to be proactive while also looking out for the health of the population in the future.

4th Week Readings

I find it usual but disrespectful that doctors assume that a female patient's symptoms are "in her head." It is a complete disregard for the women's well-being, and a residual prejudice from the days when men assumed that women were simply "hysterical" and "weak." However, I am really glad that a mainstream news website like the New York TImes is reporting on this issue, so that people will take notice. In the other article, I was surprised to find that there is an actual difference between "sex" and "gender' differences, which I had used interchangeably. The article was pretty dense, but very interesting and informative. However, in the conclusion, the article professed high hopes for change, and I noticed that it was written in 2001. That is now 10 years ago, and it doesn't seem like much has chanegd. However, perhaps this is due to my lack of exposure to the medical field?

The article on Sex differences in autoimmune disorders said that at the time of its publication there was an increase in focus on these differences, the article was published in 2001 and it makes me wonder what has changed since the implementation of these new approaches especially those which used the collaborative efforts of different fields. I would hope that they've made significant progress. It really seemed as though they were approaching the topic from several angles.

The article which focused on heart disease reminded me of the morbidity/mortality discussion we had during our second week however it seemed to be somewhat contradicted by "women are less likely than men to develop heart problems, but once the disease does occur, women often fare worse than men."

I was surprised to hear that some women's symptoms were not taken seriously until they almost became fatal, this definitely showed a lack of knowledge in the field and again makes me wonder how this has changed medical approaches since its publication in 2006.

Both articles were rather interesting. For the first one, I thought it was very interesting how they made the distinction of the terms "gender" and "sex" at the beginning. I also thought it was intriguing that people used to study autoimmune disease individually, without trying to put them together or study connections. Although the logic of making studies specific and therefore "manageable" is a very often used tactic, I would have thought that they would put together the similar disease sooner. In a similar way, I suppose that the connection between gender and disease might have escaped people's notice too. That said, it was interesting to observe how all the "key events" highlighted in the paper seems to follow one after another, as if they were influenced by the previous event to happen.

I did also notice that a lot of the experiments done relating to females, was that they were either performed on rats or on non-living things, but hardly ever on humans (I think). Although there might be some risks involved in studying pregnant women, it might be worthwhile to take the study to a more direct place.

For the second article, I think it's really important for doctors to really be careful and listen carefully to what patients say. In this course and the article, the focus is on women, so it might sometimes feel like women are the only ones that usually get this sort of trouble because they are under-studied, but the issue of overlooking details that are not studied yet probably exists in all cases. So this idea could be expanded in a more general sense too?

I thought the two readings this week were really interesting! The first one, about heart disease, was very informative as to the differences between men and women in relation to heart disease. I believe that a lot more research must be done on women, because women are obviously being hurt by this lack of research (i.e. clinicians failing to diagnose microvascular disease, because their diagnostic methods most fittingly address men; lack of knowledge of why microvascular disease is more common in women than men; bypass surgeries historically putting women at greater risk for post-surgery complications). What jumped out at me the most was how the patient, Kim Kachmann-Gelz, was completely disrespected by her physicians. And Dr. Sopko’s suggestion to other physicians, “Let’s listen to her,” seems to imply that most women are not taken seriously by their physicians when their symptoms do not fit what a “normal” male with cardiovascular disease would present. I think this is a major problem in medicine, and I suspect it expands beyond cardiovascular disease.

The second article was a bit over my head, but I still appreciated how informative it was. The background it gave on how research is focusing more and more on sex differences in health gave me hope that more research is being done. Since the article was published in 2001, I wonder how much research has been done since then and if interest in sex differences is still significant.

I'm afraid I didn't really absorb the more technical article. Really what I got out of that article was that there is loads of research being done on sex differences in autoimmune diseases, which I think is great. Honestly I'm just glad it's being funded, and its seems to be producing comprehensive results.

The New York Times article kind of freaked me out, because a perfectly healthy woman got heart disease. Until recently I've thought of heart disease as being associated with mostly men (and heart attacks), of course now I know this isn't the case. I think my misconception is largely due to campaigns for 'traditional' women 's health issues, like for breast and cervical cancer we discussed last week. Anyways, I found this article particularly interesting because doctors didn't catch it at first, it took I think two years after she was waking up from chest pains for a doctor to diagnose her correctly. Indeed from this article it can be seen there is a lot more research to be done in this area of sex differences. Just getting smaller instruments to operate on women with seems to have helped (I found it surprising that this was even an issue).

So the first article (more technical) was from 2001 and the NY Times article was from 2006, clearly there's more work that needs to be done. Anyways, I found both to be interesting.