“Bikini medicine” treated men and women as the same, except when it came to reproductive health. “Women’s health” essentially covered what’s primarily underneath a bikini – uterus and ovary. Women’s health = reproductive health. For reasons including the safety of child-bearing aged women in clinical trials and general implicit sexism, men and male physiology (including male mice) became our references for how our bodies work, how drugs work in our bodies, and how symptoms manifest.
The Fall of Bikini Medicine and its uber importance especially to women’s health is addressed in The Longevity Book. Co-authored by Cameron Diaz and Sandra Bark, the book’s casual and conversational tone makes this information interesting and accessible.
In many ways, it levels the playing field – we didn’t all get the same science and health education growing up. Women still get dismissed when they complain of pains and aches. It’s in your heads, women are told, or in years before, female hysteria. When women’s health comes up, it’s often couched in confusing and conflicting terms. If you have read Eve Ensler’s Vagina Monologues or seen the stage adaptation, you will know how little many women actually know about their own bodies!
Being reminded of basic information, spiced up with interesting factoids, is always helpful. The Longevity Book, written by and for women, adds to the voices of women and invites all of us to ask more and better questions.
Bikini medicine was the product of centuries of misunderstanding about female anatomy that began with all that hysteria about hysteria.
The Longevity Book1
Did you know?
Here’s perhaps something not everyone knows or remembers from high school biology – the X chromosome is larger and contains more information than the Y chromosome. This means that women (XX) are cellularly different than men (XY). It seems obvious but get this – it wasn’t until 1993 that the US Congress mandated that for studies to receive federal funding, women must be included in clinical trials.
Here’s something else perhaps not everyone knows or remembers – there are 300+ X-linked disorders. This means the coding comes from sex-linked genes, on the X chromosomes.
So why do women live longer? We don’t know; however, here’s a thought. Women have two X chromosomes so if one X has a faulty gene, there is another X chromosome. This may explain why colour blindness is more prevalent in men than women. It’s X-linked.
Women’s Health
Women’s health, as we know it today at least in North America, didn’t really start to take shape until the 1960s. So women’s health – not “bikini health” – is quite new. It was only in recent years that the general public came to understand heart disease manifests differently in women than in men. In understanding heart disease in women, they did not take into account the architecture of the female heart – smaller size, thinner vessels.
Heart disease and heart attacks are more commonly incorrectly diagnosed in women. Because we are more familiar with symptoms such as strong chest pains, which applies to men, women may not always know they are experiencing a heart attack, and not just a fierce flu. Not knowing, women are less likely to seek appropriate medical help.
How may a heart attack look and feel like for women?
“Women do have chest pain, but unfortunately, women can be having a myocardial infarction, having a heart attack, and have no chest pain. They may just have more fatigue than usual, difficulty with sleep, other problems, headache, stomach ache, indigestion without the chest pain.” – Dr Janine Clayton [source]
So … if clinical trials excluded women, how did they test the birth control pill? Aside from a small sampling done at the medical practice of John Rock, one of the first pill’s creators, the first proper human trial was with 1,500 Puerto Rican women. You can read more about this in Washington Post’s article, Guinea Pigs or Pioneers? How Puerto Rican Women Were Used to Test the Birth Control Pill by Theresa Vargas.
As part of the book’s research, Cameron Diaz and Sandra Bark visited Dr Janine Clayton of the National Institutes of Health. She’s the director of the Office of Research on Women’s Health, founded about 15 years ago. 15.
Dr Clayton shared a few reasons why the effect of medicine on women is different.
- The female liver metabolize drugs differently.
- Women are generally smaller so we need to adjust dosages. (They cut the recommended dose for Ambien by half for women due to unexpected symptoms such as sleep walking.)
- The effects of some drugs last longer because women generally have more fat than men.
It is not only major illness that this blindspot affects women. With the lack of research, we are only discovering the extent of what we don’t know.
The Fall of Bikini Medicine
Women are not men. We are biologically different. Women’s health is unique and means far more than reproductive health. So it seems like a no-brainer that research, medical training, diagnosis, and treatment should include women and their physiology.
Why else is this important? Women make up just over half of the world’s population, still make the majority of health care decisions in the family, and and generally live longer than men. More family caregivers are also women, who experience chronic stress and burnout. Women need better care.
So, ask questions, no matter who you are. Seek individualized treatment. Find a health practitioner who listens to you – because we know ourselves better than anyone. If you aren’t sure how to answer your practitioner’s questions? Keep a food diary. Keep a mood diary. Be more mindful of your own ecosystem. The days of “bikini medicine” are not that far behind us; thankfully we have entered a new age of awareness.
1 The Longevity Book by Cameron Diaz and Sandra Bark. New York. Harper-Collins, 2016. p50
