According to a recent article in Science (10/10/2008), there’s no evidence suggesting that women were excluded from clinical trials funded by NIH since 1985. As they say:
Six years ago, A New York Times columnist confidently stated that, before Bernadine Healy became director of the National Institutes of Health (NIH) in 1991, “women were usually excluded from clinical trials.” It’s a popular and tenacious view, but it’s hard to find evidence for it. In fact, the current ratio of women to men in U.S.-government-funded trials is about 2-to-1.
Such figures can mask other sorts of neglect, so someone else with a different take may be able to give a different version of the treatment of women in medical research. However, in the meantime, we need to face the fact that a favorite example of male influence may be more than20 years out of date.
There is another factor worth thinking about. You can see it in this passage from the article:
It’s true that until the 1980s, women of reproductive age were often excluded from trials, ostensibly to avoid harm to fetuses. The impression of male-dominated trials was reinforced by two large men-only heart trials launched in 1972 and 1981. In 1987, NIH formally made a commitment to include more women in research and followed in 1990 with the establishment of the NIH Office of Research on Women’s Health. In 1991, NIH started the 15-year Women’s Health Initiative, an intensive study of postmenopausal women.
These developments notwithstanding, many women argued that more attention was needed. In Congress, Representative Patricia Schroeder (D-CO) picked up the ball after one of her staffers called her attention to the two big male heart trials. “Because they were so big and expensive,” in part, they provoked “outrage,” says Adele Gilpin, a physician and lawyer at the Washington, D.C., law firm of Hunton & Williams. These pressures led to congressional passage of the 1993 NIH Revitalization Act, which further emphasized inclusion of gender considerations in research.
There’s a path to change: women in power get a central authority to mandate change. Not that that is easy, but it is a good example of top-down change.
4 thoughts on “Women and Medical Research: Fact vs. Fiction”
Thanks for this– very good to get examples of what has worked.
When I studied to be a physiological psychologist, I was taught that in test designs women of reproductive age were not excluded because of possible damage to a foetus, but because a woman’s cycle complicates measuring effects, particularly of psychopharmaceuticals.
This doesn’t justify not testing psychopharmaceuticals on women, it just means that more extensive methods should be applied, that reckon with cycles. But that is more expensive of course…
Thanks, Jender. We should collect this stuff up.
Saskia, that’s what I understood too. And of course men also have fluctuations, just ones harder to identify.
I think I can safely say that men are more often affected by their hormones determining their thoughts and actions than women. It’s just daily rather than monthly and more erratic, hence it has a random effect in those studies and can therefore be ignored.
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