Model of female sexual organs in a gynecological examination room
Photo: imago/YAY Images
Women’s diseases are discovered less often, researched less well and the patients treated less well. Examples include premenstrual syndrome, endometriosis (pathological growth of the lining of the uterus in the abdomen) or lipoedema, a fat distribution disorder. So there are not only different symptoms in the sexes, although they have the same diagnosis, such as a heart attack. These and other deficits in gender-specific medicine were the focus of a specialist forum of the Green Economic Dialogue in Berlin on Tuesday.
The event was apparently intended to broaden the perspective of companies on the unmet health needs of different genders. Descriptions of conditions came from politics, medicine and science. In view of many examples of how women’s health and the needs of other genders are not taken into account, Saskia Weishaupt, member of the Greens in the Bundestag, started with positive developments, initially with a reference to France. Since 2022, all women up to the age of 25 have been reimbursed for their contraceptives. There is a general assumption of costs for contraceptives up to the age of 18. However, condoms do not fall under this rule. In Germany, on the other hand, prescription contraceptives are subject to additional payment from the age of 18, so contraception remains a question of cost here.
In addition, France launched a national strategy against endometriosis last year. In Germany, too, research into the disease is currently being promoted with state funding: The Greens made sure that an amount of five million euros was allocated to the federal budget for 2023 and want the funding to be increased again in 2024. Spain also scores well on women’s health: the new abortion law, passed this February, guarantees abortion in public health centers and lowers the age for an abortion without parental consent to 16 years. The free distribution of the morning-after pill is also guaranteed.
Even though the traffic light coalition is the first federal government to include gender health tasks in the coalition agreement, there is an enormous backlog in this area that cannot be dealt with in one legislature. Among other things, gender medicine is only a compulsory subject in medical studies at a German university. For example, the medical and pharmaceutical setting of the male body as the norm continues to have an effect in most clinical studies. In drug therapy, this leads to women receiving an overdose of drugs and suffering more side effects.
However, it is not just about the biological differences between the sexes. Among other things, Weishaupt says that certain themes Women’s health in male decision-making bodies find no consideration. That is why one-to-one care by a midwife during the birth is not yet guaranteed, and delivery rooms run by a midwife are not yet available everywhere. In North Rhine-Westphalia, for example, there are only 27 of these delivery rooms out of 132 birth departments in hospitals.
Mandy Mangler, head physician in this area in two Berlin Vivantes clinics, gives amazing insights into gynecology. She points to the fact that there are still more men in management positions in obstetrics, even though 77 percent of those who practice the profession are women, quite apart from the sex of the patient. Medicine practiced more by women could also become safer for men: a large Harvard study evaluated interventions in 104,000 patients that were performed by around 3,300 operators. In cases where women operated, fewer patients died, there was less mortality in the first 30 days after surgery, and fewer hospital admissions. Conversely, the results of operations on women are worse when they are performed by men.
Mangler also lacks the women’s perspective in studies devoted to female diseases, for example when the women themselves are not asked at all when researching the effects of a hysterectomy. Medicine that is not gender-sensitive also ignores health problems that primarily affect men. The fact that the latter in Germany die on average almost five years earlier than women is a bad figure in an international comparison, she says Psychologist Gertraud Stadler, who holds a professorship for gender-sensitive prevention research at the Charité. When it comes to behavioral prevention, men are hardly reached. A specific address is probably missing. In addition, obesity affects not only the fertility of women, but also that of men. However, studies on this topic only examine women. From Stadler’s point of view, this has to be done systematically data gaps getting closed. In the end, everyone’s health could be improved.