Sofia Mykytenko, 12/19/23, Period 7

 Sofia Mykytenko

Period 7

12/21/23

Modern Mythology 2023

Socio-Political Consciousness 

The 1983 film Yentl tells the story of a woman who disguised herself as a man to receive an education. Surprisingly, the movie has found its way into medical lore as Yentl Syndrome, which describes the misdiagnosis and mistreatment of women’s heart disease, stemming from treating women just like men despite biological differences. This phenomenon can be applied not only to heart disease but also to drug prescriptions and more. 

For decades, scientific studies, experiments, and clinical research trials have only utilized male test subjects. Studies on males were preferred since researchers didn’t have to consider changing hormonal cycles, the effects of different types of birth control, and anatomical differences between males and females. Accounting for these differences takes more time and money, which are the most significant limits to research. In addition, in 1977, the FDA even excluded “women of all childbearing potential” from clinical studies after witnessing the tragic deformities that a new medicine (thalidomide) caused in recently born children. The lack of representation of women in medical studies led to a lack of understanding of women’s health and the effectiveness of medicine on women.  

An important example of this is heart disease in women. For decades, women were believed to exhibit the same typical symptoms of men when having heart attacks: chest pain, shortness of breath, and pain in the shoulder, jaw, or arm. Therefore, doctors would look for similar symptoms, perform the same diagnostic tests, and give the same treatment. However, women experience heart attacks differently – more frequently in smaller arteries rather than larger ones, so they experience different symptoms, sometimes not experiencing chest pain at all. This makes typical “male” methods for detecting and treating heart disease ineffective. Women have been mistreated for heart disease for decades, resulting in tens of thousands of preventable deaths. 

Not only do women suffer consequences from misrepresentation in medicine when it comes to heart disease, but also when taking prescribed drugs. Women are nearly twice as likely to suffer side effects from drug prescriptions compared to men, and oftentimes, the side effects are more severe. Many of the drugs in current circulation were produced from male-only clinical trials, effectively not studying the impact of the drugs on women and using dosage amounts that are male-specific. Women have different body weight and composition than men and also metabolize drugs differently due to differing hormone levels that affect metabolism. Overall, women are often overmedicated, leading to a reduction in the therapeutic effect of the medication and an increase in adverse side effects. 

Only in 1993 did Congress require the National Institutes of Health (NIH) to solely grant funding to studies that include females and minorities, analyze potential ways controlled variables could affect them differently, and prohibit cost as an excuse not to include them in research. Still, this did not stop research from only utilizing male animals and cells. More recently, studies have discovered physiological differences in animals and cells of different sexes. Only twenty years later, in 2014, did the NIH declare that studies must also use equal amounts of male and female cells and animals.

 These are important steps in the right direction to prevent further misrepresentation and revise past studies that did not take biological differences between females and males into consideration. However, many of the drugs that are currently approved and in use did not consider differences in dosage or effectiveness between males and females and must also be reevaluated. About a third of current drugs have no research available on this matter. Women are also still twice as likely to die from heart attacks as men due to the failure of women and doctors to recognize the warning signs of cardiovascular issues and heart attacks. Public awareness campaigns have been an integral part of decreasing the gap in the survival rate between men and women. However, there is still much work to be done. 

 Although the healthcare system should be designed for everybody’s individual needs, it evidently is not. This is just an example of why diversity and representation is important in all aspects of life. People’s voices should always be sincerely listened to, unlike the thousands of women with cardiovascular problems whose symptoms would get dismissed by their doctors since heart attacks were a “man’s disease” and their symptoms didn’t align with the typical male symptoms. An important lesson to learn here is also to take into consideration how something affects everybody. Not just medical prescriptions but new developments, inventions, policies, and even what people say or share on social media. 

I chose this topic because of my interest in biology, medicine, and feminism. I developed these interests from observations of my life experiences, and I’d like to share one of them. Just last year, my father and I were both experiencing knee pain. He recommended I take this over-the-counter medicine that helps with joint inflammation and pain. So, I did. I took the recommended dosage, “1 tablet every 8-12 hours for adults and children over the age of 12”. After taking two a day for about three days, I experienced some truly terrible stomach irritation. Thankfully, it was just that and nothing worse, but I asked him how he takes the medicine and copes with the same side effects because I was not enjoying these side effects at all, and I would rather not have taken the medication. He told me he didn’t experience any side effects. I wondered why and started searching for a possible answer. It turns out the answer was right in front of me – my father is 6 feet tall and over 200 pounds, and the same medicine doesn’t have the same effect on him as it does on me. This experience has simply been on my mind ever since. 

Bibliography

Bailey, Sarah. “Science Experiments Traditionally Only Used Male Mice – Here’s Why That’s a Problem for Women’s Health.” The Conversation, 4 Dec. 2023, theconversation.com/science-experiments-traditionally-only-used-male-mice-heres-why-thats-a-problem-for-womens-health-205963. 

Brigham and Women’s Hospital. “Heart Disease: 7 Differences between Men and Women.” Brigham and Women’s Hospital Giving, 5 Oct. 2023, give.brighamandwomens.org/7-differences-between-men-and-women/. 

Zucker, Irving, and Brian J. Prendergast. “Sex Differences in Pharmacokinetics Predict Adverse Drug Reactions in Women - Biology of Sex Differences.” BioMed Central, BioMed Central, 5 June 2020, bsd.biomedcentral.com/articles/10.1186/s13293-020-00308-5. 

Lamon, Severine, and Olivia Knowles. “Why Are Males Still the Default Subjects in Medical Research?” The Conversation, 4 Dec. 2023, theconversation.com/why-are-males-still-the-default-subjects-in-medical-research-167545#:~:text=Even%20when%20research%20with%20females,limited%20by%20time%20and%20money.

O’connor, Anahad. “Why Heart Disease in Women Is so Often Missed or Dismissed.” The New York Times, The New York Times, 9 May 2022, www.nytimes.com/2022/05/09/well/live/heart-disease-symptoms-women.html. 

C. Noel Bairey Merz, MD. “The Yentl Syndrome and Gender Inequality in Ischemic HD.” Healio, 1 Aug. 2011, www.healio.com/news/cardiology/20120225/the-yentl-syndrome-and-gender-inequality-in-ischemic-hd. 

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