Like most living things, I’m interested in sex. By sex I mean both the pleasurable act of sensual engagement as well as the reality that men are one sex and women are the other. Vive La Différence! As important as sex is in our lives, new findings from the emerging field of Gender-Specific Medicine (GSM) are changing our view of sex and health.
What Is Gender-Specific Medicine?
Gender-Specific Medicine examines how biological sex or gender affects normal function and the experience of disease. Marianne J. Legato, M.D. is one of the founders of this new field of medicine and author of Eve’s Rib: The New Science of Gender-Specific Medicine and How It Can Save Your Life. “Until now, we’ve acted as though men and women were essentially identical except for the differences in their reproductive function,” says Legato. “In fact, information we’ve been gathering over the past ten years tells us that this is anything but true, and that everywhere we look, the two sexes are startlingly and unexpectedly different not only in their normal function but in the ways they experience illness.”
When we talk about men’s and women’s health, we need to talk about both sex and gender. Sex = male and female. Gender = masculine and feminine. So while your sex as male or female is a biological fact that is the same in any culture, what that sex means in terms of your gender role as a man or a woman in society can be quite different cross culturally. These gender roles have an impact on the health of the individual.
We know that men and women have different levels of hormones. Men have much higher levels of testosterone and women have higher levels estrogen. But hormone levels change. Testosterone levels drop and low testosterone can cause problems for men. However, men and women are different in more ways than our sexual organs and hormone levels.
Seven Critical Ways Knowing About Sex Can Save Your Life
1. Every cell in your body is sexed.
We all know that, with few exceptions, there are two kinds of people in the world: Penis people and vulva people. But it isn’t just our sex organs that are different, but our glands are different and our brains are different. What’s more, every one of the 10 trillion cells in our body differs by sex.
Quick reminder from biology class: We all start out our lives when a single, fast-swimming, sperm is accepted by an egg. That first cell has 22 sets of identical chromosomes that are the same in men and women. But that 23rd set is either an XY or an XX, making us either a male or a female. As one cell divides into two and two into four, all the way up to 10 trillion, each of those cells carries either the XY chromosome or the XX chromosome.
The poet, Robert Bly, captured this essence when he says that boys must be in the company of men in order to “hear the sound that male cells sing.” As it turns out there is a 10 trillion member choir singing in each one of us. They are either singing in the key of he or the key of she and their collective song has a lot to do with our health or illness.
2. Males and Females Are Very Much Alike and Essentially Different
The truth is that all of us in the community of life are more similar that we would like to believe. We have come to accept the fact that more than 90% of our genes are the same as chimps. But did you know that we share 24% of our genes with wine grapes and 25% with rice? 18% of our genes are even identical to baker’s yeast.
A recent article, “Genes are Us” in National Geographic Magazine, noted that “The genes we share with rice—or rhinos or reef coral—are among the most striking signs of our common heritage. All animals, plants, and fungi share an ancestor that lived about 1.6 billion years ago.”
Until recently, even scientists believed that humans are 99.9% the same, regardless of race or where in the world we live. But according to the research conducted by David C. Page, M.D., the truth is more complex and interesting. Dr. Page is one of the world’s experts on genetic differences between males and females. He is a professor of biology at the Massachusetts Institute of Technology (MIT) and the director of the Whitehead Institute, a scientific community exploring biology’s most fundamental questions for the betterment of human health.
It turns out that humans are 99.9% the same if we compare men to other men and women to other women. “But if compare genome of a man and a woman they are only 98.5% identical,” says Page. “The genetic difference between a man and a woman are 15 times greater than the difference between two men or two women.” Page makes this essential difference abundantly clear in lecture “Why Sex Really Matters.”
3. Males and Females Have Different Hearts
The most prevalent cause of death for both men and women is heart disease. But in general coronary artery disease strikes men almost two decades earlier than it does women; most men with coronary artery disease are dead by the time they are 65. Heart disease presents differently in men and women. Men often feel a crashing pain in their chest while women often experience fleeting pain in the upper abdomen, shortness of breath, and sweating.
4. Males and Females Have Different Brains
According to Marianne J. Legato, M.D. “Men have larger brains, but women have more brain cells and men and women use different parts of their brains while thinking.” Because males mature later than girls, the parts of the brain that weigh risks and moderates impulsive behavior are not as developed in adolescent boys than in girls. As a result adolescent boys are more likely than girls to take life-threatening risks, commit suicide and die violently.
5. Males and Females Have Different Bones
“Eighty percent of roughly 210,000 hip fractures each year occur in women,” says Dr. Legato. Osteoporosis isn’t a disease of older women alone. Older men can develop osteoporosis as well. Doctors and patients need to be aware of that fact and doctors need to order tests to determine bone density when their patients, male or female, complain of chronic back pain or other symptoms.
6. Males and Females Show Different Cancer Risks
“Women develop melanoma on different areas of the body than men,” says Dr. Legato. “Skin cancer occurs more frequently on the ears and necks of men and on the legs of women probably due to the shorter hairstyles of men and the exposed legs of women, since they are almost always caused by exposure to the sun.”
“A typical colon cancer is located 10 to 20 percent higher up in the colon in women than in men,” says Dr. Legato. Yet, “pancreatic cancer occurs three times more frequently in men than in women.” Her research concludes that, “Estrogen and progesterone appear to protect women from pancreatic cancer.”
7. Males and Females Respond Differently to Medications
Differences between men and women affect drug activity, including the rate and extent of drug movement through the body, including absorption, distribution, metabolism, and excretion. Differences also affect the action of drugs in the body. Other physiologic differences may affect medication dosages.
Rarely do medication instructions differ for males and females. This may account for the fact that women are 50 to 75 percent more likely than men to experience an adverse drug reaction.
But things are beginning to change. I see a future where all medical professionals are trained in Gender-Specific Medicine. I picture my wife and I going into a clinic together. Once inside, I go one way and talk to my “Guy-necologist” and she goes the other way and talks to her “Gal-necologist.” We each get support for our unique health-care needs, then we come back together to talk about what we have in common and how to help each other live long and well.
As David Page, M.D. reminds us, when we expand our health focus to include the importance of sex, “We will arrive at a fundamentally new paradigm for how we treat disease.”
Please feel free to share a question or comment below. I’d love to hear you input and experience.
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MPROVING REMEDIALS FOR SEX IN WOMEN IN HER EARLY40’S S TAPAN