Montserrat Chimeno Viñas, Adriana Romaní, Lélita Santos and Juana Carretero.
reflect the different ways in which women suffer from pathologies and adjust diagnosis and treatment to their gender characteristics. This is the unanimous demand that has reflected the Ibero-American Forum of women internists held at the 43rd Congress of the Spanish Society of Internal Medicine after showing, through autoimmune pathologies, cardiovascular and infectious diseases, how there is an absence of these risk factors and there is a lack of adaptability in the clinical guidelines and the elaboration of drugs.
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“There is a gender and disease gap.” |
“We must ensure that women have the health that corresponds to us and that it is not aggravated by our fundamental role as caregivers. We must achieve gender equality in sex and achieve social justice for women. There is a gender and disease gap”, claimed Juana Carretero, president of SEMI, during the 43rd National Congress.
For the optional, a “women’s health strategy” that covers from birth to death because their own factors condition their illnesses. “We cannot ignore reproductive health and gender conditionsthe approach strategy must be global”.
As an example, Carretero has shown how in “no guide to obesity” come treatment certificates by sex. “They will see it by cardiovascular status, presence of obesity, metabolic control, but no guide says that the treatment of women has to be different from that of men. We are completely different, like night and day, let’s all walk together to achieve equality in care and put women where they deserve ”, Carretero claimed.
In the same sense, the president of the Argentine Society of Internal Medicine, Adriana Romaní, has shown herself, who considers that these strategies should be applied promptly. “In the anamnesis we forget to give importance to the genetic background, we should not treat everyone the same, we have to change the chip and diagnose with a gender difference. Also, the sooner we touch on these issues the better because with age they get worse ”, claims the doctor.
Specific strategy in autoimmune diseases
For her part, Lélita Santos, president of the Portuguese Society of Internal Medicine, detailed the major health problem for women” that represent the autoimmune diseases that occur with greater prevalence in women. “Women have four times more risk of autoimmune diseases compared to men. Therefore, we have to be treated in a more specific way”, claims the specialist.
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Lèlita Santos, president of the Portuguese Society of Internal Medicine. |
This greater impact occurs, according to Santos, due to the differences caused by the sex hormones; the cromosoma x (abnormal inactivation of the x chromosome); the microchimerism; the VGLL3 genes, Vestigial Like Family Member 3; qualitative or quantitative differences in circulating antibodies; the environmental factors that cause differences in exposures such as cosmetic chemicals or sunlight; and the microbiomeas scientific evidence suggests that men’s gut microbes are more protective.
“The susceptibility and progression of autoimmune diseases show sex differences, which requires prevention and treatment strategies specific to each sex”. explains Santos, who also considers that the fundamental aspects of immune functions and metabolic homeostasis are regulated differently in men and women. “This underlies the sex differences in autoimmune diseases and their management,” concludes the internist.
Gender factors in cardiovascular diseases
Cardiovascular diseases also represent one of the great problems of women’s health. “It is the first cause of mortality in the female sex. Specifically, they are responsible for 46 percent of the deaths of elderly women in the world. There is insufficient diagnosis and treatment”details Tatania Espinosa Espitia, former president of the Colombian Association of Internal Medicine, who also details that the main cause is not breast cancer but ischemic heart disease.
Adriana Romaní, president of the Argentine Society of Internal Medicine. |
This higher prevalence is partly explained by factors associated with women, such as preterm pregnancy, hypertension in pregnancy, gestational diabetes, the greater impact of autoimmune diseases, early menopause, or breast cancer treatment. “We must not only know the traditional risk factors, but also those of women”claims Espinosa Espitia, who believes that these particularities should be included in the internist’s anamnesis when treating a woman.
In this sense, the internist assures that it is “time for us to make a change of attitude”. “We need a more inclusive definition of women’s health, which takes into account the social, cultural, spiritual, emotional and physical aspects of well-being, the impact of poverty and violence. The current conception accepts that there is a complex interdependence of sex and gender and that the interaction of both is constant at all stages of people’s lives”, claims the specialist.
Ibero-American Forum of Women Internists held at the 43rd Congress of the Spanish Society of Internal Medicine. |
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