Pharma research just treats women as “smaller versions of men”. I’ve seen 3 dermats in the past 3 years for my hair loss and all of them have casually asked me to “just use Men’s Rogaine at half dose because that’s what we do for women” despite telling them about some of the side effects I’ve been seeing.
Hair loss is honestly just the tip of this iceberg. Medical research has a MAJOR gender gap. And most drug trials still use male subjects as the default. A 2015 NIH study found 72% of drug trials don’t even analyze results by sex which means side effects like minoxidil-induced hormone cycle changes can often (reported by 1 in 4 women) get dismissed as “anecdotal.” And even if they DO get reported, they’re likely to be severly underreported because women’s participation in phase 1 clinical trials as of 2020 was just at 22%!
The more I dug deep into this, the more infuraited I got. It was only in 2013 that the FDA halved the female dose of the Sanofi insomnia medication (after being approved in 1992!!) after recurring complaints of heart conditions and sleep disorders Women are 50% more likely to be misdiagnosed for heart attacks because symptoms differ from men. The list is immense and super concerning.
The thing that really pushed me over the edge was when I met a dermat a few months back who prescribed off-label finasteride (NOT FDA-approved for women btw) for my hair loss and when I showed him research that suggested of serious side effects such as birth defects and depression, he simply said – well yeah, there’s always small risks associated with all meds. YES – there are. But we kind of have the right to at least be AWARE about it, even if that research is frickin inadequate.
Anyway. Rant over.
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Pharma research treats women like hormonally inconvenient smaller versions of men. I worked in clinical research (as a data analyst) for years – most studies are done on men, in large part, because no one wants to deal with the covariate of hormonal/temperature/physical changes over the course of a month, even though they are predictable.
Clinical studies are done by default on men because its “just too difficult” to use women (i.e. women’s health is only as important as it is convenient). So they do the clinical studies in men and just hope for the best based on body weight, everything works out.
Its better for them financially because they know drugs will be prescribed for the illness in women, regardless of the lack of studies, because thats how its always been done.
Add on top of that, women’s side effects from medication are generally downplayed because they can, in large part, be written off by hormonal cycles. Not that the side effects are caused by anything other than the drug. Many doctors will simply assume that whatever pain/inconvenience you’re feeling is just part of being a woman and not being on that particular drug because “those side effects didn’t show up in the massive clinical study”.
Its a cycle of intentional ignorance. And its fine because…no one cares enough in the pharmaceutical industry to do anything differently. Why would they? More studies that the FDA doesn’t require is just unnecessary expense when you know the drug will be prescribed for women anyway.
https://en.m.wikipedia.org/wiki/Invisible_Women:_Exposing_Data_Bias_in_a_World_Designed_for_Men
If you are interested in further reading on this topic and other ways women are systematically underrepresented, ignored and excluded and what issues arise from that, I can recommend the above linked book.
Be warned, reading this will probably increase your aggravation even more, but it is a great book, thoroughly researched and important.
My hair started falling out when I was 14. It fell out in patches. I was told by one doctor that I had burned myself with a curling iron, despite no evidence of burn and me not using a curling iron.
My hair kept falling out. I was sent to get bloodwork several times as a teenager. They were having me tested for STIs every time. Every single time. No thyroid. No nutrition panels. Nothing but STIs.
My eyelashes fell out. Nose hair. Ear hair. Eyebrows. Everything, everywhere. Insurance like Kaiser called it a cosmetic issue and refused to check for anything. One dermatologist suggested I use those stick things with color that women use. “Makeup?” “Yeah, that stuff.” A dermatologist didn’t know the words for mascara or eyeliner or anything many women put on our faces, but he figured I could use mascara on lashes that don’t exist.
Another GP prescribed steroid shots for my scalp. I got those for five years. I got 100-200 injections into my scalp, sometimes weekly, for five years. It was painful af and I gained so much weight. That doctor didn’t mention that a topical analgesic could have made the injections less painful, but she did tell me to eat less and exercise more for the steroid weight.
An immunologist didn’t even ask my medical history, but barked at me that I didn’t have Celiacs (I absolutely fucking do) and I don’t have a compromised immune system. I am bald as an egg inside and out and couldn’t eat gluten, rice, dairy, citrus or anything with citric acid and she dismissed me with more insults. I was diagnosed with MCAS by another immunologist and, although my hair isn’t growing back, I can eat most foods as long as I’m taking half a dozen antihistamines. They have a lot of side effects and the prescribing doctor lied to me about the side effects.
And now I’ve got a GP who won’t prescribe antihistamines because I’m on “too many.” No shit. She also won’t prescribe any weight loss meds because I have to prove to her that I can make changes to my diet and that I can exercise. I’ve done nothing for the past 15 years but make massive changes to my diet and my pain levels are ridiculous. Fatigue, intermittent blurred vision, nausea from pain, tinnitus that just promoted itself into having two separate tones… but I need to lose weight before she’ll help me lose weight.
I’m more than slightly annoyed.