by Molly M. Ginty

Whatever stage of life you’re in, and whether you’re physically fit or living with chronic illness, you can find ways to be a wise steward of your health and well-being. Our health and wholeness are important keys to responding to God’s call for us and acting boldly on that call. That’s why Women of the ELCA have embarked on a new health initiative for the 2005–2008 triennium: Raising up Healthy Women and Girls. This ongoing column represents our commitment to the issue of women’s health.

Carolyn Warner nearly died of her doctors’ ignorance. In August 1997, she was driving on the freeway when she suddenly felt a tingling in her arms and shortness of breath. She got off at the next exit, pulled in at a hotel, and called for help. The emergency room doctors shrugged off her symptoms as mere anxiety. But when she visited a cardiologist two weeks later, she discovered that she had a 98 percent blockage in her right coronary artery and needed immediate surgery.

"I continued having cardiac events that required emergency attention," says Warner, 60, a food industry consultant in Upland, California. "But three more times, medical providers failed to recognize my symptoms, which are less dramatic in women than in men. Paramedics and doctors continued telling me I had anxiety — even though I eventually had a heart attack and had to have triple bypass surgery."

Warner (who had a family history of heart disease, but whose doctors never monitored her) is just one example of how the American health care system can fail women. Medical schools often do not teach their students about health problems unique to women, so physicians might not recognize them in their female patients. Because most health research, including drug testing, is conducted on men, gender differences are not always tracked in the first place.

Heart disease, the number one killer of women in the United States, is a good example of this gender gap. Two–thirds of its female victims die with no previously recognized symptoms, though heart disease is largely preventable. Health experts say part of the problem is doctors’ lack of awareness. That’s confirmed by a recent Gallup poll that revealed 88 percent of primary–care physicians are unaware that women’s heart disease symptoms differ from men’s.

Plaque that builds up in the arteries of women is likely to be softer and more diffuse than it is in men. If women have blockage, it is usually found in the smaller, often overlooked branches, not the major arteries.

"During heart attacks, women tend to have pain in the upper abdomen instead of the chest and to have more secondary symptoms like sweating, fatigue, dizziness, and shortness of breath," says Dr. Marianne J. Legato, chair of the Partnership for Gender-Specific Medicine at Columbia University in New York. "Women also tend to have heart attacks ten years later than men, around age sixty."

According to the National Coalition for Women with Heart Disease in Washington, D.C., women account for only 36 percent of open–heart surgeries and 25 percent of heart research subjects. Women are less likely to receive medication after their first heart attack, and so are more likely to die of heart disease.

The good news for women with heart disease and other illnesses is that medical experts have started to focus more on their specific needs. Gender–specific medicine, one of the hottest fields in health care, is discovering that gender makes a difference, not just in heart disease, but in many other conditions.

In some cases, these gender-specific health differences give women an edge. Estrogen helps protect women from pancreatic cancer. Stronger immune systems help women fight infections more effectively.

And across the globe, women consistently outlive men by an average of six years. In other cases, being female can pose health hazards. Because women’s lungs are more susceptible to carcinogens, women who smoke are more likely to get lung cancer than men. Women are at higher risk for gallstones (crystals in the gall bladder), osteoporosis (thinning of bones), and multiple sclerosis, rheumatoid arthritis, and lupus (all three autoimmune diseases).

"Studies also show that women are two to nine times more likely than men to contract HIV, the AIDS virus, after unprotected heterosexual sex with an infected partner," says Dr. Mary A. Young of the Center for Sex Differences at Georgetown University Medical Center in Washington, D.C.

To help women beat the odds, health advocates are developing gender-specific diagnostic tools, such as ultrasound machines that can detect their more subtle symptoms of heart disease. They are altering dosage recommendations for medications, reducing dosages for women because they tend to be of lighter weight than men. To save more women’s lives, advocates are working to improve awareness, screening, research, and treatment.

Medical experts also are urging women to speak out and become stronger advocates for their own health. "Research shows that doctors often attribute women’s symptoms to emotional disturbance, particularly when it comes to heart attack symptoms, chest pain, or shortness of breath," says Dr. Legato. "That’s why it’s important to be straightforward with your doctor. Never downplay your illnesses, and never assume you are imagining your symptoms."

Molly M. Ginty lives in New York. Her work has appeared in Ms., Marie Claire, Redbook, and Women’s eNews.

National Institutes of Health Office of Research on Women’s Health www4.od.nih.gov/orwh

To learn about ELCA resources for health and wellness, go to www.elcaforwellness.org

Eve’s Rib: The New Science of Gender-Specific Medicine and How It Can Save Your Life by Marianne Legato, M.D.