Why are women still receiving care created specifically for men?
Marianne Legato, MD: I think the answer to your question about why men and women were not treated differently resides in the fact that for a long time, we studied men almost exclusively.And this wasn't an effort of denigrating women or being prejudiced about their value. We really wanted, believe it or not, to protect them from the treat of damage to an unborn fetus,conceived during the course of a clinical trial, or in a larger sense, any damage to their reproductive ability. Also the hormonal fluctuations of women made them a less easy population to study.So for all of those excellent reasons, we assumed that men and women were alike enough to extrapolate what we learned about men to women.
Marianne Legato, MD: It wasn't until the late 1980s that the feminists finally prevailed on the government in the person of the United States Public Health Serviceto decide whether we knew about women enough to treat them in an effective way,and the Task Force on Women's Health from the Public Health Service reported that we knew nothing about women in fact through direct investigation, except about their reproductive biology.So we began a crusade to enroll women in clinical studies. We have been only partially successful at that,and almost all of our information from clinical trials, with a few exceptions, comes from an elderly post menopausal population.
Marianne Legato, MD: We still lack important information about the younger pre menopausal for the reasons that I've explained to you.We have not decided how to best deal with the effect on an unborn fetus of a clinical trial, due to an untested, or untried drug or intervention,so most of our information about younger women is still what we call observational.