Women’s hearts are disadvantaged in medicine

The “Gender Health Gap” is still a reality: women are at a medical disadvantage. This is particularly evident in the example of chronic heart failure.

In Germany there are still numerous gaps in equal treatment between men and women – one of which concerns medical care. This gap, which is also known as the “gender health gap”, is less well known and discussed less frequently than the “gender pay gap” (the wage gap between women and men). But it is at least as important.

Too rarely is it taken into account that illnesses often develop differently in women than in men and that medications can work differently for them due to body size, weight and hormones. Some symptoms of illness can differ so much that misdiagnoses are made or illnesses are even overlooked.

This is particularly noticeable in the area of ​​heart health. Although cardiovascular diseases are the most common cause of death in women, they are often not adequately recognized and treated. The German Heart Foundation points this out. But why is that?

On average, women’s hearts are slightly smaller and stiffer than men’s hearts and they beat faster. This means: You have to pump more often to supply the body with enough oxygen and nutrients. It’s not just anatomical differences: female hormones also influence heart health.

The hormone estrogen protects women’s hearts until menopause. However, with menopause the estrogen level drops and the heart increasingly loses its elasticity. This increases the risk of cardiovascular diseases.

A particularly good example is heart failure. According to the German Heart Foundation, around 2.5 million people in Germany suffer from it – a large proportion of them are women. The disease is often not recognized in time, especially in older people. Heart failure in women manifests itself in rather atypical symptoms: Many of those affected experience discomfort in the abdominal area, accompanied by nausea or vomiting. Fatigue and water retention can also be warning signs.

“Women – just like men – should definitely go to a cardiologist and have an ultrasound of the heart performed if they have symptoms such as shortness of breath, fatigue and an inability to exert themselves,” says Prof. Vera Regitz-Zagrosek from the Scientific Advisory Board of the Heart Foundation.

• Also read: This is why heart attacks in women are often diagnosed late

However, it is not just the unclear signs of heart disease that are problematic, but also its diagnosis and treatment. According to the Heart Foundation, women with heart problems tend to go to the doctor later than men and tend to suppress symptoms or classify them as less serious. At the same time, in many cases they received less medical attention because they were less often perceived as “classic” heart patients. A later diagnosis is made through timely treatment.

Studies also show that women with heart failure are less likely to receive invasive treatment, such as cardiac catheterization or bypass surgery, and many receive first-class medications instead of surgical therapy.

A central reason for the poorer care of women’s hearts and ultimately the “gender health gap”: women are still underrepresented in many areas of medical research. Until a few decades ago, studies on heart disease were conducted almost exclusively on men. This resulted in symptoms, diagnosis and treatment approaches becoming heavily skewed towards men. The standardized medications often work less well on women; the dosages are often not optimally tailored to them, which means they can experience more side effects than men.

In order to close this gap in care, far-reaching changes are necessary. This includes, above all, more gender-specific research. But patients themselves should also be better informed about possible symptoms and preventive examinations.

The German Heart Foundation advises women (and men) to have a check-up from the age of 40 – earlier if they have a family history – in order to regularly check blood pressure, blood sugar, blood lipids (cholesterol) and body weight. This can be a regular health check-up with your family doctor. “This makes it possible to uncover unrecognized risk diseases for heart attacks, strokes and heart failure,” says Prof. Christiane Tiefenbacher, board member of the German Heart Foundation.

Of course, prevention also plays a crucial role – for both sexes: a healthy diet, avoiding alcohol and cigarettes, and regular exercise can prevent heart disease.