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Of women so that the women get a fair shake when it comes to that if not why not and what we need to do to fix that doctor Marla medicine the cardiologists that that fabulous northwestern's Feinberg school of medicine and northwestern Memorial Hospital should board certified in internal medicine and cardiovascular disease and she is the co director of the women's women's health research institute institute which studies gender bias the very topic we're talking about Dr Mendelson welcome thank you you were here last year to the day you just reminded me of my gosh a whole year has gone by and you so so this isn't this is how how serious is this issue whether women get the same treatment in hospitals and doctors by doctors and hospitals as men this could be catastrophic it could be life threatening we have been looking at this for since nineteen ninety when some studies first came out that said that women were being treated different for the men when they came into the emergency room with chest pain and we've in the process we've had in cardiology we've had go read we've had all sorts of informational campaigns and things like that and we actually started to see some in roads but cardiology is not alone there are huge discrepancies in what we know about sex and gender differences in build in health and illness is it just male doctors treating women differently or are female doctors doing the same thing I don't know if we can indict a male doctors on this is I don't know if it's that issue I think we have a huge education and knowledge deficit that is feeding into this we have studies that are done on women they're not done with it I think medications we use every day I do not have to be studied in women to get approved by the FDA let's let's talk about that in a minute all I let's just talk about going into a hospital and I've heard these kinds of things that women when they complain about pain are not taken as seriously is that I know we're probably talking in big generalities here in as a cardiologists you obviously have different you know terms for these things but is that true or is it just the symptoms that are being noted are are different I think the symptoms of the manifestation of diseases different just to take effect a step back to what we're talking about sex differences are biologic differences and we see that all the time they're due to a lot of different reasons and we'll get into some of that later and then gender differences are is how you interact with society so okay in perception and women symptoms I know again I can speak from cardiology but I think this is pervasive in many areas of medicine women's symptoms are not typical alike in the text book they're not as described in the textbook they're a little bit different but they still could be due to somebody having a heart attack could you give an example of what a typical male heart attack we probably know this but how a woman might manifest the same type of problem but in a very different way so on TV you see somebody having a heart attack first they start rubbing their their rest then they grab their chest and they fall over it's usually a man a woman it's much it can be more subtle and women tent may tend to minimize their symptoms they may have a higher pain threshold they may get not crushing chest pain they may get nausea they may get pain in their jaw which could be still coming from their heart there could be shortness of breath there could be a lot of different things all of those things we look at in men and women as a sign of a heart problem but in women those maybe a little more common I'm not convinced of all the research has been done in it but women who are at risk for co heart disease good many of them are diabetics and diabetics whether you're a man or a woman you don't get classic symptoms so there's always that multiple factors that come into play here but yes this is the in the emergency room for example have to be aware of it because now we're seeing younger women even a pause the women coming in with chest pain and having a cute cardiac events having heart attacks because of a different mechanism that is more common in women the argue we kind of tears and sets up the same problem as with any other heart attack we're starting to see that really is incumbent upon emergency room providers to recognize isn't even if a woman that you're looking at is thirty five years old she still could be having a heart attack are you saying the research bears out that women are having worse outcomes it's it's to some extent then they should because of these problems and it's hard to measure that I would imagine right well the American heart association is very good it out compiling statistics every so often and for a while they're in the new area of intervening in a heart attack immediately and saving heart muscle this is his six were looking really great man the the mortality after acute event was going way down and women it was going up we're starting to see that change and the change started again with the go red campaign with well we're in is with a weight making our clinicians more aware making women more aware I think that's what we really have been focusing on at least we have at northwestern for you know thirty years twenty five years to get women more aware of that this could be happening so they can advocate for themselves and is there any kind of skipping around here but I don't think you back to my to my mom and she had some medical issues at the end which which many many women do any man too but she would downplay your symptoms to the doctor and she would kind of I'm like mom Tellem how bad it was held how bad that pain was and you know okay it's all right and what what do you think you know and and I and I think women maybe a little bit more strong minded of these days but some women are not and and even as a lawyer I see women downplaying what's going on in their lives and I I have to ask ten more questions to get it out of them in some cases and was that something sociological that we as women don't like to you know other people with their problems but is that part of this as always I mean I'm not blaming women believe me I'm not saying that I'm just saying that's how we're wired this so we get into the gender bias in gender there's gender bias within women themselves in that socialization that I'm not supposed to complain I'm supposed to take care of everybody else right right you know we try to get the message out that you can't take care of everybody else if you're not healthy and we have to sort of change that way of looking at things one of the interesting things getting them to exercise and there are a lot of barriers to exercise it it's really generational that you see and so we're starting to see improve on that front where people are valuing exercise for multiple reasons but in an older generation it wasn't as common again sweeping generalization but it wasn't as common and are you saying that it's it's easier to get mail man of a certain age to exercise than women because I always think women are you know we we we like to look good we like to keep our way down like to wear a little size dresses or whatever that that would be something that would be easier to convince a woman up than a man the supplies and also I have a hard time in convincing people who are thin to exercise so they may be thin but they not may not be fit right I think that's important distinction in that we I see almost always in women so there's a lot of eating disorder dietary things and things like that with women but I think overall in the general population you there at a certain age there's less exercise and it's just not being done there's no link to Vanity again the gender issue but it's not pervasive enough to get people exercising very interesting we're talking to a doctor Marla mental sent she is the co director of northwestern's women's health research institute which studies gender bias and we're talking to some more about what you can do to make sure that you're taking care of that some of these issues of discrimination do not impact your outcome if you have any questions give me a call here nine eight one seven two hundred or text to that same number three one two nine eight one seven two hundred this is WGN and I'm Karen Conti.