Episode Transcript
Dr. Jones: Why can't a woman be more like a man? In the musical "My Fair Lady,"希金斯教授，感谢他在研究项目中将伊莱莎培养成正派淑女的过程中所遇到的挫折. But in healthcare the, difference is important. This is Dr. 来自犹他卫生保健大学妇产科的Kirtly Jones，大发娱乐是The Scope.
Announcer: Covering all aspects of women's health. This is "The Seven Domains of Women's Health" with Dr. Kirtly Jones on The Scope
Dr. Jones: Men and women aren't the same. However, in the history of research into health outcomes in medicine, men's biology was the default mode. Except in Obstetrics and gynecology, of course. 研究人员对将女性纳入研究持谨慎态度，因为他们知道，在月经周期中，身体的运作方式和药物的代谢方式可能会发生变化. 当然，男人每天都是一样的，这并不完全正确.
Also, 妇女可能会怀孕，并服用未经测试的药物，正在进行剂量和副作用的研究, that would be a problem until drug safety was established. 所以大发娱乐指望男性进入危险的药物开发战场，但现在不是了. 性别健康医学已成为美国国立卫生研究院的一个重要焦点. Research funding requires that a woman be included where appropriate. 例如，在前列腺研究中没有必要，但在糖尿病研究中非常重要. Okay. Well, what are some of the differences?
Body size. 当然，大发娱乐知道男人通常比女人大，但并不总是如此. If body size alone were a bigger factor, we should be dosing drugs by body mass index, or body surface area or just weight. But body size does predict lung size, heart size, 动脉的大小，肾脏的大小和器官的大小可以预测它如何代谢药物或如何受到疾病的影响. For instance, 女性的心脏血管更小，它们可能更容易堵塞，也更安静. 女性不太可能有严重的心脏病发作，更有可能悄无声息地有心脏损伤导致心力衰竭.
What about body composition? Women carry more fat than men, usually. This may affect how some drugs are stored. Some drugs are distributed in water and some are bound by fat. This can be somewhat important in anesthetic agents, 哪些是脂溶性的可能会被女性的脂肪吸收导致女性的单位体重效果较低.
Anatomic shape. 嗯，大发娱乐知道女孩是有曲线的，但有些女孩比其他人更有曲线. Most women have a different hip configuration than men. They have wider hips and that is hip bones, not just fat on the hips. 这意味着从臀部到膝盖的角度更大，男性的腿从膝盖到臀部更直. 这对女性运动员的膝盖受伤率很重要，女性运动员的膝盖受伤率比男性高. 女性的膝关节置换术不一定要更小，而是要有不同的角度. This is important for your orthopedic surgeon to know.
Absorption. We absorb pills through our stomach in our intestines. 女性的胃酸略少，肠道转运时间略短, which can make some drugs stay around longer to be absorbed more. 当然，也有一些人的胃酸较低，转运时间也较短.
Metabolism. Women make more of certain kinds of metabolic enzymes in the liver, 尤其是口服激素避孕药的女性或怀孕的女性. This is particularly important in certain anti-seizure drugs, 哪种药物对女性效果较差，剂量可能需要改变. 另一方面，随着年龄的增长，女性的肾脏变小，肾功能下降. 因此，由肾脏代谢的药物在老年妇女体内的残留时间更长.
另一个重要的区别是在麻醉剂方面，女性在较低剂量下效果更好. 酒精也是如此，低剂量对女性的影响更大. The same is true for some prescription sleeping pills, 自由贸易协定为此实施了标签，以确保医生和患者知道女性应该服用较低剂量的药物.
现在有一个“大发娱乐不知道为什么”的核心类别，这是我最喜欢的类别之一. In this category, we don't really know why there is a difference. 大发娱乐不知道为什么女性大脑中的血清素比男性少. 抗抑郁药和抗焦虑药，比如选择性血清素再摄取抑制剂, SSRIs, have a greater effect, are more effective in depressed women than in depressed men.
所有这些差异会导致女性和男性产生不同的副作用. Women have more side effects in drug studies than men. They have more nausea as a side effect. So what should we do about this as clinicians and as patients? 首先，大发娱乐应该警惕假设所有的男人和女人都是一样的. 大发娱乐说所有的人都是一样的，他们都像男人，已经有麻烦了. But not all women are the same and not all men are the same. 当大发娱乐观察不同性别的大群体时，男女之间的差异就很明显了, but individuals may be larger, smaller more or less fat, have different metabolisms than average for their sex.
If our medicine isn't working in the way we hoped, 大发娱乐应该看看病人的情况，看看不同的剂量或不同的药物是否会更好. 如果你有药物的副作用，你应该让你的临床医生知道. 如果医生给你开了一种药或一个疗程，比如物理治疗或关节置换, 你应该询问你的临床医生，男性和女性之间是否存在差异，以及他们的建议应该如何修改.
我读过一项来自日本的研究，在功能性核磁共振成像中，“肥胖”、“肥胖”或“超重”等词在男性和女性的眼前闪现. 在男性中，大脑活动直接进入了大脑的语言中枢. "What was that word?" In women, the brain activity went all over to the language center, to the emotion center, to the judgment center. 我希望他们没有在这项研究上花太多钱，因为我认识的每个女人和男人都可以告诉他们，女人和男人不同.
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