Gender / Sex Medicine, What Makes Women Different

Disheartening research shows the overall health of women in Central Florida is on the decline, especially in the areas of diabetes, high blood pressure and coronary heart disease.

This startling reality comes at the same time research shows sex does matter in the diagnosis and treatment of many health conditions, as medical issues present and progress differently in women than in men.

Dr. Lori Boardman is here to explain how early disease detection and intervention is also a major focus for our women's specialists at Florida Hospital.

We emphasize education and regular examinations, including mammograms and DEXA bone density testing.

Thanks to advances in imaging and treatment, early detection can significantly increase the odds of leading a normal, healthy life.

Gender / Sex Medicine, What Makes Women Different
Featured Speaker:
Lori Boardman, MD
Learn more about Florida Hospital for Women.
Transcription:
Gender / Sex Medicine, What Makes Women Different

Melanie Cole (Host):  Men and women are alike in so many ways. However, there are such important biological and behavioral difference between the two different genders and they can affect the way we look and treat many widespread diseases and the approach to healthcare. My guest today is Dr. Lori Boardman. She’s the Executive Medical Director of the Florida Hospital for Women and a professor of obstetrics and gynecology at the University of Central Florida College of Medicine. Welcome to the show, Dr. Boardman. We hear about so many of the studies on heart disease always done on men. What’s going on now?  Are women coming to the forefront of really good health advocacy?

Dr. Lori Boardman (Guest):  Definitely women are becoming to the forefront of advocating for ourselves and our families. In terms of advocating for ourselves with respect to heart disease, more women are being enrolled in clinical trials which really gives us the evidence we need to know how to best manage women. For example, we know that women sometimes respond differently to medications. We need lower doses or we need different medications that work better for us than they do in men. So, from treatments to diagnosis there are definitely differences and they are increasingly coming to light.

Melanie:  Why do you think women are so hesitant, as we’re the caregivers of society, Dr. Boardman, and we’re the ones who need to put our own mask on before we put the mask of our loved ones on. why do you think that we are so hesitant sometimes to take care of ourselves when we are so willing to shove our spouses to the doctor and take our kids to their well visits?

Dr. Boardman Because I think exactly as you advise. We put the mask on everybody else before we bother to put the mask on ourselves. I think with the pressures of often working and taking care of a family or taking care of your parents puts the pressure on us to take care of those individuals and our health needs, our dental needs kind of go to the back of the pack.

Melanie:  We also have so many things that mimic other things. We get chest pain that could be heart disease or could be anxiety and stress. We get bloating when we’re going through menopause. What do you tell women about all of these symptoms that we get all the time?

Dr. Boardman I think we tell women that sometimes we present differently for heart disease, for example. Sometimes it’s not with chest pain. Sometimes it actually comes out as abdominal pain or pain that radiates that spreads to your back. We want women to be aware of how their symptoms may differ and to take those symptoms seriously. The other thing I see over and over again when I talk to women is, they pass over those items, pass over those symptoms they may be having and just attribute them to something else and, therefore, again, delay getting the care that they need.

Melanie:  What do you think are the most important bits of testing that women should get such as PAP smears, mammograms? What should we be getting on a yearly basis?

Dr. Boardman I think on a yearly basis, again, it depends on a woman’s age but routine testing that almost any age should get is a blood pressure check every year. We should have our body mass index, our BMI, our weight and our height checked every year. We should pay attention to heart disease when we get a little bit older and make sure that we’re getting our lipids tested. Make sure we know our cholesterol levels and the other levels that are a part of that panel. We should also be getting mammograms. There’s an argument about when to start this but certainly by the time you’re in your mid-40’s going up to your mid-70’s. Getting a mammogram, whether it’s every year or every other year. PAP tests have now had a new way of screening has been introduced with HPV testing depending on what combination, or if you pick HPV testing alone, will vary how often we need to go see the doctor. Certainly, one of the things that both men and women have a tendency not to get on a regular basis is colon cancer screening.  That can be done with things like colonoscopy or other testing but people have been slow to pick up on those. Those are things that are really critical to making sure we stay well.

Melanie:  Knowing our numbers, getting our annual physical so important and you mentioned prescription medications and how we sometimes differ in how we respond to them. So, when we are thinking of blood pressure medications or cholesterol medications or a daily aspirin, for that matter? How is it different for women?

Dr. Boardman I’ll take the one you just mentioned, the daily aspirin. I think if you look in the media and, certainly, when you read at all about the daily use of aspirin, it’s often advocated to prevent heart disease. What we know is, that works in men but it doesn’t work in women. Interestingly, what the aspirin is doing for us is, it’s reducing our risk of stroke and it doesn’t have that impact in men. I think, as we become more and more aware of these differences and that women ask their physicians specifically, “Is this a medication that you know works in women?  Are there any differences in how it works in men and women?  Is this the best medication for me?” are questions that we should be asking.

Melanie:  That’s really great advice. Now, where stress comes in. As we’ve mentioned, women--we put ourselves under so much stress. Is there a difference in the way our stress is treated or looked at as opposed to men?  It used to be, Dr. Boardman, that men were the workers, men were under stress, men had to make the money but now, that’s not the case anymore. So, is our stress different than theirs?

Dr. Boardman Our stress is often compounded by the fact that we’re really doing a couple of jobs. We’re not only taking care of our households, taking care of our aging parents, taking care of our children but trying to work or volunteer and I think that you get compounded stress with that. To your point, women have more heart disease, more women die each year in the United States of cardiac disease than do men. Whether that’s stress related or other things are at work, I think all of those things play a part in why we see some of these differences. We have to realize that this is a serious condition in women and take preventative measures seriously and see our physicians and have those conversations.

Melanie:  Another thing I’d like to ask you is that we’re seeing more autoimmune disorders in women. Again, is this something because we are overrunning ourselves, overtaxing ourselves and our immune systems are breaking down?  We just seem to be seeing more Crohn’s or Lupus and things and it seems to be more women that are getting these.

Dr. Boardman That’s absolutely true, again. About 75% of autoimmune diseases occur in women. Whether it’s lupus, whether its rheumatoid arthritis, whether it’s even thyroiditis, other disorders do present more in women and we don’t quite know what the difference is but there’s clearly a different way in which our immune systems work.  Just by virtue of our ability to have a baby, which is really a foreign body within ourselves and be able to have a baby does mean something else is going on a little bit different with our immune systems and maybe it could be tied to an increase of autoimmunity in the future. I don’t know if we have the answer to that but I think that could be one possible explanation.

Melanie:  What’s your best advice about bridging some of these gaps in women’s health and what do you tell women every single day about what you really want them to know about taking charge of their healthcare?

Dr. Boardman I think taking it on a daily basis, spending some time thinking about what makes you feel more peaceful or making sure that you’re getting access to exercise if you want to do that; that you eat healthy; that we make healthy decisions when we go grocery shopping for ourselves and/or our families. I think taking that time, again, to kind of focus on stress and do things that help you, whatever it is that you do that makes you feel more energized by being able to relax and have that time to yourself. I think it’s really important to put into our schedules time to go see the physicians or dental care or whatever it is that we need to make sure that we stay healthy. And to take a list, make lists before you go to see anybody with questions that you have about what’s going on because, as we all know, often you go to the doctor’s office, you’re nervous and leave the doctor’s office realizing there’s ten things you forgot to ask that person. So, try to, when you’re in that state before you go, and you’re not feeling anxious about the appointment, make a list of questions you want to ask your physician. Don’t be afraid to ask those questions. There are no silly questions when it comes to your own health.

Melanie:  What would you like to tell women listening in just the last few minutes about Florida Hospital for Women?

Dr. Boardman:  I think Florida Hospital for Women is a great opportunity for women to come get a great experience with their obstetrical care but to also use our hospital and our community resources that we offer to take care of the whole person. We have services built into the new Towers at the Orlando Campus and many of the other campuses, to look at women a standpoint of breast cancer screening, cardiac screens which will be coming down the road in the future. Those kinds of things. Take advantage of what our hospital and our community resources are out there for you to enjoy good health.

Melanie:  Thank you so much. What great information. So beautifully put, Dr. Boardman. Thank you so much for being with us. For more information about Florida Hospital for Women you can go to fhforwomen.com. That’s fhforwomen.com. You’re listening to Health Chat by Florida Hospital. This is Melanie Cole. Thanks so much for listening.