Women end up being overmedicated because drug dosages are calculated based on studies predominantly conducted on men, new research has suggested. One direct implication of this, researchers say, is that women end up suffering from excess side effects.
For the study, researchers from the University of Chicago and the University of California, Berkeley, analyzed 5,000 publicly available clinical drug studies and identified 86 drugs that reacted differently in men and women. These included common drugs such as aspirin, morphine, and heparin, and widely prescribed antidepressants such as sertraline and bupropion.
For all these drugs, researchers found, women metabolized them more slowly than men, ultimately resulting in higher levels of exposure to the drug and in 96% of cases, also in higher rates of adverse side effects such as headaches, nausea, bleeding, and seizures.
It has been common practice to exclude women from biomedical research and drug trials because it was believed that the influence of female hormones could complicate findings or interrupt study designs, an assumption that has been proven wrong multiple times. Therefore, a large proportion of studies underrepresent women and even if they get included, the data is not analyzed taking differences in sex into consideration. This leads to a problem in understanding how diseases, drugs, and vaccines affect men and women differently.
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Researchers from the current study explain that, in women, drugs remain in the blood and tissues longer than they do in men. The liver and kidneys also end up processing drugs at different rates in both of them and this remains true even when the dosage is adjusted according to the weight of the patient.
Although the reasons for these differences are not fully understood, Brian Prendergast, a psychologist at the University of Chicago and co-author of the study said the findings imply that “We need to immediately reevaluate the widespread practice of prescribing the same doses to men and women.” He added, “There are a lot of drugs that are prescribed on a ‘one-size-fits-all’ basis, and it’s clear that this doesn’t always work.”
Therefore, he suggested that whenever possible, doctors should start prescribing a smaller dose for women and increase it gradually to reach a balance where the medication is showing the intended effect without significant side effects. In addition, medical bodies could also specifically label drugs that are already known to have sex differences to limit the side effects women may experience from taking drugs in similar quantities as men.
“We have an opportunity to do this better,” Prendergast said. “This information needs to be widely available.”
