Doctors at new women’s health clinic share insights
By Kevin McKeough
The reason for a Rush clinic devoted entirely to providing care for women is simple: because women’s health isn’t.
“We all know that women have unique health needs, primarily gynecologic issues such as pregnancy and menopause. However we also know that there are conditions such as heart disease, hypertension and sexually transmitted infections that can develop and affect women very differently than men,” says Maria Reyes, MD, one of the doctors at the new Rush Primary Care – Lakeview clinic on Chicago’s North Side.
The clinic provides general primary and preventive care for women as well as gynecologic care. Here, Reyes and her colleagues share their insights about women’s health and how their patients’ needs differ from men.
Medicine only recently began to look at women’s health differently
“If you look at the history of medicine, a lot of the research studies used to be male-only. They extrapolated the results for women and assumed that women were the same, and they’re not,” says Jennifer Goldfarb, MD, a doctor at the clinic who previously worked with Reyes for six years in another women’s health practice.
It wasn’t until 1991 that the National Institutes of Health – by far the largest source of medical research funding in the U.S. – began requiring that most health studies include women subjects. That same year, the NIH launched the Women’s Health Initiative, which included four massive studies of cardiovascular disease, cancer and osteoporosis that enrolled a total of more than 160,000 postmenopausal women.
“Now we’re uncovering a lot of things specifically about women, such as the ways hormones work, that we didn’t know before,” Reyes says. “The effects of estrogen and progesterone (the most important female sex hormones) are more complicated and may introduce more issues than testosterone in men.”
Women experience heart attacks differently than men
“Sometimes the symptoms are more subtle. Maybe they’ll have some nausea, rather than chest pain and pressure,” says Michele Bailey, DO, who will begin seeing patients at Rush Primary Care – Lakeview starting in July (she also will continue seeing patients at Rush University Medical Center, where she already is in practice). “I find that women’s heart attack symptoms more often are fatigue, shortness of breath, changes in endurance.”
On the other hand, Goldfarb adds, women with normal coronary arteries may experience chest pain. They also are more likely to have coronary microvascular disease, which decreases blood flow to the heart.
Women have higher rates of asthma then men, and are hospitalized for it more
Studies have found that 9.2 percent of women in the U.S. have asthma, compared to seven percent of men. Their comparative risk of hospitalization is even greater – 20 vs. 12 percent – even though women who seek emergency room treatment for asthma are more likely than men to have mild or moderate rather than severe asthma.
“The difference may be related to sex hormones and their effect on airway hyperactivity,” Reyes says.
Medication affects women differently then men
“It makes complete sense that we’re not going to metabolize medication the same way as men, but a lot of the drug studies haven’t recognized it, and the dosages don’t differ,” Goldfarb says.
For example, the U.S. Food and Drug Administration cut the recommended dosage of Ambien for women in half after finding in 2013 that women seemed more susceptible to the insomnia medication’s side effects, particularly impaired mental alertness. “After eight hours, 10 to 15 percent of women still had enough Ambien in their blood to impair driving, versus three percent of men,” Goldfarb says.
Post-menopausal decreases in estrogen can wreak havoc on women
“They tend to present with more gastrointestinal symptoms, because the decrease in estrogen affects GI motility,” Reyes says. “It also can affect serotonin levels, which can affect moods. I see a lot of post-menopausal women who are experiencing anxiety, insomnia, mood swings.”
As it that weren’t enough, Bailey adds that decreases in estrogen lead in turn to osteoporosis (decreased bone density).
Women want doctors who understand their experiences
“Just because I’m female, more women come to see me,” Bailey says. “They know I can relate to some extent with what they’re going through, because I’m a woman and a mother myself and I’ve experienced some of the same things with my own body.”
Rush Primary Care – Lakeview is accepting new patients. The clinic is located at 1300 W. Belmont Ave. and is open Monday to Friday, and twice a month on Saturday mornings. To make an appointment, please call (773) 975-8900.