What is it about medications?

How many times have you heard women say “I’m just so sensitive to medications”? Maybe you have thought this about yourself. Medication side effects and adverse events are more common in women. As a physician who provides care for women, this is common knowledge.  Some may think that women are just more difficult to treat or complain more, but that is not the case.

Women are prescribed more medications for various reasons. How many times have you visited a doctor and said you were tired, feeling out of balance, or “something is just wrong”.  After talking for a few minutes and maybe some lab testing, you are told “you’re fine” but, since you still feel like something is wrong, you are given a prescription – most likely for an antidepressant or sleeping pill. I mean, if medicine can’t figure out what is wrong and your lab tests are normal – You MUST be stressed or depressed! We are prescribed antidepressants, sedatives, sleeping pills, headache and bowel medications more often. Sometimes you may wonder if you are just a sad, headachey, stomach cramping mess… Also, based on our unique healthcare needs, women are prescribed prenatal vitamins, birth control pills, breast cancer and osteoporosis medications.

Did you know that antidepressants tend to have a higher serum drug concentration in females. Females can achieve the same response with half as much flu vaccine, but are still given the same amount?  Effectiveness of aspirin in the prevention of heart attacks and strokes is different for men and women.  The listgoes on and on.

There isscience to back up why men and women react to medication differently. The way a woman metabolizes (breaks down) medications is different. There are differences in the fat, muscle, and water content in our bodies which affects how medications are absorbed, utilized and excreted (flushed out). What about size? Does a 110lb female require the same dosing as a 200 lb male?  The FDA has an online system for reporting adverse events due to medications. Based on this system, women experience more negative effects of medications than men, and, in general, these adverse events are more serious.  8 of the 10 drugs withdrawn from the market between 1997 and 2000 had greater adverse effects in women. Yet there are no sex and gender-based dosing recommendations.

How can knowing these differences benefit you and your health?

•    Has the medication been studied in both men and women? If yes, what were the results? Do you want to take a medication that has only been studied in men?
•    Ask about side effects: Are side effects from this medication seen more commonly in women?
•    Request starting at a lower dose of medication and taper up slowly. (sometimes this isn’t possible, so always take the medications as prescribed by your provider!)
•    Starting more than one medication?  Discuss starting them several days or even weeks apart sothat side effects can be identified. (It is difficult to determine which medication is causing the headache, rash, muscle aches, etc. when several medications were started at the same time)
•    If you have side effects do not stop a medication. Call your provider and discuss what effects are happening.
•    Just because side effects are listed doesn’t mean you will get them, and just because your next door neighbor, mother, sister, cousin…. had a reaction to a medication doesn’t mean you will.
•    Don’t talk yourself into side effects. Sometimes we are so fearful of medication effects we begin to blame every new ache and pain on the new medicine the doctor prescribed.
•    It is okay to ask questions!
In the end women are not more difficult just different. Knowing the difference creates an opportunity to receive the best medical care that is based on your specific needs.

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