Filling the Gaps in Women’s Health: Personalized Guidance Is Essential

Women may have gained more power and equality in many areas, but there is one that remains broken: women’s healthcare. In this sector the gender gap is real and widening. Men have an advantage in terms of research, access, opportunity, and advice. The current healthcare continues to adopt a one-size-fits-all approach and the solutions offered to women are derived from research mainly made on men and adapted for women. However, we are not simply smaller versions of men, and women need personalized solutions tailored to their unique physiology. 

Sex and Gender Differences in Women vs Men

Firstly, women experience massive hormonal shifts that men do not, including menstruation, pregnancy, post-partum, perimenopause, and menopause. The change in hormones associated with female biology is far steeper than the gradual change seen in some men as they age, known as male hypogonadism, or more colloquially as low testosterone (low “T”).

Secondly, there are biological (or sex) differences and gender differences, and the latter are socially constructed. Besides the hormonal differences, women have two X chromosomes while men have an X and a Y chromosome, and this affects factors from immunity to behavior.

Gender differences include many factors, including the fact that men account for a disproportionate number of people studied in research. Results of the studies in men have been assumed, often incorrectly, to apply across both sexes and clinicians approach care with a uniform approach, such as to heart disease and diabetes, only to learn that women have a different process and biology, and unique needs.

Women Experience Higher Rates of Trauma

Thirdly, women are disproportionately affected by trauma, particularly sexual trauma. The more trauma and adverse childhood experiences you’ve experienced, the higher your chance of suffering from psychological and medical problems like chronic depression, cancer, or coronary heart disease. Understanding your health and well-being as an adult may mean looking back to your childhood trauma. Connecting the dots can encourage you to take action to heal your present and protect your future health. You can rate your adverse childhood experiences (ACEs) here. 

Studies show that gender differences can be potentially life threatening: in a study from Florida, among patients who came to the emergency room with heart attack symptoms, female patients were two- to three-times more likely to survive if they saw a female physician compared to a male physician. Male patients had no difference in survival whether they saw a male or female physician.

These sex and gender differences aggregate to create a different risk profile: women have double the rate of insomnia, depression, and Alzheimer’s disease; four-fold the rate of autoimmune disease; and a lower risk of cancer. Conditions like thyroid disease and fibromyalgia affect far more women than men. Other conditions, such as endometriosis, polycystic ovary syndrome, and fibroids, only affect women.

Heart Disease Kills More Women Than Breast Cancer

Cardiometabolic disease is one of the greatest opportunities to personalize healthcare for women and reach higher levels of equality. One in five women die of cardiovascular disease, seven to ten times more than the number who die from breast cancer, according to the CDC,¹ yet breast cancer is what women fear the most.

At equal age, women have more cardiovascular risk factors than men.

• Despite overall reduction in cardiovascular disease mortality in the United States, mostly in men, hospital admission with acute heart attack is ON THE RISE in women aged 35-54.
• Women get less early medical care, to the tune of 10-25%, when they have a heart attack – and this translates into a higher death rate.
• In the United States, one woman dies every second from cardiovascular disease.
• Awareness that women die more from heart disease than any other cause is DECLINING over the past decade. The “Go Red” campaign for women has been a failure.
• Women have more blood vessel damage from intermediate blood sugar levels associated with prediabetes than men, and we may need lower thresholds to diagnose diabetes.

We need more research on women. We need a different approach to the healthcare team that takes care of women. We need more women-focused care and we certainly need more women cardiologists. Beyond that we need a much more collaborative and team-based approach to address these deficiencies that we have with taking care of women when it comes to cardiovascular disease and to address this gap in terms of survival.

Leverage Consumer Wearables 

Another important opportunity for personalization is to use consumer wearable devices. This is where women can become empowered to take control of their health and navigate more skillfully different stages of life from an early age through fertility, pregnancy, perimenopause, menopause, and beyond. Wearables give women the opportunity to measure their temperature, their stress levels as well as sleep dysregulation. By being able to optimize two foundational elements of good health – sleep and stress – women can take actionable steps to balance their hormones in the short, and long term. 

A large, and unfair, proportion of women experience stress that affects our physical health – and we are WEARY FROM IT because stress raises cortisol. Too much cortisol makes you gain belly fat, increases sugar cravings, and brings other hormones out of balance, including testosterone, DHEA, progesterone, and thyroid.

Many of us are unaware that properly managing stress can have positive effects and actually drive us towards success. Stress and recovery triggers are individualized and influenced by factors like personality, life experiences, coping mechanisms, history of trauma, and culture. Further, women and men respond differently to stress. Men tend to go to fight/flight. Women tend to go to freeze/fawn since fighting and fleeing don’t work so well. When we are on our game, women are especially good at tend and befriend.

Wearables like the Oura ring can help us change the way we think about stress, not as the enemy, but a valuable tool for personal growth and wellbeing.

Gut Health and the Gender Gap

The gender gap is real and it starts in the gut, specifically in the microbiome that includes the microbes as well as their DNA. Men are different than women. For example, women have so many more bladder infections than man and get treated with twice as many antibiotics which leads to a difference in the microbiome. The types of microbes you have in your gut impact your overall health. 

Gut health is the foundation of hormone health and part of the control system for your hormone balance. Here are some simple ways to bring your gut health back into balance. 

1. Stop eating three or more hours before you go to bed.
2. Improve leaky gut through diet. To help repair your gut barrier, make sure you are getting nutrients like vitamins A, B, D, zinc, and healthy fats; additional supplements may be called for too. For many of my patients, I recommend consuming bone broth–based soups and powders containing L-glutamine, which may help seal leaky gut. 
3. Giving up alcohol is another important step. Alcohol is one of the surest ways to damage the delicate cells of your gut and cause leaky gut.

Address increased intestinal permeability with an elimination diet, described in my latest book, THE AUTOIMMUNE CURE. You don’t need to have gut symptoms to have a problem with gut health – sometimes it shows up as anxiety or overwhelm.

Managing Hormones For Longevity in Women

Taking charge of your metabolic health is the key to a longer, healthier life. Metabolic health is a critical pillar that supports health and energy.  At its most basic function, metabolic health refers to the body’s ability to process and utilize energy from food. However, it’s so much more than that. Metabolism encompasses all the biochemical processes happening within the body, involving metabolic hormones like insulin, cortisol, leptin, testosterone, and growth hormone. These hormones play a significant role in various aspects of metabolic health, influencing your present well-being and, equally crucial, your long-term aging process.

Hormone balance reduces the risk of cardiovascular disease and diabetes which are or indirectly related to nine of the top 10 killers. Hormones do best with a diet of zero processed food and eating whole foods that are rich in fat, protein, and have sufficient carbs. Fat is the backbone for most hormones, including pregnenolone, the mother or precursor of all the sex hormones. I encourage my clients and followers to eat a diet that contains avocado, olives, wild-caught fish, and a pound of vegetables per day.

One powerful tool for understanding and managing metabolic health is a Continuous Glucose Monitor (CGM). This tiny device has disrupted my health more than anything else I’ve done in the past 10 years. It’s about the size of a quarter and contains a tiny sensor about a hair in diameter that measures glucose in the interstitial space. A CGM is not merely a weight-loss tool, although it can be highly effective in this regard. It provides a window into how your body responds to various foods and lifestyle choices by tracking your blood sugar levels throughout the day. When you observe how certain foods cause blood sugar spikes, it can motivate you to make dietary changes that promote stable blood sugar and, consequently, weight loss.

Stop Outsourcing Your Power

Yes, we need more research on women. We need a more equitable and nuanced approach to the healthcare team that takes care of women. Yet while we are waiting for the healthcare system to catch up, there are so many opportunities you can make to level the playing field of your own healthspan. 

Leverage wearables to balance your metabolic health, stress levels and sleep. If you’re not getting the response from the doctor or the clinician you’re seeing, find another doctor.

Refuse to participate in the dismissal of women in the doctor’s office. Find someone collaborative. Find someone who’s going to be a partner with you in your health journey, someone who cares, understands women’s unique needs, your values and purpose, and wants to help you optimize your health on every level. 

We need a bottom-up approach to close the gender gap.

1. Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/women.htm accessed November 20, 2019