It is a fact well ingrained in people’s minds: women in France have a longer life expectancy than men. But this reassuring a priori data on the state of health of French women hides a more complex reality. Since 2000 their life expectation it progresses slower than that of men and they remain healthy for a shorter time. “The idea that women live longer than men ‘guides’ everything that can be said about their health. This gives rise to all stereotypes ”, regrets Geneviève Couraud, member of the High Council for Equality between Women and Men (HCE).
Women, the big forgotten ones of cardiovascular diseases
Therefore, the idea that cardiovascular disease primarily affects men is firmly rooted. In fact, theheart attack and thehitare the leading causes of death among women today. “They are the great forgotten cardiovascular diseases”, notes bitterly Professor Claire Mounier-Vehier, president of the French Federation of Cardiology, member of the scientific committee of health magazine.
More women than men suffer from COPD
Another idea received: the typical patient profile withCOPD (Chronic Obstructive Pulmonary Disease) it would be “a 50-year-old man who smokes, coughs and spits,” according to the expression of a pulmonologist. Today, in France,40% of COPD patients are women, compared to 20% twenty years ago, linked to smoking, pollution and occupational exposure to chemicals. In the United States and Australia, they are now more likely than men to be affected by this disease.
Pain, mental health: the less treated women
Another example: pain. For a long time, doctors – and women themselves – have considered this normal to suffer during menstruation. As a result, endometriosis is often diagnosed several years late, which limits the chances of pregnancy.
Finally, in the field of mental health, scientists recently denounced the delay in diagnosing young women with autism suffer. In fact, they develop different strategies than boys to compensate for communication disorders.
Many women have difficulty accessing care
Done, symptoms of the same disease are expressed differently from one sex to another. Typical example: heart attack appears in a man from chest pains, on the left side, radiating into the jaw. In a woman, the signs will be quite digestive. “Too often, when a woman vomits into the emergency room, we think of a gastrointestinal tract or an ulcer, with the risk of losing a heart attack,” says Professor Mounier-Vehier. Consequences: women with heart attack they are treated with an hour and a half delay on average compared to a man. “A real waste of luck”, for Professor Mounier-Vehier.
Greater inequality in disadvantaged areas
The situation is particularly unfair for the most disadvantaged. In a report published on July 7, 2017 (Health and access to care: an emergency for women in a precarious situation), the HCE has investigated the issue of the working poor, 73% of whom are women, often at the head of a single-parent family. These “off the radar” women, as Geneviève Couraud says, combine the difficulties of accessing care, little participation in organized cancer screening, are not monitored at the gynecological level, suffer more than average from overweight and obesity, musculoskeletal disorders, addictions, etc. “Their health does not exist in their eyes. They tell themselves that we have to resist, ”observes Geneviève Couraud.
Treatments are often unsuitable for women
Healthcare professionals are starting to take an interest in gender specificities. “But there is very little training on these topics for medical students. Likewise, doctors are not trained enough to do this detect violence against women and to create a climate that allows these issues to be addressed in consultation “, regrets Catherine Vidal, co-author of Women and health, still a men’s business? (edited by Belin).
For a long time, scientific research on new drugs did not take into account the specificities of women. “Feminist movements in the United States were the first to denounce it and get the approval of a law, in 1993, which obliges research actors to include women in their clinical trials,” notes Catherine Vidal. Europe followed the movement, but with a delay. Consequences: Medicines are not always suitable for female metabolism.
“In the treatment of cholesterol, women taking a statin have more cramps than men, simply because the dose was calculated for men,” says Claire Mounier-Vehier.
Similarly, women who benefit from cardiac rehabilitation after a heart attack account for half of men. In some cases, the doctor did not offer it to him. But sometimes it was the patient who refused. To move things forward, women will also need to change their view of their health.