Women's Health in the Spotlight
Women have been understudied in health and medicine for far too long. A lack of funding for women's health research and exclusion of women from clinical studies have resulted in incomplete data, substantial knowledge gaps, and tangible ‒ often detrimental ‒ impacts to patient care.
It wasn’t until the 1990s, with an act of the U.S. Congress, that the inclusion of women in NIH-funded clinical research became a requirement. Still today, women remain underrepresented in clinical trials ‒ even for diseases commonly affecting them, like cancer, cardiovascular disease and psychiatric illnesses.
It is astonishing to think that, until just 30 years ago, medical research at every stage lacked the essential representation of roughly half of the population. Yet it has taken the advocacy of countless scientists, researchers and women’s health champions to bring about a sea change.
At CU Anschutz, we have helped turn the tide, leading the national conversation on women’s health and standing as a destination for the latest in the field.
Driving Breakthroughs in Women's Health
Established 20 years ago this year, the Ludeman Family Center for Women’s Health Research is the hub of our work in women’s health and sex differences, and a powerhouse of interdisciplinary collaboration.
“We provide talented, passionate scientists with the time and tools to answer research questions about women’s health and sex differences that have long been overlooked.” - Judy Regensteiner, PhD
Over the last two decades, more than 100 researchers from 35 departments, centers and divisions have received funding from the Ludeman Center to support investigation and discovery in areas including cardiovascular disease, diabetes and mental health.
“At the Ludeman Center, we provide talented, passionate scientists with the time and tools to answer research questions about women’s health and sex differences that have long been overlooked,” says director and co-founder Judy Regensteiner, PhD. “We need to make sure that both women and men of all races and ethnicities get answers.”
The work underway today is wide ranging, with projects like these helping to deepen our understanding of women’s health and inform patient-centered clinical care across the lifespan.
Advanced Heart Failure
Heart disease is the leading cause of death for women, yet women are less likely to be referred to a cardiologist or to receive potentially lifesaving specialty care. Fewer than 20% of heart transplants and just 15-20% of all heart pumps, or VADs (ventricular assist devices), go to women.
“We understand what happens in a lot of disease processes based on what happens in men's bodies but not necessarily what happens with women.” - Prateeti Khazanie, MD, MPH
Prateeti Khazanie, MD, MPH, is working to understand why these realities persist. Part of the reason may be that the symptoms many women experience with heart disease may not be recognized for what they are.
“We understand what happens in a lot of disease processes based on what happens in men’s bodies, but not necessarily what happens with women,” Dr. Khazanie said. “Ignoring that fact is dangerous long term, so it’s important to understand how women present with diseases, how we treat them appropriately, what types of therapies work better in their bodies, and make sure they’re referred for therapies and other options the same as men.”
Additionally, Dr. Khazanie notes, there is increasing awareness of social determinants of health and how they influence care. Barriers to treatment impact some individuals more substantially than others. For example, someone who may qualify for heart transplantation medically can be denied therapy based on whether or not they have a caregiver for a specific period of time post-transplant. Such policies disproportionately affect women, who are often caregivers for others but who may lack support for themselves. For Dr. Khazanie, understanding these factors is essential to making patient care more uniform and equitable.
Depression & Type 2 Diabetes
Noy Phimphasone-Brady, PhD, has a passion for helping women with chronic health conditions improve mental and behavioral issues such as depression, anxiety and eating disorders. Her research explores how complex sex, gender, racial and ethnic differences influence response to treatment of mental illness among those with physical health conditions.
“Depression and Type 2 diabetes are very much linked. We're here to help, and we see this work having a major impact on people's lives.” - Noy Phimphasone-Brady, PhD
One of her studies focuses on helping those with Type 2 diabetes who have mood disorders or depression ‒ an illness that affects women at about twice the rate it affects men.
“Depression and Type 2 diabetes are very much linked,” she said. “When you’ve been diagnosed with something pretty serious, your life turns upside down. Type 2 diabetes is one of the few conditions where people have to think about how their behaviors impact their glucose every day, and that can be a lot for people. We’re here to help, and we see this work having a major impact on people’s lives.”Through targeted behavioral therapies, Dr. Phimphasone-Brady is helping patients manage the demands and stresses of diabetes to focus on living healthy, balanced lives.
Childhood Trauma & the Menopause Transition
Adverse childhood experiences such as abuse, neglect and violence can affect mental and physical health throughout a person’s lifetime. These factors may play a role in exacerbating women's experiences during the transition into menopause, which can bring cognitive symptoms, irritability and depression.For Christina Metcalf, PhD, understanding the impacts of such experiences over time is enabling her to better promote mental health for her pregnant, postpartum and perimenopausal patients with anxiety or depression, many of whom have come from difficult childhoods.
“Researching who is most likely to experience cognitive and mood difficulties during the menopause transition and why is critical to improve quality of life for thousands of women.” - Christina Metcalf, PhD
Dr. Metcalf is using a series of assessments to determine who is most at risk for mental health conditions during perimenopause, with the goal of offering targeted interventions to help women optimize brain health throughout the menopause transition.
“Researching who is most likely to experience cognitive and mood difficulties during the menopause transition and why is critical to improve quality of life for thousands of women,” she said. “This scientific knowledge will assist us in developing interventions to relieve these symptoms, and understanding for whom the interventions are most likely to work.”
Advancing Women’s Health for Better Human Health
We know research that includes women and accounts for sex and gender differences means better healthcare for all.
The work underway at CU Anschutz is not only improving the way we prevent, diagnose and treat diseases prevalent in women, but also uncovering insights that translate into better outcomes for everyone.
Sincerely,
Don Elliman