Artificial hip joints fail more frequently in female patients because the unisex design is not tailored to the differences between men and women's hip anatomies and bone strength. Identical immunotherapy cancer treatment has lower success rates in women than men due to differences in immune response between the sexes. Even popular wearable health tracker devices often fail to adjust for phases of the menstrual cycle or pregnancy, resulting in inaccurate data and false illness reports for healthy female users.
The consequence is sub-optimal care from what should be cutting-edge biomedical technology.
“You go to this one-size-fits-all approach, and then you find it doesn't work very well,” says Dr. Shreya Raghavan, assistant professor at Texas A&M University’s Department of Biomedical Engineering.
This is the problem that Raghavan and Dr. Erika Moore of the University of Maryland seek to highlight and solve. In a new paper published in Med, they lay out plans for a holistic consideration of women's health and biomedical engineering — an approach that could result in more effective healthcare for both women and men. The paper is based on their findings as the chairs of the National Science Foundation’s ElevateHER Conference, which Texas A&M hosted in August.
“The goal is to move forward human health for everybody, not just for women. By disaggregating and studying differences in women's health, you're now finding out information about men and women, and now you can tailor things for each,” said Raghavan.
Raghavan and Moore present a list of clear and detailed actions to revolutionize women’s health, identifying key research areas and calling for open communication between fragmented engineering and medical fields.
“Our work and the conference are hoping to address the silos and separations that we see happening around women’s health and to coalesce effort so that together we can make a more substantial impact in women’s health faster,” said Moore.
Currently, many existing biomedical engineering breakthroughs remain unused in women’s health due to a lack of awareness and limited focus on reproductive health.
The goal is to move forward human health for everybody, not just for women. By disaggregating and studying differences in women's health, you're now finding out information about men and women, and now you can tailor things for each.
“A striking example of this phenomenon is seen when breakthroughs in biomaterials for bone repair and orthopedic health are not immediately recognized as beneficial for addressing bone density loss associated with menopause,” the paper states.
The biomedical technologies that are applied to women’s health often perform poorly because they are not tailored to women’s physiology.
“Immunotherapy is much more effective in men than it is in women because we don't ever think of immunity as context dependent,” explained Raghavan.
Men, who have a weaker immune response than women on average, respond well to immunotherapy. Female patients’ stronger immune systems receive less help from boosting the immune system but have a far better response to treatments that enhance the body’s ability to recognize tumors. Tailoring treatment to the patient’s sex would result in more effective care for all cancer patients.
Even consumer health goods suffer from the one-size-fits-all approach. Raghavan points to wearable health tracker devices, which track the user’s biometrics like heart rate and temperature. Despite manufacturers' resources and desire to succeed in a competitive market, some of the most popular devices take generations of development before they address simple usability issues that dramatically decrease the accuracy and usability for women. Female customers complain of devices sending illness alerts simply because of the natural temperature fluctuations during menstrual cycle phases or repeatedly warning expectant mothers that they are experiencing unhealthy weight gain because the device has no way to mark the user as pregnant.
“My biggest hope from publishing this paper is that we'll have tangible action,” said Raghavan, “We put this paper together so all the stakeholders can find action items: What are the most pressing problems in health, especially women’s health? Where do we need to invest?”
The future now rests in communicating and raising awareness – with isolated researchers and clinicians, with the public, and with the prospective students who will become the next generation of biomedical engineers.
“The science is there. There's a critical mass now, driven by many early engineers who pioneered and championed engineering for women’s health. Now, it's all about continued organization and action,” said Raghavan, “I don't think we have to wait 10 more years to see results. I think we're seeing it in action already, but there’s always more work to be done.”
At Texas A&M’s biomedical engineering department, the future is already arriving. Raghavan and Moore plan for the next ElevateHER Conference to include the students and trainees who will go on to create the next wave of biomedical breakthroughs.