Q&A: Stephanie Faubion, MD, talks goals beyond ‘bikini medicine’ for Women’s Health Week

Each year, National Women’s Health Week emphasizes how important it is for women to prioritize their health.

According to the HHS Office on Women’s Health, this includes keeping up with routine and other health appointments — which was often not possible with restrictions imposed during the COVID-19 pandemic — eating healthy, staying active, addressing your mental health and creating healthy habits.

Healio spoke with Stephanie Faubion, MD, MBA, director of the Mayo Clinic Center for Women’s Health, medical director of NAMS, and Healio Women’s Health & OB/GYN Peer Perspective Board Member, to learn about the role medical professionals play in supporting women’s health.

Healio: Why is women’s health important?

Faubion: Women's health is important for everyone — for men, for women, for people who don't identify as either. Determining differences in health and disease based on biological sex is incredibly important and something that's been overlooked. So far, we have assumed that the physiology of women is identical to that of men, which has led to some misconceptions. An example is Ambien. The fact is that we never studied Ambien in women and, lo and behold, found that it had different effects and was metabolized differently by women. We're missing a lot if we don't take into account sex as a biological variable. So, big picture: Women's health is important for everyone's health, because we need to determine the best way to treat each individual person based on a whole host of factors including genetics.

Healio: What topics in women’s health should clinicians focus on in their practice?

Faubion: Women's health is so much more than what has been termed bikini medicine. It's more than just breast health and reproductive health. Cardiovascular disease remains the number one killer of women, and so we really need to take into account all body systems when we talk about women's health. Not all body systems are different in women than they are in men, but identifying where those differences are is really important, because that means identification of disease might be different, prevention of disease might be different, treatment of disease might be different.

So, what is important for clinicians to pay attention to? I think there are many key areas that are overlooked. We tend to be better about looking at reproductive health, but when we get to middle aged women and management of menopause and understanding the body system changes that occur around menopause, it’s overlooked. For example, our heart disease risk really increases after the menopause transition, and we're just starting to understand why that is. It's probably a combination of things — our risks go up, blood pressure goes up, we tend to gain weight, we are more likely to develop diabetes after menopause, our cholesterol looks a little worse. In general, our cardiovascular risks go up after menopause. Some of that may have to do with aging and some may have to do with the menopause transition and loss of estrogen. So, paying attention to cardiovascular risk right around the menopause transition is critically important. Clinicians also need to keep up with regular screening for women as they do in men, and that [includes] the female specific cancers such as breast cancer and cervical cancer, but also the other cancers that are common to both sexes such as colon cancer.

Healio: What women’s health research is needed?

Faubion: I think understanding sex as a biological variable is an important focus. Even with a couple of big drug studies that came out in the recent past that were published in big journals such as JAMA and The New England Journal of Medicine, the authors did not disaggregate the data by sex, which is so disappointing in today's time when we need to be pushing our journals and our researchers and authors to report data by sex. If we don't have this data, we won't be able to make informed decisions, such as understanding whether a particular drug works better or not as well in women vs. men. We won’t know these things if we're not looking.

Healio: Is there anything else you would like to add?

Faubion: I'm happy to see menopause coming to the forefront of our conversations more recently. I think women are pushing that agenda and that's wonderful. We as health care providers also need to be advocating for women and for the management of menopause symptoms. We're finding more and more that those symptoms are very disruptive at work and have resulted in a lot of lost work productivity, lost opportunities for women and increased health care costs. So, I think better understanding of how we can help women through the menopause transition so that they can continue to be important contributors to our society is really important.

Reference:

• About National Women’s Health Week. https://www.womenshealth.gov/nwhw/about. Published May 6, 2022. Accessed May 12, 2022.