This is reference man. He’s a white, 30-year-old, male who weighs about 155 pounds. And he decides how we live. For decades, industries have considered this the standard human. And designed the world around him. Everything from air conditioning in offices, to cars, even military equipment. But there are other ways we use reference man, that aren’t so obvious. Like in medicine, where it doesn’t just lead to discomfort. Here, the disparity can be incredibly dangerous for women. A few years ago, something strange was happening. Headline after headline recounted a similar story. Dozens of women were crashing their cars, under the influence of sleeping pills. In many of these cases, they had taken a dose of Zolpidem, the night before. It’s what you probably know as the common sleep aid, Ambien. The problem wasn’t entirely the drug itself — it was the dosage. Women and men were both prescribed ten milligrams of the drug for eight hours of sleep. But it turns out, women metabolize the active ingredient in Ambien twice as slowly as men. That means by the time men woke up the next day, the effects of the pill had usually worn off. While for many women, the drug was still in their system. After the crashes, the Food and Drug Administration issued a safety warning in 2013 and changed the recommended dosage for women, cutting it in half. The reason the right dosage for women had been overlooked is that the clinical trials on Ambien focused on male test subjects. If they’re using this hypothetical “average man” and they are basing dosage on it, that’s kind of scary. Not just because it doesn’t apply to women, but because it also doesn’t apply to a lot of men either. There are several factors that can affect
how a person metabolizes drugs, from size, to body fat, to hormonal fluctuations. And these factors can vary drastically based on sex. But many clinical trials don’t account for this. They often don’t include enough women as test subjects. And even when they do, data from women is often mixed in with data from men, which can hide sex-specific reactions to medicine. I don’t care that it’s more effective for
men. I just want to know, is it going to be effective for me as a woman. So you don’t know that unless you look separately at those groups. Take, Acetaminophen, the active ingredient
in Tylenol. It’s flushed from a woman’s body slower than in men, so the prescribed dosage can put women at more risk for potential overdose and liver failure. And one heart medication that’s supposed to prevent heart attacks may actually trigger one in women. So we know that this is still a problem, but
it’s so hard to know how often that happens because there’s no research. If the companies did a better job of looking at men and women separately and studying them separately, I think we’d have a lot more dosages that
are different for women and men. In 1993, the National Institutes of Health created regulations, saying women must be included in human studies and have their data analyzed separately. But the problem is, It’s the FDA, the Food and Drug Administration, that’s making the decisions about what medications are being sold to you and to your loved ones and they are not required to include women, people of color, people over 65. You know if you’re only studying white men, you don’t have to study as many people. And the more people you study the more it costs to do the research. But, the more meaningful the information is so that we can all make informed decisions about what’s good for us.