WOMEN'S HEALTH

What is women’s health?

The ideas of women’s health are applicable to everyone. Not just women.

The definition, scope, clinical and research priorities of women’s health have evolved as it has gained recognition as a discipline. In fact, this has paralleled the emergence of complexity, ideas discussed in Dr Eileen Hoffman’s article in the journal Academic Medicine, “Women and Complexity Science” which will be summarized below .

• A sex- and gender- informed practice centred on the whole woman in the diverse contexts grounded in an interdisciplinary sex- and gender- informed biospsychosocial science
• Screening, diagnosis and management of conditions that are
• unique to women, more common in women, more serious in women
• or have manifestations, risk factors and interventions that are different in women
• recognizes multidisciplinary team approaches
• includes the empowerment of women to be informed participants in their own healthcare
• recognizes the diversity of women’s health needs over the life cycle and how these need reflect differences in race, class, ethnicity, culture, sexual preference, and levels of education and access to medical care

reference: American College of Women’s Health Physicians and National Academy on Women’s Health Education

 What does complexity have to do with women’s health?

* Click here for an introduction to basic concepts of complexity science, and resources for further information on this emerging science of and for the real world

• HISTORY OF MEDICINE
• Newtonian science dominated thinking in physical, biological, and chemical sciences for more than 300 years: the whole is the sum of its parts. Understanding each component and present state would lead to a linear cause-and-effect prediction of the system’s outcome.
• This led to the coalescence of professional medicine around organ-based disciplines (eg. Cardiology: the study of the heart, Respirology: the study of the lungs, etc.)
• Women’s physiology was considered analogous to men’s – women were not included in any clinical trials for fear of hormonal confounding, the risk of teratogens influencing potential pregnancies, and structural gender inequities.
• Whenever women did not demonstrate the same behaviour as men, they were labelled "atypical", "outliers"
• Women’s health was strictly defined as “bikini line” reproductive medicine.
• With the vast expansion and accumulation of knowledge and information, medical schools began to shift educational goals from subject matter acquisition to critical appraisal and discriminative thinking.
• Alongside the integration of technology, emerged a movement within modern medicine to create structures bringing critical thinking and discrete knowledge into active connection in interdisciplinary environments. Women’s health begins here, at this intersection.

 

• RECOGNITION OF LIMITATIONS
• The machine model could not explain the unpredictable responses of living systems: at every level from the molecular ultra-sensitive feedback-mediated processes regulating gene transcription, translation, and activation in the nuclei of our cells, thus causing the liver to metabolize a drug faster or slower, interacting with other physiologic systems and resulting in an individual patient responding or not responding to her blood pressure medication – the body was clearly more complex than a gear with some cogs. New models were sought.
• The machine model could not explain how living systems, like the immune system, could learn, adapt and innovate. New models were sought.
• The machine model could not explain how several neurons could interact, self organize into an organ, dynamically respond to experience, environment, hormones and a host of other factors, and produce consciousness – an emergent outcome that is characteristic not of each part, but of the whole. New models? Sought.

 

• A NEW SCIENCE BUILDING ON THE OLD
• The science of complex adaptive systems allows us to use the metaphor of living systems for better insights and understanding of… living systems, organizations, market economies, and everything in between.
• Complexity science is by nature interdisciplinary, thus is particularly well suited to women's health scholarship
• Complexity approaches have the potential for being sources of innovation and creativity - women's health emerged.
• Sex differences were observed to exist at all levels of scale
• Complexity in women can be exemplified by the capacity to adapt to the pregnant state while maintaining structural integrity and relationships.
• Complexity was able to use a "WHOLE WOMAN PERSPECTIVE," appreciating the interactions between organ systems, hormones, genetics, the environment, the woman's experience of illness, mind-body integration, leading to better understanding and treatment of complex medical conditions such as Polycystic Ovarian Syndrome.
• Complexity also demonstrates ultimate outcomes are unpredictable, for example which women will develop Post Traumatic Stress Disorder, a result of the interdependencies between biology, cognition, relational contexts and the larger environment in which women live.
• Complexity values the the interaction of ethnicity, subgroups and health, allowing us to focus efforts on cultural competency, and also identification of nonlinear risk factors which may be more important in certain high risk ethnic groups, with the concomitant opportunity for medical intervention and better care.

Women's health is an exciting field with many subsections. Click on the following links to enter a discussion of specific topics of interest to you.

Cardiovascular

Pregnancy

Sexuality

Mental Wellness

Cognitive Differences between Men and Women