性差医学・医療の普及と発展—病状説明で「性差へ配慮」する重要性

Importance of "Sex- and Gender- Considerations" in Explaining Medical Conditions

性差医学は，生物学的性差・社会的文化的性差およびライフステージ（LS）が心身に及ぼす影響を明らかにする。脳神経疾患でも性差とLSに配慮した診療が求められる。性差医療により，前医で不定愁訴とされた女性患者の27％に器質的疾患が診断された。女性は月経や更年期症状によって他の疾患が隠れ，見逃されやすい。医療者が「性差とLSの視点・知識」を持つことで，診断の精度，病状説明，疾患予防や治療の質的向上が期待される。

Abstract

Gender medicine aims to improve the quality and accuracy of medical care by considering the influence of sex difference, gender difference, and life stage (LS) in the pathophysiology, diagnosis, treatment, and prevention of diseases of the reproductive system and common diseases of both sexes. In particular, sex and gender differences exist in the risk of developing and the way symptoms manifest in cerebral and cardiovascular diseases, endocrine disorders, autoimmune diseases, and psychiatric disorders. Cranial nerve disorders also require medical care that considers gender differences and LS. In one outpatient clinic specializing in women's health, 27% of patients previously diagnosed by their previous physicians with complaints were found to have underlying organic diseases. Women are more likely to have menstrual and menopausal symptoms that mask other diseases, and the diagnosis is more likely to be missed. The tendency of women to report symptoms from the periphery, due to their reluctance to speak clearly, also makes differential diagnosis difficult in the limited clinic time available. The accuracy of diagnosis, explanation of medical conditions, and quality improvement of disease prevention and treatment is expected to be achieved when medical providers have a “perspective and knowledge of sex and gender differences and LS.”