by Jackie Powder
In 2003, Judy O’Neill had her first “spell”—intense chest pain, shortness of breath, a shooting pain in her left arm and vomiting.
It marked the beginning of seven years of regular trips to the emergency room, countless tests and procedures—and, at times, dismissive attitudes from her doctors.
Eventually, the 69-year-old O’Neill reached cardiologist Pamela Ouyang, MD. Ouyang, director of the Johns Hopkins Women’s Cardiovascular Health Center, diagnosed coronary vasospasm (a coronary artery constriction).
More common in women, the condition causes some of the classic symptoms of heart disease, but tests don’t necessarily show severe coronary artery atherosclerosis causing obstruction to blood flow, which is more often found in men.
It’s not uncommon for clinicians to fail to recognize that women can experience heart disease—and many other medical conditions—differently than men. This fact highlights the need for research with a women’s health focus, say members of the Women’s Health Research Group (WHRG) at Johns Hopkins. Ouyang and her WHRG colleagues are committed to bridging the research gaps in women’s health. From the schools of Public Health, Nursing and Medicine, this band of scientists seeks to discover the health implications of fundamental sex-based differences and to better understand health issues unique to women.
“We know there are mechanisms impacting health differently for the sexes, and this makes it important to study health in women as well as men.” —Karen Bandeen-Roche
“Our group represents diversity—from policy and behavior to cancer, immunology, infectious disease and other aspects of women’s health,” says Sabra Klein, PhD, MS, an associate professor in Molecular Microbiology and Immunology. Klein’s own investigations into the ways that male and female hormones affect susceptibility to infection have gained national attention.
The group’s interests include reframing pregnancy as an opportunity to shape a woman’s long-term health, diagnosing and preventing frailty, and discovering how basic physiological sex differences affect diseases of the immune system.
WHRG’s research reflects the slow evolution of women’s health science beyond a reproductive focus. “When our office was formed in 1990, women’s health was really viewed as ‘bikini medicine,’” says Janine Clayton, MD, director of the Office of Women’s Health Research at NIH, explaining that decades of women’s health research often led by men focused primarily on the areas of the body covered by a bikini.
It wasn’t until 1990 that Congress mandated that women be adequately represented in NIH-supported research. Until then most clinical trials only enrolled men, assuming that the findings applied equally to both sexes—when the reality was quite different.
Morgana Mongraw-Chaffin, PhD ’13, MPH, a cardiovascular epidemiologist and WHRG member, says she has benefited from the WHRG’s collective experience and support. She wants to see sex-based research evolve from its status as a growing field to standard practice.
“My hope is that at the end of every talk I go to, I won’t have to raise my hand and say, ‘That’s great, but did you look at the differences between men and women,’” says Mongraw-Chaffin. “It should be as standard as any of the other research methods we use.”
WHRG members investigate a wide range of issues related to women’s health. Read about some of their work on the next two pages.
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