Nearly half of genes are expressed differently in men and women.1 Consequently, the incidence and severity of disease symptoms vary from one sex to the other, as do the probabilities of developing a disease. However, in many cases, these differences are poorly understood and sometimes have serious consequences for patients. To address this issue, Servier’s challenge is to raise awareness of these differences in order to improve patient care.
Significant consequences regarding patient care
The figures are significant: it is estimated that the risk of death or serious complications following a cardiovascular event is approximately twice as high in women as in men.2 This is mainly due to the lack of awareness of typically female symptoms and has the consequence of hindering medical care in women, and therefore ultimately their diagnosis and treatment.
“A woman is 40% less likely than a man to have a coronary artery exam prescribed.3 This lack or delay in care partially explains why women are more likely to die in the aftermath of a cardiac event than men.”4
Nicolas Garnier, Chief Patient Officer Servier
Below, four common misconceptions about male-female symptoms. It’s your turn to play!
For the same disease, the symptoms are always the same, whether the patient is a man or a woman.
FALSE – The medical history of diseases shows the opposite! Symptoms are different or have a greater or lesser degree of severity; men and women are not equal. This is the case, among others, for angina pectoris, which is traditionally expressed by chest pain following exertion or stress. Some women also experience significant pain in the neck, jaw, throat or back, as well as palpitations even at rest, nausea and intense fatigue.2
Myocardial infarction is a disease that only affects men.
FALSE – Out of the 65,000 cases of heart attacks in France each year, a quarter affect women.5 The symptom of sharp chest pain, most commonly identified by the public, has a lower incidence in women. Conversely, they exhibit signs such as fatigue, pain in the neck, jaw and shoulders, as well as shortness of breath and nausea. Since there is less awareness of the significance of these signals, they are therefore less quickly taken care, which doubles the risk of death.4
A woman is more likely to suffer from an atypical form of angina pectoris.
TRUE – Recent studies actually show that although coronary heart disease is the leading cause of comorbidity and mortality in women and men, women are more prone to developing a different form of angina pectoris. This is characterized by the specific symptoms specified above.6
Women are fully aware of the symptoms specific to their sex.
FALSE – It is estimated that less than 15% of women would be able to cite one or more risk factors specific to their sex. Among other symptoms, 64% of women ignore that digestive problems are a possible sign of a heart attack.7
What about other diseases?
It is established that Y chromosome expression in men results in a protective action against certain diseases such as multiple sclerosis. It logically follows that three quarters of patients affected are women.8
In the same way, the X chromosome carries genes whose role is to neutralize tumors. Their dual presence in women therefore protects them more from developing cancer (1 in 5 men risk having cancer in their lifetime versus 1 in 6 women)9.
Men are also faced with the issue of underdiagnosis. For example, although the incidence of this disease is higher in postmenopausal women, one in five men over the age of 50 is also prone to osteoporosis fracture.10
“Lack of awareness of symptoms for certain patient profiles might lead to late treatment and can have very negative consequences. As a major player in cardiology,11 it is our responsibility to raise awareness of these differences among healthcare professionals , so that they can take care of patients in the best conditions. To achieve this, we work hand in hand with patients to increase our knowledge and develop together prevention campaigns.”
[1] The impact of sex on gene expression across human tissues – Science. 2020 Sep 1;369(6509):eaba3066. doi: 10.1126/science.aba3066
[2] Santé cardiaque : les inégalités femmes-hommes ne sont pas une fatalité ! – FFC (fedecardio.org) (site visited in March 2024)
[3] FÉDÉRATION FRANÇAISE DE CARDIOLOGIE, « Cœur, artères et femmes… », op. cit., p. 12, January 2022
[4] Comment reconnaître les signes précurseurs d’un infarctus chez la Femme ? – DefMe (publication on April 9th, 2021 ; visited in March 2024)
[5] Infarctus : les symptômes de la crise cardiaque chez la femme, (e-sante.fr), from an interview with Dr Christelle Diakov, cardiologist, unité Cardiologie médicale et interventionnelle (Institut Mutualiste Montsouris) following the conference « Femme et infarctus du myocarde » at l’Institut Mutualiste Montsouris (24/9/2015) – (visited in March 2024)
[6] Frontiers in cardiovascular medicine : Gender-Related Differences in Chest Pain Syndromes in the Frontiers in CV Medicine Special Issue: Sex & Gender in CV Medicine
[7] L’observatoire du cœur des français – cœurs des femmes mars 2018 (visited in March 2024)
[8] Définition et chiffres – Fondation Sclérose en plaques (arsep.org) (visited in March 2024)
[9] Cancers – Santé publique France (santepubliquefrance.fr) (visited in March 2024)
[10] Ostéoporose chez l’homme (revmed.ch) (published in June 2013, visited in March 2024)
[11] QVIA, Analytics Link World 75 countries – MAT Q3-2023