
New study provides evidence that we need different drugs for men and women - andrewl
https://www.wired.com/story/womens-pain-is-different-from-mens-the-drugs-could-be-too/
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tropdrop
Some takeaways that underscore the fact that it took the NIH until 2016 to
require animal research to feature both male and female animals -

"Women greatly outnumber men among migraine sufferers, and women made up about
85 percent of the participants in the Phase 3 clinical trials of the three
anti-CGRP drugs approved by the Food and Drug Administration in 2018. Price
wonders if the anti-CGRP drugs aren’t specific to migraines—but to women. His
work with mice suggests that the drugs don’t work in males, but block pain in
females.

Mogil once emailed a researcher, asking whether a pain drug worked better in
men than women. The researcher didn’t know, and couldn’t pursue the question
because the data was controlled by the pharmaceutical company. Mogil was left
wondering if drugs that looked promising in male-only animal studies might
have failed in clinical trials when the results were blended with those in
women, depriving men of a viable treatment...

[Meanwhile] medicines that could work best for women wouldn’t make it into the
pipeline at all when basic science excluded female animals. Price wonders if
unresolved pain among women might have led to their higher levels of chronic
pain."

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hutzlibu
So slowly, it seems we are going back to the primitive healer's approach where
they did not had a specific drug for a specific disease, but rather they made
a individual combination of drugs (and other methods) for every individuals
problems.

Because, of course men and women are different so it should not be surprising
that they react differently to drugs, but also men or women in itself are very
different, depending on their genes obviously, but also their age, their
routines, their diet etc.

So good to hear, that we are going one more step away, from the generalistic
approach. Which was a cheap way, thats why it did produced results as well,
but maybe not the best results.

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rygxqpbsngav
Yes. Ayurveda does treat every individual differently and does customized
medicine on case-by-case basis after observing the patient carefully asking
questions that provide root cause and then make a medicine that only works for
that individual for that issue alone. No side effects. Modern medicine treats
every one equal and prints a list of side effects on drugs as if they are
nothing. But it is the body's way of saying it is not happy with whatever
external chemical he has taken is not for that body! Finally it's a good step
which modern medicine is ignoring for ages even after advised by a few before.

~~~
adrianN
Ayurveda hasn't been shown to work better than placebo as far as I know.

~~~
rygxqpbsngav
Then you don't know anything about true ayurveda. Have you ever met someone
practicing ayurveda for anything and got treated? I got cured for 2 things,
one of which has no known medicine (only repeated surgery for life) and it
never got back in past 18 years.

~~~
adrianN
I don't know very much about medicine either, but it's easy to find double
blind studies that show efficacy for all kinds of medical procedures. Is there
anything similar for Ayurveda?

~~~
rygxqpbsngav
That's not how it works. Ayurveda is not a medical pharmacy. It's a way of
treating individuals. Like I said earlier, each case is different. There are
no common medicines other than a few (6 or 7), which are known to work for any
body type. For anything that doesn't get cured through them needs customized
medicine. I am no expert either. But there are no lobbyist pharmas backing
studies on Ayurveda medicine as they are like open source, free. Since you
asked I know one, KSM-66, if you know anyone with depression/insomnia/high
heart rate etc. they can try it. That's one of the common one of the 6 or 7 I
mentioned above.

~~~
collyw
Of course you could study it. Give 50% of the participants individualized
Arurdvedic medicine and 50% the standard medicine. Give both groups the
consultation Adudveric style as a control measure. See if there is a
statistically significant difference in results, then you have an answer.
(Your starting point will be people with the same problems/symptoms).

Or am I missing something?

(Your answer comes across as implying "no one is the same we can't possibly
disprove / prove this stuff")

~~~
hutzlibu
"(Your starting point will be people with the same problems/symptoms).

Or am I missing something?"

I don't know much about Ayurveda, but the general idea is, that there are no
people with the exact same problems/symptoms.

Which is not, how far I would take it, so you have to do generalisations, but
maybe much finer grained.

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curry-castaway
Direct link to the study – "Electrophysiological and transcriptomic correlates
of neuropathic pain in human dorsal root ganglion neurons":
[https://academic.oup.com/brain/article-
lookup/doi/10.1093/br...](https://academic.oup.com/brain/article-
lookup/doi/10.1093/brain/awz063)

------
wtdata
It is interesting, but since quite a few examples here pertain the brain. By
accepting the conclusions of the article we must also accept the idea -
presently under attack - that there are indeed clear biological differences
between the male and female brains.

~~~
omnomnomtea
I don't think it's as black-and-white as that.

There can be statistical differences on average, without requiring that every
brain is unambiguously classifiable as "male" or "female" on a biological
level based on that trait.

For example- if a drug works well for 80% of women and 15% of men, that
implies that there are some men whose brains utilize the "female" pain pathway
and some women who use the "male" pain pathway. It also suggests that that
drug might be a good first line of treatment for female patients and a
secondary or tertiary line of treatment for male patients. Trying to classify
brains like this is like trying to classify sex based on height- on average it
sort of works, but there's enough overlap between the heights of women and men
that you can't actually do it reliably on an individual level.

So tl;dr I don't think that "clear biological differences between the male and
female brains" is actually a reasonable conclusion that can be drawn from this
research.

~~~
freshm087
Yes, except practically nobody claims that it's black-and-what. This idea
which is under attack (for which James Damore got fired, for example) is that
measuring equality by setting 50/50 female-to-male ratio as an ideal doesn't
reflect reality, because _in general_ sex differences very likely exist beyond
culture, and they logically should lead to different representation in various
fields of occupation.

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belorn
The article starts out with saying that drug development begins with studies
on male rats and mice, but then goes on to describe difference the biological
pathways for pain in men and women. That creates some obvious question. How
similar is the pain pathways between humans and rats, and is it more similar
than between women and men?

There should basically be 6 sources of differences. Animal M vs Human M,
Animal F vs human F, Animal M vs Human F, Animal F vs Human M, Animal F vs
Animal M, and last Human M vs Human F.

A difference in any of those could potential cause a wrong conclusion in a
study. The question I hope researcher has is which of those are more likely to
have a significant difference in pain research

~~~
coldacid
Different model animals are picked for different types of medical studies, or
at least they are supposed to be, based on similarities between the model and
humans within the context of the functionalities under test.

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damla
Link to another recent study related to pain differences between men and women
(Male-Specific Conditioned Pain Hypersensitivity in Mice and Humans)
[https://www.cell.com/current-
biology/fulltext/S0960-9822(18)...](https://www.cell.com/current-
biology/fulltext/S0960-9822\(18\)31496-9)

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known
And women also display different cardiac symptoms from men
[https://outline.com/aYwSJV](https://outline.com/aYwSJV)

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xeeeeeeeeeeenu
The mechanism of action of analgesic drugs is very simple and well-understood.

Considering the fact that the very same painkillers that humans use are
effective on _drastically_ different organisms, such as snails or crustaceans,
I find it extremely unlikely that gender plays any significant role in their
effectiveness.

To be honest, it feels like this study was politically motivated.

~~~
EvilTerran
> The mechanism of action of analgesic drugs is very simple and well-
> understood.

[https://academic.oup.com/bjaed/article/14/4/153/293533](https://academic.oup.com/bjaed/article/14/4/153/293533)
(2013)

 _the exact mechanism of action of paracetamol_ [ie acetamophen] _remains to
be determined. There is evidence for a number of central mechanisms, including
effects on prostaglandin production, and on serotonergic, opioid, nitric oxide
(NO), and cannabinoid pathways, and it is likely that a combination of
interrelated pathways are in fact involved._

That's the most widely-used analgesic in the world, and its mechanism is
evidently neither simple nor well-understood.

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tomlock
I'd ask everyone who came to this article with the assumption that someone
would object to or get offended by this finding, to actually observe if anyone
does.

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Swizec
Right above you, someone getting offended that there aren’t enough trans
people in the study. I thought that was an interesting coincidence.

[https://pasteboard.co/I6fhTWy.jpg](https://pasteboard.co/I6fhTWy.jpg)

~~~
tomlock
Seems like a reasonable comment to me, and not an objection to the finding.

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m463
I was told that the clinical studies of birth control pills were done on male
subjects.

~~~
sagartewari01
I guess they had 100% success rate.

~~~
djsumdog
I'd assume it was mostly just to test their ability to harm/toxicity?

~~~
m463
I believe the fundamental reason was that testing on women of childbearing age
was not recommended, so they tested on men.

