Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick

by Maya Dusenbery

Given the NIH’s lack of record keeping, it was impossible to say exactly how underrepresented women were, but the public learned that women had been left out of many of the largest, most important clinical studies conducted in the last couple of decades. The Baltimore Longitudinal Study of Aging, which began in 1958 and purported to explore “normal human aging,” didn’t enroll any women for the first twenty years it ran. The Physicians’ Health Study, which had recently concluded that taking a daily aspirin may reduce the risk of heart disease? Conducted in 22,071 men and zero women. The 1982 Multiple Risk Factor Intervention Trial—known, aptly enough, as MRFIT—which looked at whether dietary change and exercise could help prevent heart disease: just 13,000 men. The default to studying men at times veered into absurdity: in the early sixties, observing that women tended to have lower rates of heart disease until their estrogen levels dropped after menopause, researchers conducted the first trial to look at whether supplementation with the hormone was an effective preventive treatment. The study enrolled 8,341 men and no women. (Although doctors began prescribing estrogens to postmenopausal women in droves—by the midseventies, a third would be taking them—it wasn’t until 1991 that the first clinical study of hormone therapy was conducted in women.) An NIH-supported pilot study from Rockefeller University that looked at how obesity affected breast and uterine cancer didn’t enr...