Gender, health, and responsible research

In women, the prevention or management of diseases and disorders particular to middle-age, as well as those that do not present until later life, requires a substantially improved knowledge base to differentiate those conditions whose causes stem from ovarian hormone insufficiency (and thus are treatable by hormone therapy) from those that do not. Only then can we prevent misdiagnosis, avoid dismissing middle-aged women's medical complaints as "menopausal," and attempt to change the perception that physicians do not render the same attention to women or take women's health care concerns seriously. It is inevitable that dramatic changes in the health care system will be required to accommodate changing population demographics resulting from the burgeoning aging population. Currently, more than 35 million women, or one third of the total female population, is postmenopausal. Last year alone, the number of women reaching age 50 (the average age for menopause in the United States), reached 1.3 million, and this number will approach 2 million per year in the first decade of the 21st century as peak numbers of women from the baby-boom generation reach this milestone. Clearly, as the proportion of older women continues to grow, the need to expand our scientific and medical knowledge base assumes even greater urgency in order to develop efficacious strategies for the delivery of preventive, diagnostic, and clinical health care to older women. These strategies are crucial in reducing morbidity and maintaining the independence of this rapidly growing segment of the population.