Women Were Excluded From Medical Studies Until 1993

episode

Previously titled “Has The Medical System Betrayed Women? How To Take Back Control of Your Health” — renamed by the publisher on Sep 3, 2026

The School of Greatness 1h 21m 5 speakers 4 chapters transcribed
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Transcript generated automatically by AI and may contain errors.

Why has the medical system failed women historically?

Dr. Mary Claire Haver 0:56
I would have to agree with you. The medical system, I don't think the individual doctor goes out in the world and thinks, I'm going to fail a woman. I think the way we've built the system was for the basic white guy. at least in the US. And so all of the studies, women were not even required legally to be in studies until 1993 from the NIH. So we have an entire generation. Now that happened because thalidomide was being used in pregnant women For nausea and ended up causing birth defects and that freaked everyone out understandably But they removed all women from studies after that just in case they might get pregnant then when you talk to researchers It's much more expensive and harder to study women because of their cycles or because of peri or postmenopause and men are just predictable so they just study mostly men and just take those things and infer them to women when we don't really understand the gender differences and the sex differences and
Dr. Mary Claire Haver 1:51
and how cardiovascular medications affect. So greatest example, statins, right? We use statins left and right to treat high cholesterol. Most women will have significant elevations of cholesterol through menopause. So here she goes through the change, boom, her cholesterol goes up, goes to her PCP, you need a statin. Statins have never been shown in women to decrease the risk of a heart attack or decrease death from cardiovascular disease.
Lewis Howes 2:15
So why do we do it?
Dr. Mary Claire Haver 2:16
Because it worked in men and we- Just do it. So there is no evidence to support that. It will lower cholesterol, will not decrease the risk of a heart attack. Because we develop disease differently and for different reasons. And it's, you know, this is published by the American Heart Association in Circulation Magazine. I didn't make this up. And so, yet... There's no studies right now.

What challenges do women face with menopause and hormone therapy?

Dr. Mary Claire Haver 2:39
So now it's like us fighting, getting NIH grants, getting Congress on board. What the menopause is doing is advocacy, is fighting on a legislative level to force these things to happen, force these American College of OB-GYN, American Board of OB-GYN. And why should all of women's health fall in the lap of the poor, busy OB-GYN who's trying to deliver babies and prevent cervical cancer, right? I did that job. It's a hard job. This should be required in medical school. I got one hour of menopause in medical school. Every clinician who touches a woman should have required menopause training, not just hot flashes, night sweats, and what HRT may or may not do for you, but how our sex differs in disease and how we need to treat women differently.
Dr. Mary Claire Haver 3:25
I mean, if you read Eleanor Cleghorn's The Unwell Woman and you look at The Invisible Woman just came out, Invisible Women, just looking at how in science women are just kind of ignored because we're harder. Harder to study. Yeah. And so we're not little men. We're more than just a man running, a short man running around with a breast and a uterus, you know, breast and uterus. So we're actually, the way we present with disease, the way we're treated with disease is vastly different.
Unknown Interjector 3:51
Yeah.
Dr. Mary Claire Haver 3:52
So what started out with like hot flashes and weight gain is actually a much bigger, bigger picture.
Lewis Howes 3:57
And one of the biggest, I guess, risk factors for disease with menopause?

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