Beyond Women’s Hearts

Most people know that pressure, tightness and pain in the chest can be a sign of a heart attack. And yet, the fact that heart attacks in women may also cause more subtle symptoms such as nausea, vomiting, shortness of breath or upper body and jaw pain is only slowly entering public awareness – and is one of the main reasons why many women don’t act quickly and call for the emergency services. The varying heart attack symptoms are one of many examples that illustrate the differences between men and women’s bodies.

In recent years, awareness of the differences in how female and male bodies function has grown. Doctors, clinics, prevention centers and the pharmaceutical industry worldwide have joined researchers in recognizing that women do not experience medical conditions or respond to therapies in the same way as men, but may exhibit completely different symptoms and react differently to treatments. The field of gender medicine sheds light on these sex- and gender-specific differences.

UZH took the lead in 2024 by establishing Switzerland’s first chair for gender medicine. The chair is held by cardiologist Carolin Lerchenmüller, who chaired the program committee of the inaugural Swiss Gender Medicine Symposium on behalf of the Vice President Medicine and the Swiss Initiative Foundation. Together with Switzerland’s five medical faculties, they came up with the pioneering idea of a nationwide exchange on gender medicine.

We spoke with Professor Lerchenmüller about the symposium and the latest developments in gender medicine.

Carolin Lerchenmüller, why do we need an international symposium on gender medicine?

Carolin Lerchenmüller: Gender medicine brings together basic research, clinical medicine, public health and social and behavioral sciences. A forum such as the Swiss Gender Medicine Symposium provides a setting for experts from these different fields to connect and work on challenges together. Only through this kind of targeted exchange of knowledge and experience is it possible to harmonize data collection and transfer research results into clinical practice more quickly.

The symposium also helps to expose blind spots in research. Many preclinical and clinical studies still fail to adequately consider the influence of biological and social gender – common standards and methods are needed here to make data more comparable and meaningful.

The event also brings together key stakeholders: researchers, clinicians, decision-makers, funding institutions, and representatives from business and politics. The symposium aims to contribute to developing a shared agenda – with clear strategies, funding mechanisms and policy frameworks to strengthen gender medicine in the long term.

How does gender-specific medicine in Switzerland compare to other countries?

Lerchenmüller: Switzerland is catching up. My professorship in gender medicine at UZH was established in 2024 and marks a major step in anchoring the field at the institutional level. Compared internationally, countries such as the USA, Canada, Sweden and Germany are slightly ahead. But current developments in Switzerland are very dynamic. Thanks to a network that has been active for many years, the newly founded Swiss Society for Gender Health and additional professorships – at the University of Bern, for example – gender medicine is becoming more visible and gaining importance.

Through these networks, but also through platforms such as the Swiss Gender Medicine Symposium, Switzerland now plays a key role in the European context. We’re on the right track.

Which areas of gender medicine have seen the most progress in recent years?  

Lerchenmüller: Above all, awareness has changed significantly. It is now widely recognized that biological and social gender differences must systematically be taken into account in research and clinical practice. This insight now needs to be implemented across the board.

My own field of expertise, cardiology, has also seen a lot of progress. By introducing a women’s heart health program at the Heart Center of the University Hospital Zurich, for example, we’re now able to provide sex-specific care. This includes not only diagnostics for non-specific chest pain or shortness of breath, but also targeted prevention, therapy and interdisciplinary collaboration with other departments and clinics.

There has also been a great deal of progress in pharmacology. We now know that drugs can have different effects on women and men due to differences in their metabolism, hormonal status or the composition of fat, muscle, bones and water in the body. As a result, there are growing calls for clinical studies to be consistently evaluated on a gender-specific basis.

Last but not least, there have also been changes in the scientific system. There is more discussion about genuine equal opportunities, and measures are being taken to establish them. The aim is to achieve greater diversity among researchers and medical professionals, which will pave the way for broader research and care. These are all important steps towards a form of medicine that truly includes everyone.

Do unhealthy habits such as smoking or lack of exercise affect everyone equally, or are there differences between women and men?

Lerchenmüller: We know that risk factors such as smoking, obesity, lack of exercise and diabetes affect men and women differently. There are even sex- and gender-specific risk factors. This is partly due to biological reasons and partly due to variations in life circumstances, stress patterns and role models. Prevention programs should take these differences into account and be tailored to individuals and their respective circumstances.

What about differences in mental health?

Lerchenmüller: Loneliness, especially among single or older men, has been established as a risk factor for cardiovascular disease and premature mortality. Innovative approaches to social connection, early detection and education are needed here. Mental health must not be overlooked.

Where is there an urgent need for action when it comes to treating diseases? 

Lerchenmüller: We’ve achieved a great deal in recent years, but there are still key areas that require attention. In diagnostics, for example, we need to improve how we recognize gender- and sex-specific symptoms and adapt clinical guidelines accordingly.

There’s also room for improvement in therapy and drug safety. We know that dosages, effective levels and side effects often vary significantly because of differences in body weight, hormones and metabolic processes. We must systematically evaluate these differences and translate these insights into practice.

Finally, we must ensure that sexual and gender minorities are not excluded from care. There are still major data gaps in this area, for example regarding specific health risks or access to appropriate care. Clear structures, guidelines and research are crucial here to enable truly inclusive medicine.

Is there anything researchers should focus on more?

Lerchenmüller: Women are still underrepresented in clinical trials, and intersectional factors such as age, ethnicity and social background are considered too rarely. It is important that study designs become more diverse and analyses more gender-specific in order to produce truly reliable results.

Is gender medicine included in medical education?

Lerchenmüller: Not as much as it should be. Education and training in the healthcare sector need to be expanded. From the very beginning, students and professionals should learn to consider sex and gender aspects in diagnosis and treatment as a matter of course – not as an add-on, but as an integral part of good medical practice.