The ‘bikini approach’ to women’s health research

by Carolyn Thomas

We know that, until very recently, cardiac research for the past three decades has been done either exclusively on men, or with women represented in statistically insignificant numbers. Medical researchers have largely taken a ‘bikini approach’ to women’s health care – in which women’s health research focuses on breasts and the reproductive system.

In a recent WomenHeart interview, Mayo Clinic cardiologist Dr. Sharonne Hayes, founder of the Mayo Women’s Heart Clinic in Rochester, MN, explains:

“In the 1960s, erroneous assertions that heart disease was a man’s disease were widely spread to the medical community and to the public.  This led to research almost exclusively focused on cardiovascular disease in men.  Many clinical trials in the 70s and 80s excluded women or simply didn’t make an effort to enroll women in sufficient numbers to draw sex-based conclusions.”

Dr. Sharonne Hayes
Sharonne Hayes

At the Canadian Cardiovascular Congress in Toronto last fall, researchers announced that even now, women are still under-represented in heart research. Although 53% of heart disease patients are women, we make up only 25-34% of the subjects in cardiac studies.  Dr. Hayes adds:

“The lack of relevant research in women has resulted in a substantial sex-based knowledge deficit about everything from the ‘typical’ heart attack symptoms in women, to the risks and benefits of commonly used diagnostic tests and therapies.

We are not necessarily analyzing current research data by gender, and the need for gender-specific studies is not on the radar screen of researchers.  Plus it’s difficult to recruit women for these cardiac trials.  Women have not bought into heart disease as a ‘woman’s disease’, so they don’t see the relevance or potential benefit of seeking out clinical trials.”

This is a critically important factor. Women do volunteer for hormone or breast cancer clinical trials – but don’t seem as interested in participating in cardiac research. As Dr. Hayes reminds us, many women still mistakenly believe that heart disease is a man’s problem, even though it is the #1 killer of women.

Many of us – including most physicians – still mistakenly believe that heart disease is a man’s problem, even though it is the #1 killer of women.

A 2005 American Heart Association study, in fact, found that only 8% of family physicians and – even more shocking! – only 17%  of cardiologists were aware of the fact that heart disease kills more women than men each year.

Find out more about gender differences in our cardiac diagnoses, treatment and care, or about heart research that does include women.

See also: 

3 thoughts on “The ‘bikini approach’ to women’s health research

  1. Great post – thanks for this. Unbelievable that women seem reluctant to enroll in cardiac studies. But without our numbers fully represented in research, current diagnostic and treatment decisions will just continue as before, based on MALE research outcomes.


  2. This is shocking and disturbing. Even though we are now well aware of the rate of heart disease in women, the medical profession is still largely operating based on those decades of belief that heart disease is a man’s problem, not a woman’s.


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