Care and Prevention of Women. Gender Medicine for Precision Medicine. Interview with Dr. Tiziana Ferri.

A service for women, managed by women, for health, from female prevention to precision medicine, based on a new multidisciplinary approach based on gender. We asked Dr. Tiziana Ferri to present the service of “Gender Medicine – Women's Care and Prevention” of which she is coordinator in UPMC Salvator Mundi International Hospital.

It is a new gender clinic, dedicated exclusively to women, with a multi-specialist character: cardiology, senology, radiology, gynecology, postural and urogenital rehabilitation, clinical and microbiological analysis. It therefore deals with women from prevention to rehabilitation. Is it aimed at a specific age group?

Gender medicine is today a goal for health, so applying its concepts in daily medical practice becomes essential to outline innovative programs, to organize the offer of services by improving the quality and appropriateness of the services provided, to promote health, to inform and communicate correctly, to personalize care in the direction of developing precision medicine. For this reason, we have decided to organize a multi-specialist clinic dedicated to women that stands out for its ability to welcome, listen, assist, which ranges from prevention when the woman is healthy and correctly frames the disease if, getting sick, she becomes a patient throughout her life.

Women for women. A team of female doctors are at the service of all patients who choose to turn to the new service of "Gender Medicine – Care and Prevention women" in UPMC Salvator Mundi. How did the idea of proposing a service like this come about?

The idea was born from the memory, shared with colleagues, of a thought of Hippocrates, a doctor of the fourth century BC, considered the father of medicine, who asserted: "it is more important to know what kind of person has a disease than to know what kind of disease a person has". Convinced of this we have deepened the studies on gender medicine that can be defined as a new dimension of medicine that studies the influence of sex and gender on physiology, pathophysiology, pathology, psychology and clinic. It is therefore not a new discipline, but a new approach that crosses all medical disciplines, at all stages of life to arrive at evidence-based therapeutic decisions in both men and women. Sex and gender are not synonymous: sex is linked to the genetic aspect, defined by the chromosomal kit; Gender is a concept defined by social, environmental, cultural and behavioral aspects that a society considers specific to men and women. The state of health and illness of a subject can be influenced by both. Being a woman or a man affects both the onset and course of diseases, as well as the diagnostic aspect, treatment, cure, response to drugs and rehabilitation. Sensitive to this new approach, our project started.

Women and men therefore get sick differently. Can you give some examples?

Yes, women and men get sick differently and also have significant differences in terms of incidence, progression of many diseases and response to therapy. Women, for example, have more adipose tissue and a different hormonal profile and this leads to important variations in the response to drugs. Heart diseases, for example, are more frequent in women than in men but, they manifest themselves about 10 years later when, with menopause, the estrogenic rate drops definitively. Consider that 40% of female deaths are due to acute myocardial infarction and stroke. There is still an underestimation of the knowledge of cardiovascular pathology. In a recent survey it was found that more than 50% of women believe that it is the prerogative of the male sex.

Many times women are still responsible for the role of caring for the family and, given the hectic pace of work, the time to devote to themselves and their well-being is very small. In any case, prevention is fundamental, as well as the personalization of therapy. Based on your professional experience as a cardiologist and coordinator of the service of "Gender Medicine – Women's Care and Prevention", what indications do you feel to give to women?

Yes, women play the role of caregiver as the approach to health and the female psychological aspect leads to think first of others and therefore manage the health problems of the family often neglecting themselves. It's time to change course. Better awareness leads to greater responsibility that leads to change, for example, eating habits and lifestyles that are decisive for the onset and/or progression of certain diseases. We must raise the bar and remember that prevention is fundamental and that is why it is important to have dedicated prevention and possibly treatment paths.