This Sunday is International Women's Day: time to reflect on female health care. It is still lagging behind, also in the Netherlands. Five questions to professor of cardiology for women Angela Maas.

How is it possible that female healthcare is lagging behind?

"The male patient has been the norm for a long time. Think of The Human Body by Leonardo Da Vinci, the world-famous painting of a naked man in a circle. It is already 550 years old and the male body is still the starting point."

What is the result of this?

"That female ailments are sometimes seen as atypical. Much less research has also been done. Research has for a long time been conducted mainly by men on men."

Why?

"Because men are easier subjects; they do not suffer from fluctuating hormones. Even test animals were exclusively male until five years ago. Now that is no longer allowed. If you only use male test animals or subjects in your study, you simply will not receive a subsidy "

“Sometimes women are not taken seriously at the doctor or in the hospital. Then it is 'between the ears'. ” Angela Maas

But don't women's bodies differ enormously from men's?

"Exactly. Female sex hormones affect all kinds of processes in the body, including the kidneys, brain function, emotions and the immune system. But we do not understand many of the complaints that cause, because there is not much research yet done."

"Sometimes women are not taken seriously at the doctor or in the hospital. Then it is 'between the ears'. Or it is due to the transition and it will 'go away by itself'. The result is that women sometimes don't get the right one get care. "

Are there examples of this?

"Heart complaints are a good example. Women often express themselves differently than men. The heart works the same, but the way in which the veins calcify differs. In men the large coronary arteries clog up. In women it is often the small vessels that aging and spasm are more common (vascular cramps). "

"That gives other complaints. But because we often think of an older man who grabs his chest when we have a heart attack, we do not always immediately think of heart problems with a young woman with pain between the shoulder blades or cramps in the jaws. With all the consequences of that is, women often end up in hospital much later and ultimately die more often from heart disease than men. "

Is there good news too?

“More and more research is being done not only into differences between men and women, but also into specific female health. But we are not there yet. If we continue like this, we cannot speak of genuine equality between men and women in a hundred years' time. More research is needed for that. As doctors, we must take women's complaints seriously, even if we do not understand them. In addition, gender and gender must become part of the medical course. "

"Inequality in care provision can also be improved. 70 percent of care workers are women. But at managerial level that is only 25 percent. In addition, women earn less than male colleagues. Offer women career perspectives and reward them. We need women in care In addition, this will put female health care higher on the agenda based on personal interest. These are developments that go hand in hand. "

Angela Maas is professor of cardiology for women at the Radboudumc. In addition, she will be a UN women's representative in 2020 and will go to the UN meetings in New York on women's rights with a delegation from The Hague on 8 March.