February 1999 Bulletin

Academy urges women's health research

Testimony in yearbook recommends areas of study of musculoskeletal problems

Academy testimony about advances made in women's health research over the past year is included in the Society for the Advancement of Women's Health Research Yearbook.

The yearbook will be distributed to policy makers, opinion leaders and private industry. It will also serve as the Society's basis for planning educational efforts such as briefings, public relations, and public and professional outreach programs. The society is a private, non-profit organizations established in 1990. It's three strategic priorities are to promote the study and acceptance of gender-based biology in the scientific community, to enhance the recruitment and retention of women in clinical trials and to increase research funding for women's health research.

The testimony was prepared by Laura L. Tosi, MD, and Rebecca R. Schwaab, policy analyst in the Academy's department of research and scientific affairs.

Dr. Tosi said offering testimony of this nature is one way the Academy can aid in the fight for more research funding to be directed to musculoskeletal research. "Every testimony that we give wakes people up in Washington," said Dr. Tosi.

While the testimony highlights advances in treatment and management of arthritis, osteoporosis, sports injuries and upper extremity musculoskeltal problems, it also provides recommendations for research to help medical professionals further understand these four health problems.

The recommendations include:

• further research to better understand why arthritis is more common in women, what triggers it, the role that risk factors play in the progression of the conditions and the different gender patterns in some diseases.
• research to explore the biological and mechanical factors that influence the progression of osteoarthritis and address the possible early biological repair process in osteoarthritis with attention to the role of growth factors, among others, that would prevent late changes that lead to joint replacement.
• prospective clinical trials for various surgical procedures designed to stimulate repair of osteoarthritic joints and outcomes studies of these procedures.
• life-long prospective studies to determine the effects of childhood calcium intake on peak bone mass.
• increasing awareness of and education about the triad of osteoporosis, eating disorders and amenorrhea found in young female athletes.
• developing a better understanding of the effects of drugs that stabilize bone mass and a better understanding of the different forms of osteoporosis, their courses of progression and the impact of types of treatment programs.
• addressing the questions of why osteoporosis is more common in the female Caucasian and Asian populations, what triggers it and the role that risk factors play in its progression.
• developing a better understanding of the role of falls in fractures.
• research relative influences of osseous anatomy, ligamentous laxity, and the effect of sex hormones on knee injuries and anterior cruciate ligament (ACL) injuries, spondylolisthesis, stress fractures in the pelvis and hip, pelvic floor dysfunction, patellofemoral problems, and bunions to help develop an understanding of why injury patterns differ between men and women.
• further research on devices and surgical technique improvements to enhance patient care and facilitate an earlier return to function.
• developing a better understanding of molecular signals that control repair and growth function in cells of the musculoskeletal system.
• developing synthetic replacements for muscle, soft tissue and bone damaged beyond repair, and enhancing the ability to manipulate the body's immune system to increase successful transplantation of donated bone and ligaments.
• exploring the basis for gender differences in treatment: what is effective, why outcomes in men and women differ when receiving the same treatment, and what mechanisms are underlying these differences.
• research on the pathophysiology of carpal tunnel syndrome is necessary before research into the prevention of the condition can be undertaken.
• further research of the impact of ergonomically correct workstations and physical activity on the incidence of carpal tunnel syndrome.
• research to gain a better understanding of the basis of arthritis of the basilar joint and prevention of the condition.
• research to determine why gender differences exist in the prevalence of frozen shoulder syndrome.
• Research to determine who might be at risk for Colles' fracture.

The Society for the Advancement of Women's Health Research also incorporated some of the Academy's written testimony into an oral presentation at its scientific advisory meeting attended by national medical and scientific experts, representatives of medical specialty societies, policy-makers and journalists in early November.