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  • This is Reference Man.

  • He's a white, 30-year-old male who weighs about 155 pounds.

  • And he decides how we live.

  • For decades, industries have considered this the standard human, and designed the world around him.

  • Everything from air conditioning in offices to cars, even military equipment.

  • But there are other ways we use Reference Man that aren't so obvious.

  • Like in medicine, where it doesn't just lead to discomfort.

  • Here, the disparity can be incredibly dangerous for women.

  • A few years ago, something strange was happening.

  • Headline after headline recounted a similar story.

  • Dozens of women were crashing their cars under the influence of sleeping pills.

  • In many of these cases, they had taken a dose of Zolpidem the night before.

  • It's what you probably know as the common sleep aid, Ambien.

  • The problem wasn't entirely the drug itselfit was the dosage.

  • Women and men were both prescribed 10 milligrams of the drug for 8 hours of sleep.

  • But it turns out, women metabolize the active ingredient in Ambien twice as slowly as men.

  • That means by the time men woke up the next day, the effects of the pill had usually worn off.

  • While for many women, the drug was still in their system.

  • After the crashesthe Food and Drug Administration issued a safety warning in 2013 and changed the recommended dosage for women, cutting it in half.

  • The reason the right dosage for women had been overlooked is that the clinical trials on Ambien focused on male test subjects.

  • If they're using this hypothetical "average man" and they are basing dosage on it, that's kind of scary.

  • Not just because it doesn't apply to women, but because it also doesn't apply to a lot of men either.

  • There are several factors that can affect how a person metabolizes drugs, from size to body fat to hormonal fluctuations.

  • And these factors can vary drastically based on sex.

  • But many clinical trials don't account for this.

  • They often don't include enough women as test subjects.

  • And even when they do, data from women is often mixed in with data from men, which can hide sex-specific reactions to medicine.

  • I don't care that it's more effective for men.

  • I just want to know: Is it going to be effective for me as a woman?

  • So, you don't know that unless you look separately at those groups.

  • Take Acetaminophen, the active ingredient in Tylenol.

  • It's flushed from a woman's body slower than in men, so the prescribed dosage can put women at more risk for potential overdose and liver failure.

  • And one heart medication that's supposed to prevent heart attacks may actually trigger one in women.

  • So, we know that this is still a problem, but it's so hard to know how often that happens because there's no research.

  • If the companies did a better job of looking at men and women separately and studying them separately,

  • I think we'd have a lot more dosages that are different for women and men.

  • In 1993, the National Institutes of Health created regulations saying women must be included in human studies and have their data analyzed separately.

  • But the problem is...

  • It's the FDA, Food and Drug Administration, that's making the decisions about what medications are being sold to you and to your loved ones,

  • and they are not required to include women, people of color, people over 65.

  • You know, if you're only studying white men, you don't have to study as many people.

  • And the more people you study, the more it costs to do the research.

  • But, the more meaningful the information is so that we can all make informed decisions about what's good for us.

This is Reference Man.

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