Preface

Although every person is a special patient requiring the utmost in medical and medication therapy, the primary emphasis of this book is individualizing therapy for girls and women. This book builds upon learning from standard medical and pharmacotherapy textbooks by describing the sex gender differences in biology, pathophysiology, assessment, social determinants, pharmacotherapy, and health care services that require different assessments, diagnoses, treatments, communications, and health care delivering specific for female patients. Basic, clinical, social, and health care service research continue to document how health care needs to be differentiated based on sex and gender versus a one-dimensional approach that ignores these two important concepts.

The goals of the second edition of this book are to help health care students, professionals, and educators and are as follows.

• discover the unique facets of girls’ and women’s health care from biological and social determinant perspectives;

• address health care needs across the female lifespan including medical, cultural, and social needs in a culturally sensitive manner; and

• provide rational, evidence-based pharmacotherapeutic interventions based on sex and gender differences.

This comprehensive resource should improve the care provided to girls and women and also help advance educational and research endeavors in girls’ and women’s health.

Each chapter has stated learning objectives and is a concise, up to date review of known science. A patient case is included with each chapter beginning with the pertinent social and medical history of the patient. The reader is encouraged to develop her/his own therapeutic plan and then compare it to the treatment of the patient at the end of the chapter. Section 1 will be focused on social determinants, Section 2 on sex gender differences, and Sections 3 to 8 on diseases and their treatments. Sections 3 to 8 will follow a similar clinical template. The primary emphasis of the clinical chapters is individualizing care including nonpharmacologic and pharmacotherapy options. Current guidelines and medication tables are included. Therapeutic challenges are embedded in the chapters to provide the reader with an opportunity to expand thinking to complex patients, require additional literature searching, and or generate research ideas for unknown solutions to current health problems. They are intended to inspire critical thinking and further exploration of a topic and are suitable for in-class and group discussions.

Section 1 focuses on history, social determinants, and bioethics that are important to understand the external influences on girls’ and women’s health, wellness, access to care, and adherence to therapies. In the past, health care professional education on girls’ and women’s health and needs was minimal due to various reasons such as inequities, discrimination, health care disparities, lack of science, and limited or nonexisting sex- and gender-based policy. Now with great advances in research, insurance coverage, and a holistic health care team approach to care, female health care has improved but the external environment or social determinants that a girl or woman faces must be considered so that good therapy can be implemented and followed. These chapters will help identify these issues and provider ideas to improve health and health outcomes. Gender identity and sexual orientation is explored in the culture chapter.

Section 2 focuses specifically on sex and gender differences in terms of use of medication and complementary health approaches, female body response to medications, and differences from a disease orientation. From birth on, differences in genes result in some differences in medication absorption, distribution, metabolism, and elimination. Pregnancy and lactation pharmacokinetics are discussed in this section and in some of the clinical chapters. Because girls and women are different, the chronic illness chapter highlights the sex gender differences in disease prevalence, diagnosis, medication effectiveness and safety, and health delivery for some cardiovascular, gastrointestinal, mental health, substance abuse, autoimmune, bone and joint, and neurological disorders.

Sections 3 to 5 provide comprehensive coverage of conditions or disorders related fully to girls and women based on reproductive health differences from men. Section 3 explores the menstrual cycle starting with menstrual cycle disorders and concluding with the cessation of menses. Section 4 covers contraception care from natural family planning to pharmacotherapy with nonhormonal and hormonal options. Section 5 is focused on pregnancy starting with planning to conceive and ending with postpartum care. Within this section behaviors and therapies for normal pregnancies will be covered, as well as increasing the health and safety of mother and fetus for women with many acute and chronic illnesses. Therapies to prevent premature deliveries and improve delivery are discussed.

Sections 6 to 8 focus on medical conditions that are prevalent, unique, or require specialized therapy for girls and women. Section 6 focuses on eating, sexual, and genitourinary disorders. In this edition, a full chapter has been devoted to transgender health care. Section 7 is focused on infectious diseases that can be related to sexual activity with education that should be provided to those that are sexually active. In addition therapy for the selected sexually transmitted infections is discussed. Section 8 focuses on female cancers and treatment of common treatment-related complications.

We are sincerely grateful for the time and talents contributed by the section editors, chapter authors, and reviewers. They generously shared their knowledge, skills, and experiences to enhance the scope, depth, and accuracy of this resource. Some first edition authors were not able to participate in the second edition but allowed their chapters to be the foundation of the updated chapters, thus their valuable contributions are also acknowledged.

Our greatest hope is that you, the reader, will find that this resource helps you expand your knowledge and improve your skills in caring for and treating your patients in a way that considers all the unique, complex, and dynamic aspects of girls and women during their lifetime in a holistic and culturally sensitive approach. We welcome all feedback that will be used to enhance the third edition.