Women’s Health 2023: What We Know and Why it Matters

Yale Medical School hosted a March 28 gathering at the Yale Club of New York City to feature the work of Women’s Health Research at Yale (WHRY). The evening’s event and the featured speakers were introduced by Nancy J. Brown, MD, the Jean and David W. Wallace Dean of the Yale School of Medicine and C.N.H. Long Professor of Internal Medicine. Dean Brown highlighted the national impact of WHRY over the last twenty-five years in remediating the gap in essential information on the health of women and generating clinically meaningful data that improve health outcomes for women and men.

Addressing the unique and important contributions of Carolyn M. Mazure, PhD, WHRY director and Norma Weinberg Spungen and Joan Lebson Bildner Professor in Women’s Health Research, the dean pointed to Dr. Mazure’s early recognition of both the need and the opportunity to study the wide scope of health conditions women face, and her vision in building an interdisciplinary research center that makes it possible to study conditions ranging from cardiovascular disease to cancers.

The evening’s interactive conversation, led by Dr. Mazure, provided the audience with emerging new information from WHRY investigators Samit Shah, MD, PhD, Assistant Professor of Medicine (Cardiology) on the diagnosis of heart attack in women, and from Clare Flannery, MD, Associate Professor of Internal Medicine and Obstetrics, Gynecology, and Reproductive
Sciences on endometrial cancer – a fast rising gynecological cancer, particularly in younger women.

“Many women report understandable stress and anxiety when signs and symptoms of a heart attack are present, yet standard diagnostic testing does not reveal a blockage in one of the major cardiac arteries — the common cause of heart attack for which there are well-developed treatments,” shared Dr. Shah in describing his personal commitment to improving the diagnosis of heart attack in women. With support from WHRY, Dr. Shah has adapted standard cardiac catheterization – in which a thin, flexible tube is guided through a blood vessel to the heart – to assess reduced blood flow to the heart caused either by a major blockage or by small vessel disease, which is a more frequent cause of heart attack in women than men. This diagnostic technique now accurately detects the distinctive way in which heart attack can occur for both women and men and offers the opportunity for effective treatment.

Dr. Flannery introduced her interest in endometrial cancer by sharing a story with the audience about a young patient with atypical endometrial hyperplasia (AEH) – an irregular thickening of the lining of the uterus that can signal a precancerous condition and obesity. The common association of these two conditions prompted Dr. Flannery to wonder about the biological mechanisms that are common to each condition. Moreover, with limited treatment options for AEH, this condition can potentially require a hysterectomy – a concerning option for young women. Her interest in a shared mechanism led Dr. Flannery to investigate how the high insulin levels that result from obesity combine with estrogen to promote AEH and progress toward cancer.

Dr. Flannery’s comments focused on how hormones interact and how her work is designed to offer early detection of the biological process that results in endometrial cancer in women with elevated insulin levels.

As the evening’s conversation progressed, the questions, answers, and the discussion focused increasingly on how research can inform diagnosis and treatment, increase understanding of sex-specific physiological differences, and give women the information needed to improve their health outcomes. In showcasing two of WHRY’s innovative researchers, the practical value of WHRY’s work in improving the health of women was clear, and the impact of our work spurred interest in the future of WHRY as we enter our next twenty-five years of discovery.