Nicole C. Woitowich's picture

Nicole obtained her PhD in Biochemisty and Molecule Biology from Rosalind Franklin University with a focus on Reproductive Physiology. She utilizes traditional and non-traditional science communication methods to educate and engage the Northwestern community on the importance of sex and gender inclusion in the biomedical and clinical fields. Her work varies from developing tools to help researchers incorporate sex as a biological variable in their research, to meeting with community members to discuss differences in their health and well-being based on their sex.  Additionally, she oversees programming which promotes the advancement and retention of women in science in medicine no matter what stage in their career – from high school students to the tenured professor. 

My Blog Posts

Posted by on March 23, 2017 - 3:38pm

Throughout the 2016-2017 academic year, Northwestern University medical students have taken an active role in advancing women’s health. Students participated in workshops and activities sponsored by the Feinberg School of Medicine (FSM) Chapter of the American Medical Women’s Association (AMWA). The events incorporated aspects of women’s health while providing students an opportunity to improve their clinical skills, engage with faculty members, and advocate on behalf of their future patients.

Natasha Rich, a 2nd-year medical student and co-president of the FSM-AMWA chapter, finds these extracurricular activities to be particularly rewarding. “There is a strong interest amongst our members to gain additional training and experience in the unique aspects of women’s health and care that may not necessarily be covered on the day to day in the classroom,” she states.  


Students learn how to incorporate sexual health history into a routine exam. 

Recent AMWA-sponsored activities have included workshops on obtaining sexual health histories and recognizing intimate partner violence. In January, a group of medical students participated in the Chicago Women’s March. “Many of our members are passionate advocates for their communities and patients,” Rich shares. “As women and future physicians, students who participated in the march wanted to express their desire to protect their patient's [access] to healthcare.” 


FSM-AMWA members participate in the Chicago Women's March on January 21st, 2017. 

Students involved with the FSM-AMWA chapter are integrating women’s health into the classroom, clinic, and beyond. To learn more about their efforts or to become a member please contact Prianka Raju (prianka.raju@northwestern.edu) or Annika Nielsen (annika.nilsen@northwestern.edu). Medical, physician assistant, and physical therapy students, regardless of gender, are encouraged to become members. 

Posted by on March 16, 2017 - 11:04am

Gout is a form of inflammatory arthritis which affects over 8.3 million adults in the United States [1]. It stems from the build-up of uric acid, a common chemical found in the body.  When uric acid is over-produced, it can form tiny crystals which are deposited into joints of the toes, feet, wrists and fingers, causing arthritic pain. A recent study published in the journal BMC Musculoskeletal Disorders found that women may experience gout differently than men [2]. The study analyzed health information from 1237 patients who have been diagnosed by rheumatologists with gout. Women with gout were more likely to have their work and daily activities impaired by the disease as compared to men. In addition, women with gout typically had other health issues such as high blood pressure, diabetes, and kidney disease. This may indicate that women with gout may benefit from customized treatment plans due to their co-existing health conditions.

If you are interested in learning more about gout please consider checking out the following resources: 

References: 

  1. Centers for Disease Control 
  2. Harrold et al., BMC Musculoskelet Disord. 2017;18(1):108. 
Posted by on February 28, 2017 - 3:52pm

The human gut microbiome contains over 1,000 different species of bacteria which may play a significant role in our overall health [1]. Over the last decade, the study of the human microbiome has expanded tremendously through the support of the Human Microbiome Project [2]. We now know that imbalances in our gut microbes can play a role in the development and progression of various diseases and disorders [reviewed in 3-4]. A recent study published in PLoS One found that physical activity may impact the amount of “healthy” gut bacteria in women [5]. The study examined the activity patterns of 40 women over the course of one week and categorized them into a sedentary or active group based on the amount of physical activity they participated in. Stool samples from all of the participants were evaluated to determine the type and abundance of bacteria present. The authors found that while both groups of women had similar types of gut microbes, active women had higher amounts of health-promoting bacteria such as Faecalibacterium prausnitzii, Roseburia hominis, and Akkermansia muciniphila. These results suggest that physical activity can directly impact our microbiome in a beneficial way. Thus, providing yet another example of why physical activity is important in maintaining a healthy lifestyle! 

References:

  1. Arumugam et al., Nature. 2011;473(7346):147-180.  
  2. Human Microbiome Project
  3. Lynch et al., N Engl J Med. 2016;375(24):2369-2379.
  4. Shreiner et al., Curr Opin Gastroenterol. 2015; 31(1): 69–75.
  5. Bressa et al., PLoS One. 2017 Feb 10;12(2):e0171352.

 

 

Posted by on February 6, 2017 - 2:23pm

The American Heart Association (AHA) journal, Circulation, has dedicated its February issue to women’s health and sex-based research in the cardiovascular field [1]. The issue follows suit in the AHA campaign “Go Red for Women,” which raises awareness of women’s cardiovascular health and promotes sex-specific treatment guidelines, risk assessment, and sex-based research. Research featured in the issue focuses not only on sex-based cardiovascular health but also broader topics such as gender-bias in faculty rank among academic cardiologists and sex-bias in preclinical cardiovascular research.  

Dr. Marla Mendelson, Associate Professor of Medicine (Cardiology) and Pediatrics (Genetics, Birth Defects and Metabolism) at Northwestern University, shares her thoughts on the issue:

"Finally, after 20 years of messaging to women and their health care providers, we see cardiovascular mortality declining in women and that is just providing them with the cardiac care we know works in men.  We are beginning to see a glimmer of more women in cardiovascular studies of drugs and procedures.  We have some early gender specific outcome data and sometimes, women do better after certain interventions.  We have to keep this momentum going and see more in the literature regarding the cardiovascular care of women in not just the February journal issue."

To access the February issue of Circulation, click here.

February is American Heart Month, to learn more about heart health check out the following resources:

Reference:
1. Circulation. 2017;135(6). 

Posted by on January 27, 2017 - 2:17pm

On January 25th, 2017 the Women’s Health Research Institute, in collaboration with the Northwestern University Clinical and Translational Sciences Institute, hosted the Sex Inclusion in Biomedical Research Workshop and Symposium. The event celebrated the 1-year anniversary of the NIH policy which asks federally-funded investigators to consider sex as a biological variable. Numerous students, faculty, staff, alumni, and community members attended the day-long event which featured a panel discussion, keynote lectures, and invited talks by experts in sex-based research.

An excerpt from the opening lecture given by WHRI founder and director, Dr. Teresa Woodruff, can be found below.

Resources from the workshop, including lecture videos, will be accessible through the Sex Inclusion @ NU toolbox (sexinclusion.northwestern.edu). 

Posted by on January 13, 2017 - 10:54am

This week, the podcast associated with the journal Neuropsychopharmacology, “Brainpod,” released an episode entitled, “Sex as a Biological Variable: Who, What, When, Why and How.” The podcast discusses the eponymous article penned by Drs. Tracy Bale and Neill Epperson from University of Pennsylvania [1]. The authors provide guidance on sex-based study design and rationale for incorporating sex as a biological variable within both biomedical and clinical research. They debunk common misconceptions surrounding the use of female rodents, provide context as to what would be considered an appropriate “single-sex” study, and briefly discuss the organizing effects of estrogen and testosterone in brain development.

 Click here to listen to the podcast.  

 Want to learn more about sex-inclusive science? Visit Sex Inclusion at NU!   

 References:
1. Bale and Epperson., Neuropsychopharmacology (2017); 42:386–396. 

Posted by on January 1, 2017 - 4:18pm

Inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis, cause chronic inflammation and irritation of the digestive tract. Affecting over 1 million Americans, these disorders can cause significant physical and emotional distress due to frequent abdominal pain, diarrhea, and rectal bleeding [1]. A recent study in the journal Inflammatory Bowel Disease found that women who suffer from Crohn’s disease may respond differently to treatment than men [2].

The study examined how both men and women with Crohn’s disease respond to treatment with adalimumab, a common biologic therapy used to suppress the immune system and reduce inflammation [3]. The authors found that women who took adalimumab experienced more side effects than men, and were more likely to discontinue treatment as a result. Although this study was limited in scope with only 188 participants, it demonstrates a real issue in healthcare – men and women may respond differently to the same type of treatment. The authors suggest that healthcare professionals discuss realistic expectations for treatment with adalimumab, which includes full disclosure of potential side effects. Likewise, the results of this study may help guide the development of sex-specific therapies and personalized treatments for irritable bowel disease. 

 

References: 
1. Centers for Disease Control
2. Lie et al., Inflamm Bowel Dis. 2017 Jan;23(1):75-81.  
3. Crohn's & Colitis Foundation of America  

 

Posted by on December 14, 2016 - 11:41am

High impact medical journals have the ability to generate substantial changes in clinical research methods, analyses, and reporting through publication guidelines. This week, executive editor of The Lancet, Jocalyn Clark, co-authored an editorial urging for thorough reporting of sex-specific findings in medical journals [1]. The authors analyzed data from 60 clinical trials published in The Lancet and The New England Journal of Medicine, and found results which require thoughtful attention.  

While the overall number of female participants in clinical research has increased from 37% in 2009 to 41% in 2016, it still falls short of the ideal goal of 50%. Despite the fact that each study included male and female participants, 57% did not perform any sex-specific data analysis. The authors note that The Lancet encourages, but does not require, researchers to analyze data by sex. Therefore, they suggest if high-profile medical journals were to make sex-based analyses and reporting a requirement for publication, this would lead to improved health outcomes for all.

For further reading on this topic:

Sex based subgroup differences in randomized controlled trials: empirical evidence from Cochrane meta-analyses
Wallach et al., BMJ. 2016;355:i5826.

Implications for Journals of Sex-Specific Reporting Policies of Journals
Sex-Specific Reporting of Scientific Research: A Workshop Summary
Institute of Medicine, 2012.

References:
1. Avery and Clark, Lancet. 2016; 388(10062): 2839-2840.  

Posted by on November 22, 2016 - 3:41pm

A recent study published in the American Journal of Public Health, found that women who had children at an older age were more likely to live a longer life [1]. The authors analyzed the medical, reproductive, and lifestyle histories of more than 20 thousand women who participated in the Women’s Health Initiative, a long-term study designed to learn more about women’s health and well-being through the ageing process. They found that women who had their first or only child after the age of 25 were more likely to live into their 90s than women who had their child(ren) before they were 25 years old.

The present study is the latest in a series which have explored the relationship between maternal age and longevity [2,3]. Together, these studies suggest that reproductive health is an indicator of overall health. However, the authors caution that this data should not encourage individuals to delay childbearing in an attempt to live longer, as the study has some limitations. First, women who had children after the age of 25 were more likely to be college educated and have a higher income. These socioeconomic and lifestyle factors may influence overall health. Likewise, they were less likely to be obese or suffer from any chronic conditions that might reduce longevity.

Within the United States, the average age at first childbirth has increased significantly, from 24.9 in 2000 to 26.3 in 2014 [4]. Going forward, it will be of great interest to study this generation of women, so that we may gain a better insight into how reproductive habits influence women’s health and well-being.

References:
1. Shadyab et al., Am J Public Health. 2016 Nov 17:e1-e7. [Epub ahead of print].
2. Sun et al., Menopause. 2015 Jan;22(1):26-31.
3. Jaffe et al., Ann Epidemiol. 2015 Jun;25(6):387-91.
4. Centers for Disease Control

Posted by on November 11, 2016 - 2:48pm

The Journal of Neuroscience Research released the on-line version of its January/February 2017 issue [1], which is dedicated to sex- and gender-based research in the field of neuroscience.  Aptly titled, “An Issue Whose Time Has Come: Sex/Gender Influences on Nervous System Function,” the issue features a series of commentaries, reviews, and research articles highlighting the sex and gender differences that exist within the brain and nervous system.

The special issue was edited by Dr. Larry Cahill,  neuroscientist and sex-inclusion advocate, from the University of California Irvine. Dr. Cahill will be a featured speaker and panelist at the Sex Inclusion in Biomedical Research Workshop & Symposium hosted by the WHRI on January 25th, 2017.

With the push for sex and gender inclusion in the biomedical sciences, the WHRI encourages other journals to highlight sex-based research and applauds those who have already done so, such as Addiction Biology [2] and Atherosclerosis [3].

1. Journal of Neuroscience Research. 2016; 95(1-2): 1-791.
2. Addiction Biology. 2016; 21(5): 993-1059.
3. Atherosclerosis. 2015; 241(1): 1-288. 

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