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Mulheres e homens apresentam diferenças relacionadas com o género e sexo que podem influenciar a sua saúde e bem-estar. Todavia, o estudo destas disparidades tem sido restrita às esferas reprodutiva e social. Num mundo em constante mudança, ameaçado pelas alterações climáticas, caracterizado por fluxo migratório intenso e preparado para embarcar em missões aeroespaciais, é necessário assegurar a saúde de todos os indivíduos que se confrontam com estes desafios. Contudo, a investigação científica geralmente não tem em conta as variáveis sexo e género, o que condiciona a equidade a todos os níveis de prevenção e nos cuidados médicos. Esta revisão sistemática pretende aferir a existência de evidência científica publicada na última década sobre a influência do género e sexo na adaptação a ambientes extremos, sistematizar quais as diferenças encontradas que conferem vantagem e desvantagem adaptativa às mulheres, bem como identificar potenciais implicações para a Medicina da Mulher. Foi realizada uma pesquisa bibliográfica em diversas bases de dados e analisados um total de 7 artigos, que apresentam informação sobre respostas aos extremos térmicos, pesquisas realizadas na Antártida, diferenças na resiliência e na adaptação ao Espaço. Em primeiro lugar, conclui-se que, apesar de os homens apresentarem uma maior mortalidade em temperaturas extremas, disparidades antropométricas tornam as mulheres mais intolerantes ao calor, facto que pode ser contrabalançado com treino aeróbio apropriado. De seguida, é sobretudo ao nível do sistema imunitário que se documentam mais diferenças significativas entre homens e mulheres. Já a vantagem de sobrevivência feminina é um fenómeno historicamente demonstrado. Por fim, são necessários mais estudos e um maior recrutamento de astronautas do sexo feminino para que conclusões definitivas relativas à adaptação espacial possam ser retiradas. Em suma, continua a ser fundamental apostar na investigação científica das diferenças entre sexos em Medicina para que se atinja uma real igualdade de género.
Women and men present gender and sex-related differences that can influence their health and well-being. However, the study of these disparities has been restricted to the reproductive and social spheres. In a world in constant change, threatened by climate change, characterised by an intense migratory flow and prepared to embark on aerospace missions, it is necessary to ensure the health of all individuals facing these challenges. However, scientific research generally does not take into account the gender and sex variables, which impairs equity at all levels of prevention and in medical care. This systematic review aims to assess the existence of scientific evidence published in the last decade on the influence of gender and sex in adaptation to extreme environments, systematize which differences are found that give women an adaptive advantage and disadvantage, as well as identify potential implications for Women’s Medicine. A bibliographic research was conducted in several databases and a total of 7 articles were analysed, which present information on thermal extremes responses, research conducted in Antarctica, differences in resilience and adaptation to space. First of all, it is concluded that, although men show a higher mortality in extreme temperatures, anthropometric disparities make women more intolerant to heat, fact that can be counterbalanced by appropriate aerobic training. Next, it is mainly at the level of the immune system that significant differences between men and women are documented. The advantage of female survival is a historically demonstrated phenomenon. Finally, more studies and more recruitment of female astronauts are needed so that definitive conclusions on spatial adaptation can be drawn.
Women and men present gender and sex-related differences that can influence their health and well-being. However, the study of these disparities has been restricted to the reproductive and social spheres. In a world in constant change, threatened by climate change, characterised by an intense migratory flow and prepared to embark on aerospace missions, it is necessary to ensure the health of all individuals facing these challenges. However, scientific research generally does not take into account the gender and sex variables, which impairs equity at all levels of prevention and in medical care. This systematic review aims to assess the existence of scientific evidence published in the last decade on the influence of gender and sex in adaptation to extreme environments, systematize which differences are found that give women an adaptive advantage and disadvantage, as well as identify potential implications for Women’s Medicine. A bibliographic research was conducted in several databases and a total of 7 articles were analysed, which present information on thermal extremes responses, research conducted in Antarctica, differences in resilience and adaptation to space. First of all, it is concluded that, although men show a higher mortality in extreme temperatures, anthropometric disparities make women more intolerant to heat, fact that can be counterbalanced by appropriate aerobic training. Next, it is mainly at the level of the immune system that significant differences between men and women are documented. The advantage of female survival is a historically demonstrated phenomenon. Finally, more studies and more recruitment of female astronauts are needed so that definitive conclusions on spatial adaptation can be drawn.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020
Palavras-chave
Diferenças entre sexos Género Adaptação Ambientes extremos
