Emerging Subspecialties in Neurology: Women’s Neurology, 2024, Thornton et al

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Emerging Subspecialties in Neurology: Women’s Neurology
Hayley F. Thornton,, Sara C. LaHue, Riley Bove, Janet Waters, Mary A. O’Neal, Esther Bui

The influence of sex and gender on neurologic disease has become increasingly recognized in science and medicine. This is evident across a woman’s lifespan especially during periods of hormonal transitions. Leaders in neurology have advocated for the importance of sex and gender-enriched clinical care, education, and research. The scope of women’s neurology spans across a woman’s life including puberty, adolescence, peripartum care, menopause, and aging.

Women’s neurology is a new subspecialty that aligns with a specific patient population and intersects with established neurology subspecialties and other specialties such as obstetrics, maternal fetal medicine, endocrinology, and psychiatry. Its establishment and collaboration with existing and emerging fields enables a more comprehensive approach to neurologic illness through the lens of sex and gender. Women’s neurology is rapidly evolving through increased focus at academic centers, including expanded women’s neurology curricula, dedicated women’s neurology fellowship programs, improved understanding of sex and gender issues in neurosciences, and expansion of therapeutic options.

Herein, we describe the history of the women’s neurology field, emerging need for women’s neurology specialists, information about training and career opportunities, and future directions.

Link | Paywall (Neurology)

 

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Historically, there has been a male bias in scientific literature leading to limited inclusion of female subjects in research. Since the early 21st century, leaders in neurology have advocated to reduce this bias and emphasize the importance of sex and gender-enriched clinical care, education, and research.

The scope of women’s neurology spans topics across a woman’s life especially during periods of hormonal transitions such as pregnancy. Broader efforts in recognizing the importance of this have contributed to a revised drug labeling system and improved drug accessibility specific to pregnancy and lactation. Further examples include advancements in understanding risks associated with neurologic medications in pregnancy for diseases such as epilepsy, migraine, and multiple sclerosis

Women’s neurology is a subspecialty that is not disease-specific but aligns with a specific patient population and intersects with multiple disciplines such as endocrinology, psychiatry, and obstetrics.

Unique aspects of care result from multidirectional interactions of hormones, medications, and neurologic disease spanning a woman’s lifetime and include sexual development, gender affirmation, fertility, preconception, conception, pregnancy, postpartum, lactation, menopause, and aging. The field is rapidly evolving, and a framework for minimal competencies and a resource for emerging, evidence-based applied practice is needed.