The 70-Kilogram Man: How Medicine Built Itself on a Body That Isn't Yours

‍You already know how this story starts, because you’ve lived it.

You sat on the crinkly paper. You described what was happening to you — the 3 a.m. wide-awake heart-pounding, the fog that swallowed words mid-sentence, the rage that arrived from nowhere and frightened you, the exhaustion that sleep never touched. And someone with a clipboard looked at you and said some version of the same sentence every woman in this movement has heard:

“Your labs are normal.”

“It’s probably just stress.”

“It’s your age.”

“Have you thought about managing your anxiety?”

And you went home. And somewhere on the drive, you started to wonder if maybe it really was you. Maybe you were being dramatic. Maybe you just couldn’t handle what other women seemed to handle fine. Maybe you were, a little bit, losing your mind.

Stop the car. Because I need to tell you something, and I need you to actually hear it, not skim it:

You weren’t imagining it. You weren’t weak. You weren’t crazy. You were measured against a man who does not exist — and no one ever told you.

Let me introduce you to him. Once you’ve met him, you will never sit in an exam room the same way again.

Meet the Reference Man

In 1975, an organization called the International Commission on Radiological Protection published the specifications for a standard human body — a baseline that medicine and science would quietly build themselves around. They called him “Reference Man.”

Reference Man weighs 70 kilograms — about 154 pounds. He stands 170 centimeters tall. He is between 20 and 30 years old. He is Caucasian. And he is, of course, a man.

That was the template. For decades, that body was the default used to study disease, calculate drug doses, define what a “normal” symptom looks like, decide what a heart attack feels like, and determine how much of a medication is safe to put in a human being. When researchers said “the patient,” this is the body they pictured. Lean. Young. Male. Hormonally uncomplicated.

Here is the thing about Reference Man that should stop you cold: he is not real. He never sat on the crinkly paper. He never swallowed the pill and drove to work. He is a statistical mannequin — and your body, your actual living body, with its cycles and its shifting hormones and its genuinely different way of absorbing and clearing medication, was treated as a smaller, messier, hormonally-inconvenient footnote to him.

You were not the patient medicine was built for. You were the exception it didn’t have time for. And you were never told that — you were just left to conclude, quietly, in the car, that the problem must be you.

You were never a small man

The assumption underneath all of this — the one that let them wave us off for a century — is deceptively simple: that a woman is just a smaller man. Shrink the dose, adjust for weight, and you’re done.

It is wrong in nearly every way a thing can be wrong.

Start with the obvious: body composition. Women carry a higher proportion of body fat and less water than men of the same weight. A great many drugs distribute differently through fat than through water — which means the identical milligram does not reach the same concentration in your body as in his. It can linger longer. It can hit harder. Ambien wasn’t a freak accident; it was the entirely predictable result of pretending a real difference isn’t real.

Then there are the enzymes. The liver enzymes that break medication down run at different rates in women and men. Kidney clearance differs. So a drug goes in at the “standard” dose and comes back out on a completely different timeline — building up when it should be clearing, fading when it should be working.

And then there is the part they found most inconvenient of all: the cycle. A woman’s hormones fluctuate — across the month in younger women, and across the entire seismic transition of perimenopause and menopause for women in midlife. Those fluctuations change how the body absorbs, uses, and clears medication. Rather than study that complexity, researchers decided it was simply easier to leave us out. Our biology was formally labeled a “confounding variable.”

Let that phrase land. The very thing that makes you a woman was, in the language of the studies, a nuisance — something to be excluded so the data would come out cleaner. So when a doctor gives you the “standard” dose and it makes you sicker, or does nothing at all, or flattens you — you are not defective. You are being dosed off a map that was never once drawn for your body.

“Wait — is this new information?”

No. And I’m not going to pretend it is, because you deserve honesty far more than you deserve a tidy story with me as the hero of it.

The gender data gap has been documented by brilliant people. Caroline Criado Perez won every major book prize there is for Invisible Women, which laid out in devastating detail how the world — from crash-test dummies to prescription medicine — was designed around the male body. Maya Dusenbery’s Doing Harm and Elinor Cleghorn’s Unwell Women did the same for how women are dismissed and misdiagnosed. If you want the full, magnificent, 400-page account, read them. Genuinely. They are extraordinary, and they are the shoulders this movement stands on.

But here is what those books didn’t do — what no one has put directly into your hands until now:

They wrote the history. I want to show you the evidence — and then show you that the exact same thing is being done to you, right now, in the way medicine treats your menopause.

This is not a closed chapter in a textbook. You are living inside it. So let me walk you through the evidence — and fair warning: by the end, you may be furious. Good. That fury is not another symptom to be managed. It is the most accurate thing you will feel all day.

How they got away with it

In 1977, the U.S. Food and Drug Administration recommended that women “of childbearing potential” be kept out of early-stage drug trials. Not only pregnant women — the guidance was breathtakingly broad. It swept in women who used contraception. Women who were single. Even women whose husbands had had vasectomies. If you had a functioning uterus, you were, by default, out.

The justification was safety. And to feel the full cruelty of that word here, you have to understand what they were pointing at: thalidomide.

In the late 1950s, a pill was handed to pregnant women across 46 countries to ease morning sickness and help them sleep. They were told it was gentle. One advertisement promised the drug “can be given with complete safety to pregnant women.” Complete safety. Doctors handed it out freely, and women did the most ordinary, trusting thing in the world: they believed that the people in white coats would never give them something that could harm their baby.

It had never been properly tested on pregnant women at all.

Then the babies came. More than ten thousand of them — born with arms that stopped at the shoulder, hands formed like small flippers, some with no limbs at all. And around half of them did not survive their first months of life. Thousands of other pregnancies simply ended before they began. Mothers who had swallowed something they were promised was safe now held the consequence in their arms — or buried it.

There is no woman reading this who cannot feel the floor drop at that. A mother, trusting. A baby, harmed or lost. It is the single thing none of us would ever, ever wish on another woman.

And here is where the story turns — and where it should take your breath away for an entirely different reason. The United States was very largely spared that horror. Do you know why?

Because of a woman.

Dr. Frances Oldham Kelsey, a medical reviewer at the FDA, refused to approve thalidomide for the American market. She held the line against enormous industry pressure, demanded evidence that didn’t exist, and would not sign. She was right. Her judgment protected an entire generation of American children.

So sit with the full shape of it: a woman’s brilliance and stubbornness saved the country from thalidomide — and then that same tragedy was used as the reason to lock women out of the research that would decide how their own bodies were understood and treated. A woman prevented the disaster. Women were made to pay for it anyway. For the next two decades, the drugs still sitting in your medicine cabinet today were tested, dosed, and approved almost entirely on men.

And when medicine did deign to study women, it mostly studied the parts that made us obviously different — the breasts, the ovaries, the uterus. Researchers have a name for this, and it is not a compliment: “bikini medicine.” As though the only parts of a woman worth investigating were the parts a bikini covers. Your heart, your brain, your metabolism, your immune system — the entire rest of you — could simply be extrapolated from the man and hoped for the best.

The proof it was never harmless: Ambien

If you want one single story that proves this was never a harmless oversight — that it had a body count — it is this one.

Ambien, the sleeping pill that millions of women were handed, was approved in 1992. And buried in the data, from the very beginning, was a fact hiding in plain sight: women clear the drug from their bodies far more slowly than men do. At the identical dose, a woman can wake up with roughly 45% more of the drug still active in her bloodstream. Still sedated. Still impaired. Behind the wheel of a car on the morning school run.

Women were falling asleep at red lights. Women were drifting across lanes. Women were crashing — and then being told they were careless, or overtired, or overreacting.

The data was there in 1993. The FDA did not cut the recommended dose for women until 2013.

Twenty years. And it was the first time in history the FDA had ever set a different drug dose for women than for men. The first time — in 2013.

Read that number again slowly. Twenty years of women being over-medicated by a standard that was never built for them. How many crashed? How many were blamed for it? How many quietly concluded, in the car, that the problem must be them?

The one that kills us: the heart

Here is the fact that made me put my pen down and get really PO’d.

Heart disease kills more women than all cancers combined. It is the number one killer of women. Not breast cancer. The heart.

And medicine has known — for a very long time — that it was failing us on exactly this point.

In 1991, Dr. Bernadine Healy, the first woman ever to direct the National Institutes of Health, wrote an editorial in the New England Journal of Medicine. She gave the problem a name that has stuck for more than thirty years: the Yentl Syndrome — after the character who had to disguise herself as a man simply to be allowed to learn. Healy’s point was blunt and furious: a woman having a heart attack was less likely to get the right tests, the right drugs, the right procedures — unless she presented “just like a man.” Only by proving she was like a man would she finally be treated as well as one.

That was 1991. They named it, in the most prestigious medical journal in the world, more than three decades ago.

And why didn’t the textbooks know what a woman’s heart attack even looks like? Because the foundational studies didn’t include us. One of the landmark trials that shaped how we use aspirin to prevent heart attacks enrolled about 22,000 people — and every single one of them was a man. Zero women. They studied the male heart, wrote the symptoms of the male heart into every textbook and every training program, and then labeled our symptoms — the jaw pain, the nausea, the crushing fatigue, the pain between the shoulder blades — “atypical.”

Atypical. As though a woman’s own heart were the deviation from the human norm.

The consequence is not academic. Women today are up to 50% more likely to be misdiagnosed after a heart attack. And for women under 50, the death rate from a heart attack runs roughly twice that of men the same age — younger women dying at higher rates, in part because the person examining them is still looking for a man’s heart attack.

So when you ask — as you should — “how long have they known, and why didn’t it matter?” the answer is precise and damning: they named it in 1991, and you are still more likely to be sent home from the emergency room today. That is the answer. It should make you sick. It made me sick.

Follow the money

You might think: surely, now that we know all this, we’re pouring resources into fixing it.

In 2023, the National Institutes of Health spent about $56 million on menopause research. That sounds like real money — until you learn that the NIH’s total budget that year was roughly $45 billion.

Menopause — a transition that every single woman who lives long enough will pass through, some 1.2 billion women worldwide by the end of this decade — received barely one-tenth of one percent of the research budget. Around 0.12%.

One crumb. On an enormous, groaning banquet table. And they handed it to us

and called it a meal.

And if you think menopause is just uniquely unlucky, look at the pattern around it.

Erectile dysfunction — a condition affecting roughly 19% of men — receives around five times the research funding of premenstrual syndrome, which affects up to 90% of women. Read that twice. A condition affecting one in five men is studied five times more than a condition affecting nine in ten women.

Or follow the private money, where intentions get very honest very fast. In one recent year, startups working on erectile dysfunction attracted about $1.24 billion in venture and startup funding. Endometriosis — a brutal, frequently disabling disease affecting an estimated 190 million women worldwide — drew about $44 million. That is a ratio of roughly 28 to 1: twenty-eight dollars chasing men’s sexual comfort for every single dollar chasing a disease that leaves women doubled over on bathroom floors, often for the decade it routinely takes just to get a diagnosis.

This is not a cartoon conspiracy with a villain twirling his mustache. It is something quieter, and far more damning: a century of small decisions, made mostly by men, about what counted as important enough to fund, to study, to teach. And what counted, over and over and over, was not us.

And now — watch them do it to you again

Here is why this is not history. Here is why I need you angry, and not merely sad.

Everything that was done to women in cardiology — the dismissal, the “it’s anxiety,” the “your labs are normal,” the symptoms filed under “atypical,” the decades of knowing and shrugging — is being done to you right now, in menopause. The playbook has not changed. Only the words on the discharge papers.

You are told the 3 a.m. panic is anxiety. You are told the fog is stress. You are told the joint pain, the palpitations, the crashing fatigue, the sudden unfamiliar rage are simply “your age.” You are handed an antidepressant and walked to the door. And the reason your doctor may never connect any of it to your plummeting, fluctuating hormones is the same reason they didn’t recognize your heart attack: nobody adequately studied it. Nobody funded it. Nobody built the map.

You are not reading about history. You are standing inside it. Same pattern. Same shrug. Same woman, doubting herself in the car.

That is the “what the hell” rising in your chest right now. Do not swallow it. Because it is about to become the single most useful thing you own.

The cost they never counted

Every one of these decisions carried a price, and women have been quietly paying it the entire time.

The price is the antidepressant you were handed when what you actually needed was honest information about your own hormones. It is the years — sometimes a full decade — between “something is wrong” and a name for it. It is the promotion you didn’t reach for because the brain fog had you doubting your own competence. It is the marriage that strained under a rage you couldn’t explain and no one would help you understand. It is the nights you lay awake googling your own symptoms because the person with the medical degree wouldn’t take the time.

It is the label, too. “Difficult patient.” “Anxious.” “A little dramatic.” Written into a chart you never got to read, trailing you from appointment to appointment, quietly teaching the next doctor to take you a little less seriously before you had even opened your mouth.

And it is the self-doubt — the most expensive cost of all, because it is the one that stops you from going back. When a system tells you enough times that your body is fine and the real problem is your attitude, you eventually stop trusting the one instrument that was telling the truth the whole time: yourself.

That is what “atypical” and “confounding variable” and “0.12%” actually cost, once you convert them into a human life. Not abstractions. The years you lost. Your career. Your marriage. Your grip on your own sanity. Nobody ever put that on a spreadsheet — so we are putting it on the record right here.

Now the part that changes everything

I promised this would not leave you in the dark, and I keep my promises. Because here is what they never tell you about that history:

It changed. And it changed because women refused to accept it.

That same Dr. Healy who named the Yentl Syndrome in 1991? In that very same year, as director of the NIH, she launched the Women’s Health Initiative — one of the largest studies of women’s health ever undertaken, still following the health of well over a hundred thousand women today. In 1993, Congress passed the NIH Revitalization Act, which for the first time legally required women to be included in federally funded research. The exclusion that began in 1977 was overturned — not because the system grew a conscience overnight, but because women organized, testified, published, marched, and flatly refused to keep being sent home quietly.

The wall cracked. Not on its own. Because women put their shoulders to it and pushed.

And that is precisely where you come in. The job is not finished — you are living proof it isn’t — but the way it gets finished is the same way it started cracking: with women who stop doubting themselves, start naming exactly what is happening in their own bodies, and refuse to be dismissed one more time. You were never crazy. You were under-researched. And the cure for being under-researched is not to sit quietly and hope. It is to walk into that exam room armed.

Why this isn’t theoretical for me

I need to tell you one more thing before you go, because you deserve to know why I’m the one handing you this.

A few years ago, my body broke down. I had come through a long stretch of relentless, grinding stress — the kind that leaves your system soaked in cortisol for months on end — and when it finally ended, my body sent me the bill all at once. First an infection in my eyes so severe I couldn’t see. Then, by that autumn, a hospital bed, with pneumonia on top of Covid.

That is where they told me my heart was failing.

And that is the moment this entire movement was born. I lay in that bed and something in me refused to accept the story — not out of denial, but because I knew my own body, and it didn’t fit. So I asked them: are you certain? What I knew that the “professionals” didn’t is that I have been a vegetarian for more than forty years. No one had asked. It had not occurred to a single person in that building to ask any other questions. Just an assumption. And when they finally ran the test, my arteries were clear. Completely clear. I knew my body. You know yours.

They had been ready to treat me for a disease I did not have — because no one asked the one question my own life could have answered.

So I started asking hard questions. I weighed the evidence on every prescription, and I made my own informed decisions alongside my doctors — because I had just learned, the hard way, that “standard” is not the same as “right for me.” I reasoned my way toward the real culprit: my cortisol was through the roof, and much of it was riding on the weight I had carried through those punishing years. So I started there. Sixty pounds later, I have cut my medication in half and I am back to the body I had at twenty.

But here is the part that turned my recovery into a mission. When I went looking for the science — clear, honest information connecting menopause, cortisol, and women’s hearts — I found gaps where the answers should have been. The same gaps you have been falling through. The same 70-kilogram man, standing exactly where my care should have been.

So I wrote the book I couldn’t find. It’s called You’re Not Crazy... You’re Menopausal, and it exists for one reason: so that the next woman lying in that hospital bed, being told a story that does not fit her body, has what she needs to say — wait. Ask me the another question.

I am not a statistic in this story. I am one of the women it happened to. And I got out with my health, my clarity, and a promise: that I would not stay quiet about it.

What you do with this

Knowledge was the first thing they could never fully take from us, and it is the thing that changes your next appointment.

Here is your first step, and it costs nothing. Start tracking. When you can walk into a doctor’s office holding seven days of documented symptoms — the patterns, the timing, the triggers, in your own words — you stop being a vague complaint that’s easy to wave away and you become a set of data that is very hard to ignore. You turn “I don’t feel like myself” into evidence they have to look at.

I built a free tool to do exactly that — the 7-Day Symptom Tracker + Doctor Visit Guide. It is yours, no strings. Get it at notcrazymovement.com, and bring it to your next appointment.

And then — join us. This is the Not Crazy Movement, and it exists for one reason: what was done to us in cardiology, in pharmacology, in the whole long story of the 70-kilogram man, is not going to keep being done to our daughters. We are the generation that read the evidence out loud.

The man they built medicine around never existed. But you do. And it is long past time medicine was built for you.

You’re not crazy. You’re not alone. And you were never, ever the problem.

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Sources

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1.  ICRP / “Reference Man” standard‍ ‍

2.  Dr. Alyson McGregor — “bikini medicine” (TED / FindMeCure)‍ ‍

3.  Dr. Frances Oldham Kelsey — FDA biography‍ ‍

4.  Heart disease is the #1 cause of death for women (American Heart Association)‍ ‍

5.  Women 50% more likely to be misdiagnosed after heart attack; 59% STEMI (University of Leeds / BHF)‍ ‍

6.  ≈88,200 women's lives lost to unequal heart-attack care, England & Wales (University of Leeds / BHF)‍ ‍

7.  Women under 55 seven times more likely to be sent home from the ER (WomenHeart / NEJM)‍ ‍

8.  Ambien / zolpidem — FDA sex-specific dosing announcement‍ ‍

9.  Ambien / zolpidem — FDA review noting ~45% higher levels in women (FDA approval package)‍ ‍

10.  Women experience adverse drug reactions nearly twice as often (UC Berkeley analysis)‍ ‍

11.  History of women's participation in clinical research; 1993 NIH Revitalization Act (NIH ORWH)‍ ‍

12.  NIH Sex as a Biological Variable (SABV) policy‍ ‍

13.  NIH SABV policy briefly labeled “historic document,” 2025 (The Transmitter)‍ ‍

14.  A New Vision for Women's Health Research — National Academies of Sciences (2025)‍ ‍

15.  The Menopause Society — find a certified practitioner

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