Katherine D. Sherif

You currently serve as a Professor, the Vice Chair of Academic Affairs, and the Chief of Women's Health in the Department of Medicine at Thomas Jefferson University. Prior to that, you were the Director of the Center for Women’s Health at Drexel University College of Medicine for over twelve years. Could you tell us about your path to these roles? 

A group of physicians at The Medical College of Pennsylvania (MCP) created The Institute for Women’s Health at MCP in 1995, which had a triple mission: conduct research in women’s health, provide clinical care for women and develop educational programs for clinicians and trainees. A fourth mission to promote women in leadership was added later. I was very lucky to be mentored by this special group of physicians and role models. They made it possible for me to explore my research interests while building a clinical practice and teaching. The balance of research, clinical care and teaching allowed me to grow professionally and personally.

What interested you about becoming a Fellow at The College of Physicians of Philadelphia? 

Despite living in Philadelphia for most of my life, I did not know much about the College. When I was offered the opportunity to become a part of the College, I read about the history, the wide range of programs and the library. I am looking forward to widening my experiences in the art and history of medicine. I was also pleased to see so many women Fellows.

I read that you were a founding member of the Global Nutrition & Health Alliance (GNHA), which formed to educate consumers and healthcare professionals about optimal nutrition, including the use of vitamins, minerals, and supplements as part of a healthy lifestyle. I was wondering if you could speak to the connections you’ve made around the world working with GNHA, with other founding members based in London, UK and Munich, Germany, for example. 

GNHA was founded by a small group of nutrition researchers, dieticians and physicians. The first project was to examine was to examine the research on omega-3 fatty acids. There is no question about the biological importance of omega-3’s, but the literature is conflicting about just how useful supplementation is. The primary confounding factor is that most studies rely on dietary recall of intake, which is notoriously inaccurate. RBC concentrations of omega-3’s vary by as much as 5-fold, which confer very different biological effects. There are few well-designed studies that measure RBC concentrations of omega-3’s at baseline and after intervention. 

Measurements of omega-3’s (or any micronutrients) are essential in drawing accurate conclusions. We compared serum concentrations of omega-3’s in the US, London, Madrid and Munich. We were dismayed to discover that 80-90% of the populations studied had moderate-severe deficiencies of omega-3’s in all 4 countries. A separate study of vitamin D serum concentrations showed similar results. The deficiencies have profound implications for health and disease. The role of agribusiness in influencing food choices needs to be examined. 

I listened to a you were on in 2020, where you spoke to the commonality of Polycystic ovary syndrome (PCOS). You are an expert in PCOS, and I was wondering if there was something you wanted to share about PCOS specifically with those that are less familiar with it and how it is overlooked, or symptoms are misattributed.

PCOS is a paradigm of a women’s health issue in that it demonstrates the intersection of sex hormones and non-reproductive physiology. The beneficial endothelial effects of estradiol are diminished by elevated androgens. Conversely, hyperinsulinemia in PCOS directly binds to the hypothalamus and ovary, increasing androgens. A conservative estimate is that as many as 50% of women with PCOS are undiagnosed. When women with PCOS are undiagnosed or treated only for infertility, they go on to develop diabetes, fatty liver and ischemic heart disease. The reasons for missed diagnoses are largely due to 1. the artificial separation of ob/gyn from every other area of medicine and 2. Low interest and priority of women’s health conditions. PCOS women see specialists for alopecia, hirsutism, cystic acne, hidradenitis, abnormal transaminases, gestational diabetes – all of which may be driven by androgens – but they remain undiagnosed. PCOS confers a > 3-fold risk of gestational diabetes and pregnancy-induced hypertension, and a 2-fold risk of NICU admissions and pre-eclampsia. The costs of not diagnosing and treating PCOS are enormous.

Studying the physiology of sex hormones in women allows us to better understand sex hormone physiology in men. For example, while physiological levels of estrogens improve endothelial function in women, estrogens worsen endothelial function in men. Similarly, hyperandrogenemia in women worsens carbohydrate metabolism, but older men who are supplemented with testosterone have significant reductions in A1c.

You also mentioned that you go on biking trips! It has been a bit since this podcast aired and I was wondering if you have been able to do a trip since Belize and how long you have been biking for? I have been commuting via bike and riding in Philadelphia for almost 15 years and have always wanted to try something like this! 

I started going on biking trips in the 90’s. The most beautiful landscapes were in Ireland. The most challenging were the Canadian Rockies. I’m too scared to bike in the city.

You are an amazing advocate of women’s health and gender equity. What role(s) do you hope to see the College help fulfill within our community in the coming years?

I would like the College to help physicians learn about the physiological effects of sex hormones, and to integrate this knowledge to improve care for both women and men.

We must counter the corporatization of medicine. There is no way to reconcile an economic system based on profit with providing high-quality ethical care. An entire costly industry has sprung up to try to reconcile profit vs. care.

I hope the College will continue to refer to “physicians” and not “providers.” Physicians who use the term “providers” don’t realize they live in the Matrix.

Who is a physician or mentor that has influenced and inspired you?

When I was 22, I heard Dr. Nawal el Saadawi speak at the UN. She was an Egyptian physician and activist who died in 2021 at the age of 89. When she wrote her book Women & Sex in the 80’s, the book was banned, and she was imprisoned by the Egyptian government. When she wrote The Hidden Face of Eve, which described her own genital mutilation at age 5, she lost her position as Minister of Public Health. Unlike many physicians, she did not come from the elite class. She was the oldest of eight children in family from a village in the Nile Delta. As an outsider in terms of sex and class, she understood power. She told the truth and refused to behave when threatened with the loss of status, money, and power. Her effect on the world is incalculable. Her determination to tell the truth reminds me of Audre Lord’s quotation: “Your silence will not protect you.”