For *women, healthcare disparities are unfortunately commonplace. Women spend 25% more of their life in ill health than men, on average diagnosed later in life than men with the same health condition. Education in women's health for healthcare professionals is severely lacking, with less than 25% of physicians feeling comfortable diagnosing common conditions such as heart disease in women. Add to that the common issue of healthcare provider attitude, 84% of women feel ignored or not listened to by their healthcare provider, in fact, a recent study showed physicians take women’s pain less seriously than men's, leading to longer wait times and limited access to treatment. 

Poor healthcare experiences for women, coupled with factors such as financial and time constraints, stigma or cultural norms, and access issues can lead to an avoidance of healthcare. This avoidance perpetuates a lack of understanding and information about women's health, further hindering progress in recognizing sex-based differences in medicine and developing effective treatment plans.

Public interest and women’s health advocacy is starting to adjust mindsets, however, with wider acknowledgement of gender disparities perhaps being behind the increase in policy and funding, and general interest in this area. 

But undoing decades of disparities is not so straightforward. Women’s health funding, research and hence attitudes are still lacking, in the US, the National Institutes of Health (NIH) allocates 11 percent of its budget to women’s-health-specific research. In 2015, scientific studies on erectile dysfunction outnumbered those on premenstrual syndrome five to one. Despite a trial showing that sildenafil citrate could relieve menstrual pain, the research was halted due to a lack of funding.

So, we start this series by taking a look back, to understand how and why women’s health needs have been so neglected and deprioritised, before looking forward to the policy, funding, and innovation changes crucial to improving women’s health. Lastly we’ll ask the tough question, are we really creating change? 

PART 1: The Pitfalls of a Myopic View on Women's Health and How We Ended up Here

How did we get here?

In a world that prides itself on scientific and technological advancement, it's a sobering reality that the conversation around women's health remains frustratingly narrow. Too often, the narrative is confined to reproductive and gynecological care. While these aspects are undeniably crucial, focusing purely on women’s reproductive potential has led to two major barriers in the fight for health equity: lack of access to research and neglect of other health concerns. 

The Missing Half: Marginalized in Research 

Historically, women have been marginalized in healthcare research. Due to a pervasive belief that hormonal cycles could skew study results led some scientists to exclude female animal models from studies. This bias was institutionalized by the FDA in 1977 when it banned women of “childbearing potential” from clinical trials. This policy, ostensibly to protect women from potential risks, also recommended excluding women using contraceptives, single women, or even those with partners who had vasectomies. The result? A near-total exclusion of women from participating in research, stymieing our understanding of gender-specific pharmacological responses and prioritizing the safeguarding of "working" uteruses over the health of entire generations.

It wasn't until 1993 that U.S. law mandated the inclusion of women and minorities in clinical studies. During the intervening years from 1977 to 1992, the FDA approved 1,444 new drug applications, most of which were likely never tested in women. As a consequence, women are more prone to experiencing new or worsening side effects from such drugs, are less likely to have these risks communicated to them, and consequently are more likely to discontinue their use. 

Although improved significantly, this discrepancy persists; in 2022, a Harvard Medical School study found that women only accounted for roughly 40% of participants in clinical trials for cardiovascular disease, cancer , and psychiatric disorders, three of the diseases that most affect women. 

Beyond Reproductive Care

In the broader discourse on healthcare, women's health is too often narrowly defined by reproductive and gynecological issues. This reductionist view fails to acknowledge the full spectrum of health concerns that women face throughout their lives. Women's health encompasses far more than menstruation and childbirth; extending from early adolescence, into child bearing years, and beyond. Including, fertility, heart disease, mental health, bone health, and autoimmune disorders, among others. 

Heart disease, for example, is the leading cause of death among women, yet it is frequently misdiagnosed because its symptoms can differ from those experienced by men. An estimated 10 million people in the US have osteoporosis, 80% of which are women, significantly increasing the risk of fractures and long-term disability. Autoimmune diseases, which disproportionately affect women, remain under-researched and poorly understood. Mental health issues, from depression to anxiety, are prevalent and often exacerbated by the unique social pressures and roles women have to navigate daily.

The historical neglect of these areas in both research and clinical practice has left women vulnerable to misdiagnoses, ineffective treatments, and inadequate care. It is imperative that we broaden our understanding of women's health to adopt a more integrated and multifaceted approach. This means expanding our perspective to encompass not only traditional aspects of health but also the diverse and evolving healthcare needs that women encounter at various stages of their lives. By redefining women's health in this way, we can ensure a more comprehensive and holistic approach that better addresses the complexities of women's health across different life junctures. Only by doing so can we begin to develop more effective treatments, improve outcomes, and ensure that women receive the comprehensive care they deserve.

It is time to recognize that women's health is not a niche issue, but a fundamental aspect of public health that warrants our full attention and resources.

Join us on this journey as we provide a critical examination of the current state of women's health. Part 2 of this series will focus on the effects of policy on women’s health, Part 3 will analyze technology advancements and investment trends. Lastly in Part 4 we will separate the noise from the reality, assessing whether the recent trends and innovations are genuinely improving women's health outcomes.

* We have used the word ‘women’ throughout this article as our focus is the area of healthcare traditionally known as ‘women’s health’, but we recognize that these issues affect people who may identify as other genders.