Women’s Health is Human Health: Bridging the gap in women’s healthcare
March is Women’s History Month, and it’s a great time to celebrate women's extraordinary contributions to our society. We’ve come far in bridging the equity gap between men and women. However, much work remains to be done, especially when it comes to healthcare. While women live, on average, longer than men, they spend 25% more of their lives in poor health or debilitating disease. Women are underrepresented in clinical research and, on average, pay much more for medical treatment and preventative health supplies. Women comprise more than half the population but are considered a “specialist group” for any clinical trial or medical research. Women are regularly not believed when they experience symptoms, hearing too frequently, “It’s all in your head.”
A Historical Problem
For centuries, the male body has been considered the norm, while the female body has been the exception despite making up roughly half the population and even outnumbering males in the US since 1946. As such, before 1993, women were rarely included in clinical research. Today, the medical field still doesn’t know the full extent of how many drugs and devices work for women. The lack of inclusion of women in trials is multifaceted. The bias toward men's bodies being ‘the norm, ’ concern over harm to unborn children, and fear that female hormones will affect the results of the study are among the reasons women were underrepresented.
In the 1970s, the FDA imposed strict limits on including women “of childbearing potential” in clinical research following a tragic incident involving a drug prescribed to pregnant women for morning sickness in the UK and Australia, which resulted in severe congenital disabilities and even fatalities. However, these restrictions were interpreted more broadly than necessary, excluding nearly all premenopausal women, as well as women on birth control, those with sterile partners, or those who did not plan to have children.
Finally, in 1993, the U.S. Congress passed a law that required clinical research to include women. Since then, significant progress has been made in research on women’s health. However, there is still work to do as women remain underrepresented in research. For instance, there are three key diseases that most affect women - cancer, cardiovascular disease, and psychiatric disorders - and despite representing 51% of the population, women only make up about 40% of research subjects. To top it off, women of color, particularly black women, are even more underrepresented.
Women’s Health Issues are Human Health Issues
Women often face underdiagnosis for significant diseases and issues due to experiencing variant symptoms to the “typical” male symptoms. For instance, women are 50% more likely to be misdiagnosed after a heart attack than men. It wasn’t until 1999 that the medical community acknowledged that women typically experience a heart attack with different symptoms than men. This unique experience of symptoms underscores the need for more gender-specific research and healthcare practices – and this spreads far wider than just heart conditions.
Women and girls are often underdiagnosed for ADHD and autism spectrum disorder because their symptoms can differ significantly from those typically seen in men and boys. With ADHD, men may display more outwardly disruptive behaviors, such as hyperactivity and impulsivity, while women tend to exhibit more internalized symptoms, such as inattention, disorganization, and emotional dysregulation. These subtler manifestations often go unnoticed or are misattributed to other factors like anxiety or depression, leading to a delay in diagnosis. Additionally, societal expectations of women to be more organized and composed can mask ADHD symptoms, making it harder for women to seek help or for healthcare providers to recognize the condition. As a result, many women may struggle with undiagnosed ADHD throughout their lives, facing challenges in their personal, academic, and professional lives without the proper support.
Endometriosis is often referred to as “the missed disease” as it is vastly underdiagnosed, and so little is known about its cause. It is estimated that up to 68% of women of menstruating age are affected by endometriosis or uterine fibroids, but 6 in 10 women remain undiagnosed. The only way to diagnose is with exploratory surgery, currently, which is both costly and invasive. Endometriosis is a key area where more research is necessary to understand the disease better so that diagnoses and treatment become more attainable for women. Thankfully, eight start-ups addressing endometriosis in the last few years have secured $44 million in funding. However, the gap between women and men still exists as in the same timeframe, 11 start-ups addressing erectile dysfunction, among other men’s health concerns, secured a whopping $1.24 billion.
Autoimmune conditions are the third most prevalent disease category after cancer and heart disease, and women account for an astonishing 80% of those living with them. It often takes more than 5 years of living with debilitating and confusing symptoms to receive a diagnosis for an autoimmune condition. Maya Dusenbery, author of Doing Harm, states that shortening the time to a diagnosis begins with closing the “knowledge gap” and the “trust gap.” The knowledge gap, of course, refers to the lack of data from women historically excluded by clinical research. The trust gap refers to the lack of belief in women about the symptoms they are experiencing. Throughout history, it was often assumed that women exaggerated any symptom they experienced, and so symptoms were categorized mainly as “hysteria.” Still, as we’ve advanced as a society, this has morphed into an equally frustrating term, “medically unexplained symptoms.”
Women are 10% less likely to be asked about their pain when arriving at a hospital for treatment. They are also much more likely to be prescribed sedatives rather than pain relievers, furthering the idea that their pain comes from psychological stress, anxiety, or depression rather than from physiological issues. Women are less likely than men to receive prescriptions for pain management after surgery as well. About 70% of those who suffer from chronic pain are women, yet 80% of pain studies are done on male mice or men. It is crucial that women are taken seriously when they advocate for their health to close the gap in the years lived with debilitating health issues.
Here at HLTHYher, we’ve seen the data. It is scientifically harder for women to lose weight due to having generally less muscle mass than men and significant hormone differences. Women also experience more hormonal changes than men, such as pregnancy and menopause. Furthermore, the pressure is much higher for women to have a specific body type, and while that is changing, we haven’t solved this problem yet. The traditional advice to women is to eat less and exercise more, but this does not always support female hormone health. Women are finding more success taking GLP-1 medication for weight loss as it is shown to interact with female hormones, like estrogen, beneficially.
Hope for the Future
Investing in women’s health is not just a moral imperative; it can also provide significant economic benefits. In a recent analysis, the World Economic Forum and the McKinsey Health Institute found that investing in addressing the women’s health gap could generate a staggering $1 trillion for the global economy by expanding women’s ability to contribute to the workforce and live healthier lives.
Despite many challenges, the progress made since women were included in research in 1993 gives hope for a more equitable future in women's health research. For example, scientists at Stanford University recently discovered evidence for a molecule—Xist—that exists only in women and could potentially explain the prevalence of autoimmune conditions in women. This is a significant step in understanding and addressing women's health issues.
GLP-1 medication works more efficiently for women than men, leading to weight loss that previously felt impossible. This is why we are here. HLTHYher exists to listen to and believe in women as they share their health journeys. We want to help improve outcomes for women taking GLP-1 medication for weight loss or to support other health conditions. Further clinical research specific to women, believing in women when they experience symptoms, and investing in women’s health are the way to a brighter, healthier future for women.
