Women's health: Why is medical research still falling short?

Why has women’s health been excluded from medical research?

For decades, medical research was built around a male-centric model. Until the 1990s, most clinical trials in Europe and the US were conducted almost exclusively on men, even for conditions that also, or primarily, affect women, such as cancer or cardiovascular disease.

A major bias emerged in the 1960s: women of childbearing age were routinely excluded from studies due to concerns about potential harm to a future pregnancy. Their bodies, considered too complex due to hormonal fluctuations, were deemed too difficult and costly to include in research.

This systemic exclusion had lasting effects: treatments, dosages, and diagnostic tools were developed using male-centric data, leading to less effective care for women. The imbalance has also influenced medical training, which still often lacks education on sex-specific biological and clinical differences.

In clinical trials on HIV, hepatitis, and heart disease, for instance, women made up only about a third of participants. Even by 2019, their participation remained stuck at around 33%, far below their representation among those affected.

Cardiovascular disease exemplifies the disparity: women often experience heart attacks with less obvious symptoms like fatigue, diffuse pain, or shortness of breath, symptoms that are frequently underrecognized, causing dangerous diagnostic delays.

Feminist and grassroots movements like the Women’s Health Movement in the US have pushed for change since the 1970s. Their advocacy helped shape laws requiring the inclusion of women in clinical trials by the 1990s. Yet, gaps remain.

What biological differences are still ignored in medicine?

Biological differences between sexes have a direct impact on health but remain widely neglected. In women, estrogen affects the immune system, bone density, and pain perception. Women are more prone to chronic pain and autoimmune diseases, conditions that affect about 80% of women.

Hormonal shifts across life stages, puberty, pregnancy, menopause, also alter disease progression and treatment response.

Some conditions primarily affecting women still lack recognition. Endometriosis, which can cause debilitating pain and infertility, takes an average of seven years to diagnose. Similar neglect affects conditions like premenstrual syndrome (PMS), menopause, fibromyalgia, osteoporosis, migraines, urinary tract infections, and pelvic inflammatory diseases. These are often dismissed or misattributed to psychological causes, delaying proper care.

What are the real-world consequences of this medical bias?

The blind spots in research and care have tangible impacts, both physical and mental.

Delayed diagnoses with serious consequences

Women frequently face delayed or incorrect diagnoses, whether for “women-specific” conditions like endometriosis or PCOS, or general diseases like heart disease or neurodevelopmental disorders. For example, heart attack symptoms in women are often misdiagnosed as anxiety. The result? Missed treatment opportunities and increased risk of complications.

Autism in girls is another example, underdiagnosed, because symptoms differ from those in boys.

Medical limbo and psychological strain

Because of these delays, many women undergo repeated tests and doctor visits without clear answers. This medical limbo breeds anxiety, frustration, and erodes trust in the healthcare system. Financial costs also pile up, from ineffective treatments to frequent sick leave, burdening both patients and families.

Inadequate medical training

Many healthcare professionals admit they received little or no education on female-specific biology. The shortage of specialists in key fields like gynaecology, mental health, and chronic illness care worsens disparities, especially in underserved or rural areas.

Long-term social impacts

These issues extend beyond medicine. When women’s pain is downplayed or attributed to emotions, it adds to their mental load and may discourage them from seeking care. The sense of being ignored or misunderstood reinforces social isolation and injustice, particularly for those with chronic conditions.

What can be done to make medicine more equitable for women?

Change is possible, and already underway, thanks to public policies, tech innovations, and community advocacy aimed at correcting the medical gender gap.

Evolving public health policies

Awareness around women’s health disparities has grown, prompting new national strategies and funding commitments. The Department of Health and Social Care launched the Women’s Health Strategy for England in 2022, a 10-year plan designed to close the gender health gap. Key priorities include improving care for menopause, increasing research into female-specific conditions, and ensuring women’s voices shape health services.

Efforts also include expanding specialist menopause clinics across the NHS, improving education for healthcare professionals on sex-specific symptoms, and promoting better access to contraception and reproductive health services. Additionally, the National Institute for Health and Care Excellence (NICE) is updating guidelines to better reflect sex-based differences in disease presentation and treatment responses.

However, critics stress that these policies must be backed by consistent funding and robust data collection to track progress. Regional disparities in care access, especially in rural or underfunded areas, also remain a significant challenge.

Advocacy and patient groups

Advocacy groups play a vital role in raising awareness of women’s health issues and pushing for policy change. Organizations like The Eve Appeal, Endometriosis UK, and Wellbeing of Women campaign for better funding, earlier diagnoses, and more inclusive research. These groups also provide educational resources and support for conditions such as menopause, fibroids, and gynaecological cancers.

Patient voices are increasingly shaping health policy through public consultations and parliamentary hearings. Community-led initiatives and online forums help women share experiences and access advice, particularly for those managing chronic or under-recognized conditions. These efforts are helping to normalize conversations around menstrual and reproductive health, breaking down long-standing stigmas and encouraging more proactive care.

The promise, and risks, of FemTech

FemTech (women’s health technology) is booming. Apps for tracking menstruation, fertility, or menopause symptoms offer personalized insights and help women better understand their bodies. But concerns about data privacy remain, especially in the absence of clear regulations.

Participatory research

Participatory research is gaining ground as a way to bridge the gap between scientific research and lived experience. Platforms such as Use MY Data and People in Research invite patients, including women living with chronic and under-researched conditions, to actively contribute to medical studies. These initiatives help ensure that research reflects the real-world challenges women face, particularly in areas like breast cancer, reproductive health, and autoimmune disorders.

The National Institute for Health Research (NIHR) also supports patient and public involvement (PPI) in study design and policy development. By integrating women’s voices into clinical research, these efforts promote more relevant findings, greater trust in science, and ultimately, more equitable care.

Redefining scientific standards

Groups like the World Economic Forum and McKinsey Health Institute call for major reforms in scientific practices. Their recommendations include:

• Systematic analysis of sex-based disparities in outcomes
• Always reporting sex-disaggregated data
• Equal representation in clinical trials
• Increased funding for women’s health research
• Gender parity in scientific leadership

Key takeaways

The historical exclusion of women from medical research is not just an oversight, it’s a systemic bias with serious consequences. Misdiagnoses, unsuitable treatments, and neglected conditions reveal a healthcare model long built around male bodies.

But change is underway. Public policy, grassroots movements, new technologies, and patient-driven research are paving the way for more inclusive medicine. The next step? Ensuring these efforts lead to lasting, widespread changes: better training, fair funding, and full integration of women at every stage of science.

True health equality can’t happen without women, front and centre.

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