The Gender Health Gap: Why it Exists and How to Close It

In the UK, a stark gender health gap is casting a dark shadow over the well-being of women. A healthcare system designed by men, for men, has earned us the top spot for the largest female health gap among G20 countries and 12th place globally.¹ Yes, we’re even trailing behind countries like Saudi Arabia – an unlikely benchmark for women’s health.¹

Navigating Life Within the Gap

Imagine being a young woman seeking help for intense cramps. Instead of a thorough examination, like many women, you’re handed the pill and told to accept pain as an inevitable part of womanhood.^2–4 Spoiler alert: it’s not. IF you summon the courage to return when the pain persists, brace yourself for an additional eight years of being passed from pillar to post.⁴ Despite 1 in 10 women living with the condition, this is the average time it takes to get an endometriosis diagnosis.⁴

Are you in your 40s and starting to feel the effects of menopause? Bad luck. Like over a third of menopausal women – your mood swings may be misdiagnosed as depression and incorrectly treated with antidepressants.⁵ You join the 84% of women whose questions remain inadequately answered, and you are left dealing with symptoms that impact your relationships and ability to work.⁵

If you think the gender health gap only extends as far as ‘women’s problems’, think again. A study by Westergaard et al. found that across 770 diseases, from diabetes to cancer, women were diagnosed on average four years later than men – delays that can prove fatal.⁶

Even with accurate diagnosis, treatment often falls short. Women experiencing heart attacks are less likely to receive life-saving treatments than men, contributing to, over the last decade, an excess of 8,200 preventable heart attack-related deaths in women in England and Wales.⁷ This is the sobering reality of the gender health gap.

Understanding the Root Causes

At the core of this issue lies the lack of representation in research. Women’s bodies, accustomed to scrutiny, have yet to receive the same attention when understanding how they work. Until 1993, women were actively excluded from clinical trials due to fears hormones would complicate things.^8,9 But that is just the issue – hormones CAN complicate things. With a century of medical research centred almost exclusively on men, it’s no wonder women have been found to experience adverse drug reactions at nearly twice the rate of men.¹⁰

It’s not only drug development that appears to neglect women. Less than 2.5% of publicly funded research focuses on reproductive health despite one in three women experiencing reproductive issues.¹¹ There’s five times more research on erectile dysfunction, affecting 19% of men, than on premenstrual syndrome, which impacts 90% of women.¹² With such skewed data, it’s hard not to view research into medical conditions as failing women too.

Gender bias within the healthcare system is another issue. Women are often dismissed as “overly emotional” when reporting their symptoms, and their pain is not believed.¹³ This results in women expressing the same level of pain as men but receiving less effective and intensive pain relief.¹³ It’s not hard to imagine the detrimental effects this is having on women’s health, which is only intensified when compounded with other biases, such as race, creating an even wider health gap for BAME women.

How We Can Bridge the Gap

• Knowledge is Power: In 2022, the UK government unveiled the first-ever Women’s Health Strategy for England, a vital step forward in closing the gender health gap. Central to this strategy is a commitment to new research and data gathering.14Working within the pharmaceutical landscape, we hold a collective voice that can help advocate for heightened R&D focus on female conditions and increased female participation in clinical trials. Let’s use it.
• The “Davina Effect”: In 2021, Davina McCall’s documentary ‘Sex, Myths and the Menopause’ prompted a 30% surge in demand for hormone replacement therapy (HRT) and thrust menopause higher up the public agenda.15 While not all of us wield the influence of the Big Brother star, we can actively contribute by openly discussing women’s health issues, dismantling taboos, and spotlighting critical matters.
• Ride the Wave of Fem Tech: Fem tech is reshaping how women manage their health. Resources like ‘The Lowdown’ (described as ‘like TripAdvisor for your vagina’) and Hertility’s at-home diagnostic hormone tests are leading the charge and empowering women with the knowledge and tools to take control of their own health. By supporting these innovative start-ups, we can help grow an industry dedicated to addressing the health needs of women.

The Tides are Turning for Women’s Health

Change is afoot. It’s not just about improving healthcare. It’s a call for a societal shift, a breaking down of systemic sexism and demystifying of women’s bodies. However, as society itself shifts, we are already seeing the change. We are witnessing a new generation of women who, thanks to social media, podcasts, and the like, are armed with more knowledge than ever, empowering them to advocate for themselves and others. Furthermore, gender restoration within healthcare means there are more women within the system doing the research and giving the care, not just receiving it, which by default helps tip the balance. I am hopeful that by fostering open conversations, advocating for inclusive research, and embracing innovative solutions, together we can continue to close the gender health gap.

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References

1. The Men’s Health Gap. Manual. Available at: https://www.manual.co/mens-health-gap (Accessed: 28 February 2024).
2. Lindeman, T. (2023) Millions of people take birth control to treat endometriosis – but it doesn’t work, STAT. Available at: https://www.statnews.com/2023/04/04/birth-control-for-endometriosis-does-it-work/(Accessed: 28 February 2024).
3. Denny, E. and Weckesser, A., 2019. Women’s experience of endometriosis. Routledge international handbook of women’s sexual and reproductive health. London: Routledge.
4. Endometriosis in the UK: Time for Change – APPG on Endometriosis Inquiry Report 2020.
5. Savvas M, Watson N, Benster B.(2020) Women wrongly prescribed antidepressants for Menopause, Total Health. Available at: https://www.totalhealth.co.uk/blog/women-wrongly-prescribed-antidepressants-menopause (Accessed: 28 February 2024).
6. Westergaard D, et al. Population-wide analysis of differences in disease progression patterns in men and women. Nat Commun. 2019;10(1):666.
7. British Heart Foundation (2019) Heart attack gender gap is costing women’s lives, BHF. Available at: https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2019/september/heart-attack-gender-gap-is-costing-womens-lives (Accessed: 28 February 2024).
8. Liu, K.A. and Dipietro Mager, N.A., Women’s involvement in clinical trials: historical perspective and future implications. Pharmacy Practice (Granada). 2016;14(1):708.
9. Cooney, E. (2023) Females are still routinely left out of biomedical research – and ignored in analyses of data, STAT. Available at: https://www.statnews.com/2020/06/09/females-are-still-routinely-left-out-of-biomedical-research-and-ignored-in-analyses-of-data/ (Accessed: 28 February 2024).
10. Zucker, I., Prendergast, B.J. Sex differences in pharmacokinetics predict adverse drug reactions in women. Biol Sex Differ. 2021;11:1–14.
11. 11.  UK Health Research Analysis 2022 (UK Clinical Research Collaboration, 2023) https://hrcsonline.net/reports/analysis-reports/uk-health-research-analysis-2022/.
12. ResearchGate (2016) Why do we still not know what causes PMS? Available at: https://www.researchgate.net/blog/why-do-we-still-not-know-what-causes-pms (Accessed: 28 February 2024).
13. Samulowitz, Anke, et al. ““Brave men” and “emotional women”: A theory-guided literature review on gender bias in health care and gendered norms towards patients with chronic pain.” Pain Research and Management. 2018;2018:1–14.
14. Department of Health and Social Care. (2022) First Women’s Health Strategy for England to tackle Gender Health Gap GOV.UK. Available at: https://www.gov.uk/government/news/first-womens-health-strategy-for-england-to-tackle-gender-health-gap (Accessed: 28 February 2024).
15. Partridge J. (2022) Manufacturers struggle to keep up with soaring demand for HRT. Available at: https://www.theguardian.com/society/2022/apr/26/manufacturers-struggle-to-keep-up-with-soaring-demand-for-hrt. (Accessed: 28 February 2024).