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 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 gynecology, 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

Efforts to address gender disparities in healthcare have accelerated in recent years. The Office of Research on Women’s Health (ORWH), part of the National Institutes of Health (NIH), plays a central role in ensuring women are adequately represented in clinical research. Since the NIH Revitalization Act of 1993, federally funded studies must include women and analyze outcomes by sex.

Recent initiatives focus on expanding research into conditions that predominantly affect women, such as endometriosis, fibromyalgia, and autoimmune diseases. The White House Initiative on Women’s Health Research, launched in 2023, aims to drive innovation and increase funding for historically overlooked areas in women’s health.

Meanwhile, the FDA has issued stronger guidance requiring sex-based analyses in drug trials, and some states have launched local programs to improve care access for underserved women. Still, disparities persist, particularly among women of color and those in low-income or rural communities, where access to quality care remains limited.

Advocacy and patient groups

A strong network of advocacy and patient organizations is driving progress in women’s health. Groups like the Society for Women’s Health Research (SWHR), EndoFound (Endometriosis Foundation of America), and Black Women’s Health Imperative focus on closing gender and racial gaps in healthcare. They lobby for more inclusive research, equitable care access, and stronger representation of women in clinical trials.

These organizations also provide vital education and community support, helping women navigate complex diagnoses and chronic conditions. They tackle systemic issues such as medical gaslighting, underdiagnoses, and the lack of tailored treatment options, especially in reproductive and autoimmune health. Grassroots movements and online platforms further empower women to advocate for their health, sparking broader cultural and institutional change.

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 increasingly embraced to make science more inclusive and impactful. Programs like the NIH’s All of Us Research Program aim to collect diverse health data by encouraging direct participation from individuals, including women from underserved communities. This approach supports the development of personalized medicine that accounts for sex, race, lifestyle, and environment.

Organizations such as PCORI (Patient-Centered Outcomes Research Institute) also fund projects that center patient priorities, including studies focused on women’s health. By involving women as co-researchers and decision-makers, these programs ensure that studies address real-world concerns, especially in areas like maternal health, chronic pain, and autoimmune conditions.

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 center.

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