Women's Health Should Be Everybody's Concern
If you think you have an idea about the impact of gender differences on health, think again.
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I have a five-year-old, and I’m glad I have a son, not a daughter.
Many parents I speak with share a common belief: if they have daughters, they are convinced that their girls will face greater challenges in life than they would if they were boys. As it turns out, this can translate in health as well.
Migraines are three to four times more common in women than in men. Women have historically been diagnosed with depression twice as much as men, and have a higher risk of dementia. Approximately 80% of all patients diagnosed with autoimmune diseases are women.
We give birth, rehabilitate, go through a midlife crisis, and end up in menopause. Non-stop resilience training, with the constant pressure to be good mothers, exemplar and ambitious employees, and attentive lovers. Yes, women live longer than men but spend more years in poor health. According to Eurostat, in Europe, women spend on average 20 years with disability, 6 years more than men.
How did we get here? For decades, science has neglected the female body’s impact on health. At some point, it became clear that pregnancy carries specific health risks, so women of reproductive age were historically excluded from clinical trials. 4% of biopharma R&D budgets are focused on women’s health. Four percent. In many aspects, we are in the dark about where impacts on health come from. “We still don't know why female hormones play such a major role in many disease areas, not only in migraine. We have the same unspoken issue and unsolved mystery in terms of prevalence, disease progression, and diagnostic treatment response in Alzheimer's disease. We have it in multiple sclerosis,” says Dr Antonella Santuccione Chadha, pro-bono CEO of Women's Brain Project (WBP), a Swiss-based non-profit organization that wants to find scientific answers to these questions, and translate them to political measures that need to be taken to facilitate change across the planet.
Changing the narrative and the consequences of women’s health is far from easy. According to Gabor Mate and research, the reason why most patients with autoimmune diseases are women, is attributed to societally conditioned characteristics such as women often being compulsively concerned about the need for others, they believe they are responsible for how other feel and often suppress healthy anger.
On the societal level, we are making some progress in awareness about the need for a better gender balance and diversity in leadership positions. The problem isn’t just the gender ratio on management levels; it’s how we define value in society. The majority of nurses and professional caregivers are women. The demand for these jobs is growing due to the aging population, yet these professions remain poorly compensated and unattractive. Economics and health go hand in hand, and often women pay the price. “I find it very cruel how women as caregivers are treated. From when we are little girls, we're seen more as caregivers, and are socialized to do all the caregiving. In general, women tend to live slightly longer than men, and when they need to care for themselves, there's no one left to care for them. Consequently, they need to rely on institutionalized care and paid care. So it's almost, oh, thank you for the years you cared for others, but now that it's your time to care, you’re ill, you don't have the financial safety net, and you don't actually have a partner. This is not just about brain health, physical health, and emotional health; it's also about financial health as well. We as women have to be very careful in terms of our financial health and our pensions,“ says Anna De, Head of Stakeholder Engagement at WBP.
Let’s Make Babies
I consider myself extremely lucky: I live in a country that gives women a year of paid maternity leave and the right to an abortion (limited to 10 weeks). I’m horrified by the direction of women’s health policies in Poland, where women can die because doctors fear treating women with severe complications in pregnancy that could be solved by abortion. Or the US, where progress is going backward. Since 2022, in many US States, women lost the right to an abortion and they gained zero in support if they do have a child. In 2022, the United States remains the only OECD country without a federal provision for paid maternity leave, and even today paid maternity leave is not universally available to self-employed, domestic, part-time and casual workers in some other OECD countries.1 At the same time, if women do want to have a child and can’t have one naturally, medical health is far from accessible to everyone. In Slovenia, we can get a few IVF cycles covered by the healthcare system. In the US, women will mostly get charged for it - The average cost for a complete IVF cycle in the US is about $12,000 plus medications.
I wanted to have a child before I turned 30, because I didn’t want to be an “old” mother and I knew pregnancies get complicated as we age. I had no clue how much more complicated. The Centers for Disease Control and Prevention (CDC) reports that 1 in 5 heterosexual females ages 15 to 49, with no prior births, are unable to conceive on their own after a year of trying, and about 1 in 4 (26%) women in this group have difficulty getting pregnant or carrying a pregnancy to term. Additionally, in one third of cases the cause of infertility lies with men.
“Men experience age-related fertility decline as well. It's not as sudden and perhaps disruptive as it is for women who do have declining egg quality at a certain age. But infertility affects men too, but no one's telling them,” says Leslie Shrock, author, entrepreneur, and angel investor working at the convergence of health and technology. In about 25 percent of infertility investigations, men are never even examined.
Menopause: Not a Disease, Definitely a Market Opportunity
First of all: menstruation is not a disease and neither is menopause. However, both physiological processes can have a negative impact on the quality of life of women. When we’re in pain, treatment can be helpful. Yet in menopause, women often just need to “deal with” discomfort on their own. Many menopause symptoms impact wellbeing: mood, sleep, hot flashes, bone density, mental health, are cause by hormonal changes.
Menopause research has gone through hoops: hormone replacement therapy with estrogen was approved and used between 1942-1975, and as detailed by a New York Times research, halted after published research showed menopausal women who took estrogen had a significantly increased risk of endometrial cancer. Other treatments have been prescribed since, with another scientific setback in 2002, when an 8 year long clinical trial for a combination of estrogen and progestin, a synthetic form of progesterone — had been stopped prematurely.
WHO considers that social, psychological and physical health support during the menopausal transition and after menopause should be an integral part of health care. In 2021, women aged 50 and over accounted for 26% of all women and girls globally. This also makes menopause a market opportunity - Grand view research estimates the global menopause market size was at USD 16.93 billion in 2023 and is expected to grow at a compound annual growth rate of 5.37 % from 2024 to 2030.
The Startup World is Mobilizing
In 2024, with the rise of advocacy around women’s health, investments are picking up as well. While digital health funding has been falling for the last few years, the percentage of investments in femtech inside digital health investments grew from 7,6% in 2020 to 13,26% in 2022, according to Techcrunch.
Is this progress? According to investor Marija Butković, not big enough. “I've been in this space now 10 years as a woman in tech and the last seven years as a female founder in tech myself. I've spoken probably to thousands of founders over that course of time, and I'm under the impression that situation is worse than ever. I see all these initiatives and conferences and office hours and mentorship programs and I still don't think that we are any closer to the real solution. Not the same amount of money is going to female founders. Nothing almost has changed. This brings me to the conclusion that whatever we are doing now is not enough. Maybe it's not wrong, but it's simply not enough,” she says.
Numbers backing this sentiment are quite depressive. According to Harvard Business Review, women-led startups received just 2.3% of VC Funding in 2020. And here’s the real emotional rollercoaster: The good news is the number of female VCs is rising. Female VCs are twice as likely to fund women-led businesses, especially when they address women-related issues, which men can have a harder time identifying with. However, research published in Organization Science which examined 2,136 startups tracked by the Crunchbase database found that female-founded firms that received funding from female VCs had more difficulty getting funding in the future. In fact, women-founded businesses that received funding from female VCs were two times less likely to raise additional funding than women founders who were funded by male VCs. Researchers concluded that “when women receive support from other women, observers may implicitly believe that the relationship was motivated by considerations other than merit, which leads to a discount in perceptions of competence.”
Hence experts in Women’s Brain Projects and investors such as Marija Butković emphasize governments need to become more engaged in the conversation in policymaking and financial support to solve these issues.
What To Do Next?
1. Education
The concept of women's health extends beyond pregnancy care, breast and ovarian cancer, and fertility. It also includes issues like gender-based violence and aspects of sexual health and pleasure.
In developing countries, explanations for health problems or general human biology can be heavily influenced by traditional beliefs. Some communities still believe that during their period, women are cleansing of evil spirits or that if twins are born, that is a bad omen.
We need to upgrade the knowledge about these aspects early on in the lives of new generations, everything from mental health care and its impact on physical health to safe sex, and more. This goes to all cultures and markets.
Awareness is the starting point of change. If you are interested in Fertility, you might take a look at Leslie Shrock’s books: Bumpin’: The Modern Guide to Pregnancy mixes the latest clinical research with practical advice for working families, or Fertility Rules, published in June 2023, addresses male and female fertility. If you’re wondering about sex and pleasure, Emily Nagoski’s Come As You Are: Revised and Updated: The Surprising New Science That Will Transform Your Sex Life, might give you a better understanding of sexual health.
2. Invest in Women’s Health Knowledge and Science
At the moment, health education startups are paving the way. Mariatheresa Samson Kadushi started health education company Mobile Afya in Tanzania, after having worked with homeless children where she realised that helping them is just treating the symptom, the solution is to raise awareness about contraception and safe sex. Similarly, Shamala Hinrichsen is working primarily with indigenous communities in East Malaysia through the app Hanai. In 2023 they co-founded Sheher - a multilingual mobile app that delivers accurate medical information, shares women's lived experiences, and facilitates digital access to medical care. But these companies face infrastructure challenges and technology affordability issues, not to forget the before-mentioned fundraising challenges of female founders leading these ventures.
I think we live in an exciting and hopeful era. But hope alone is not enough - for it to be justified, it requires action, from everyone. As said by Marija Butković: “Every man on this planet has one or more women within their immediate circle that they care about. You have a wife, you have a partner, you have a daughter, you have a mother, right? And that's why they should care about women's health as well.“
3. There’s plenty of things you can do already this second:
Support the Women’s Brain Project in establishing the first worldwide sex and gender precision medicine research institute.
Get educated by listening to the episodes embedded in this article or by browsing through women’s health topics and episodes on the Health Podcast Network, or specialised channels such at HIT Like A Girl Community.
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