Women's health advocacy in male-dominated systems

𝗠𝗶𝘀𝗱𝗶𝗮𝗴𝗻𝗼𝘀𝗲𝗱. 𝗜𝗴𝗻𝗼𝗿𝗲𝗱. 𝗗𝗶𝘀𝗺𝗶𝘀𝘀𝗲𝗱. In 2019, I went to the ER three times in one week. • The first time: “You’re dehydrated.” • The second time: “We have no idea; here are some antibiotics.” • The third time: “Maybe it’s cancer.” Needless to say, I wasn't feeling well. My symptoms were all over the place: My thinking was foggy, simple walking was exhausting, I felt lightheaded all day long, and I felt pins and needles all over my body. After cancer was ruled out, I was told my labs looked “normal” and referred to a psychologist. In my despair, I even went. After my second session, the psychologist and I both agreed: there was nothing wrong with my mental health. Ten doctors later, someone finally asked about my lifestyle. Within hours, I had the answer: a severe vitamin B12 deficiency. A simple test. A simple fix. But it was completely overlooked. And my story isn’t rare. Here’s why this keeps happening: • 𝗕𝗶𝗮𝘀 𝗶𝗻 𝗺𝗲𝗱𝗶𝗰𝗶𝗻𝗲 → For decades, research and diagnostics leaned male. Symptoms that don’t fit the “standard template” (like heart attacks in women, often presenting without chest pain) get missed. • 𝗞𝗻𝗼𝘄𝗹𝗲𝗱𝗴𝗲 𝗴𝗮𝗽𝘀 → Endometriosis, PCOS, perimenopause, and countless other women’s health issues remain under-taught in medical training. Providers aren’t equipped to recognize them quickly. • 𝗦𝘆𝘀𝘁𝗲𝗺𝗶𝗰 𝘁𝗶𝗺𝗲 𝗽𝗿𝗲𝘀𝘀𝘂𝗿𝗲 → 5-10 minutes per patient forces doctors into quick fixes. Not malice, but overwhelm. This makes it easy to dismiss or overlook important clues. So, what can you do if this happens to you? This is inspired by Dr Karan Rajan, who posted a fantastic video about this topic a couple of months ago.  • 𝗖𝗼𝗺𝗲 𝗽𝗿𝗲𝗽𝗮𝗿𝗲𝗱 & 𝗱𝗼𝗰𝘂𝗺𝗲𝗻𝘁 𝗿𝗲𝗹𝗲𝗻𝘁𝗹𝗲𝘀𝘀𝗹𝘆: Track your symptoms over time, bring notes, and highlight changes you observe. These are harder to dismiss than vague descriptions. Write down your questions in advance so you don’t forget them under pressure. Preparation also helps reduce stress and keeps the conversation focused. • 𝗔𝗱𝘃𝗼𝗰𝗮𝘁𝗲 𝗳𝗼𝗿 𝘆𝗼𝘂𝗿𝘀𝗲𝗹𝗳: Ask open questions like “What else could this be?” or “Why are we ruling this out?” These shift the dynamic from passive to active. Remember: your doctor is the expert in medicine, but you are the expert in your own body. That doesn’t diminish their knowledge; it strengthens the partnership when you demand both perspectives to work together. • 𝗥𝗲𝗳𝘂𝘀𝗲 𝘁𝗼 𝘀𝗲𝘁𝘁𝗹𝗲: If something doesn’t feel right, don’t stop there. Request a second opinion, ask for a referral to a specialist, or reach out to experts, clinics, and advocacy groups. Sometimes the most powerful thing you can do for your health is to refuse to settle for “nothing’s wrong” when you know something is. This isn’t patients vs. doctors. It’s about giving you tools and strategies when the system falls short. Because sometimes the difference between “you’re fine” and the real answer is persistence.

New BMJ Global Health Commentary: Governing Health Systems With a Gender Lens I’m pleased to share a new BMJ Global Health commentary, written with my colleagues Aya Thabet and Anna Cocozza, on a topic that urgently needs attention: How health system governance can close—or widen—the women’s health gap. Women around the world experience, on average, nine additional years of poor health compared with men. This disparity is not just a clinical issue. It is a governance issue. For decades, health systems have relied on a narrow definition of women’s health, focusing predominantly on maternal and reproductive care. This has left significant gaps in areas such as chronic disease, mental health, menopause, autoimmune conditions, gender-based violence, and more. Our article argues that governance itself must change if we want health systems to deliver for women. Using the WHO’s Six Governance Behaviours framework, we examine how governments, regulators, and purchasers can integrate a gender lens into the rules, incentives, and decision-making processes that shape health systems. Here are some of the key insights: 1. Deliver strategy with measurable commitments Clear definitions, dedicated budgets, and accountability mechanisms across both the public and private sectors must back equity goals. 2. Build understanding through sex-disaggregated data If systems don’t collect it, they can’t govern it. Mandatory sex-disaggregated data and transparency are essential to closing gaps. 3. Enable stakeholders by aligning incentives Financing arrangements—particularly strategic purchasing—can reward equitable, women-centred care rather than perpetuating neglect. 4. Align structures through gender-responsive regulation Licensing, training, essential medicines lists, and facility standards must explicitly reflect women’s health needs across the life course. 5. Foster relations with meaningful partnerships Women’s organisations, professional associations, and patient groups are indispensable partners in designing governance arrangements that work. 6. Nurture trust with strong accountability systems Women must have access to safe, responsive grievance and redress mechanisms—and regulators must consistently enforce protections. Why this matters Health systems are not gender-neutral. Without intentional design, the rules and incentives that govern them will continue to reproduce inequalities. By applying a gender lens to governance, we can reposition women’s health as a core system priority, not a side issue—and build accountability for equitable, respectful, high-quality care. Governing Health Systems With a Gender Lens BMJ Global Health – Clarke, Thabet & Cocozza https://lnkd.in/dwXNka4a Join the conversation #WomensHealth #GenderEquity #HealthSystems #GlobalHealth #HealthGovernance #HealthPolicy #UniversalHealthCoverage #UHC #DigitalHealth #HealthReform #HealthEquity #Accountability #Regulation #StrategicPurchasing #BMJGlobalHealth

Vulva cupcakes are cute and all, but International Women’s Day is about more than sugar coating things. If we want a world where women are not just included, but valued and protected, we need to redesign the system—from the lab, to the clinic, to the boardrooms where decisions are made. When we talk about the gender health gap, what does it actually mean? Let me explain.... Imagine you’re in a car. The seatbelt, the airbags, the crash tests—they’ve all been designed for a 70kg man. But you’re not a 70kg man. So when you crash, you are 47% more likely to be seriously injured than a man. That’s not a hypothetical. That’s real. That’s how safety standards are built. Now take that same design flaw and apply it to medicine. Imagine your parents. Your father has chest pain and walks into an emergency room. The doctors immediately check for a heart attack, because that’s the "classic" symptom. Your mother walks in with the same heart problem, but her symptoms look different—nausea, fatigue, shortness of breath. She’s told it’s anxiety or indigestion and sent home. She is twice as likely to die after a heart attack than your father. Across 700+ diseases, women are diagnosed later than men—meaning by the time they finally get the right treatment, the disease has had more time to progress. This isn’t a coincidence. It’s the result of a system that was designed without women in mind. This is not just about fairness. This is about survival. But here’s the good news: we are finally changing the system. At Hertility, we refuse to accept a world where women are an afterthought in healthcare. Through personalised and preventative diagnostic care, we are closing the gender health gap by providing answers in days, not decades. 💡 We can diagnose over 18 conditions with 99% accuracy in just 8 days—conditions that, in the traditional system, might take years of misdiagnosis and medical gaslighting to uncover. 📊 We empower women with data-driven insights about their reproductive and hormonal health, so they can take control of their bodies before symptoms spiral into serious diseases. 🏥 We provide life-stage health care from testing to telemedicine to treatments- from menstruation through to menopause. Women’s health is not a side issue. It’s our mothers, our sisters, our daughters. And if we continue using a seatbelt that wasn’t designed for them, we’ll keep watching them crash. This International Women’s Day, let’s not just celebrate women—let’s fight for them. #ReproductiveRevolution #ScienceMeetLife #AccelerateAction #InternationalWomensDay #GenderHealthGap #Hertility

As a board-certified urologist that specializes in sexual health for ALL sexes... I mean this when I say "medical sexism is real." Men and women are not getting the same level of care, access to care or even scientific integrity in their care. It is so deeply ingrained in our system that we don't even notice it. So let's give some very obvious examples: 1. Hormones are celebrated for men's health and fear mongered in women despite both potentially causing cancer and side effects. 2. Vasectomies are done under local anesthesia/sedatives as standard practice. An IUD placement however is done without medication despite the immense pain that can be associated with it. It's so prevalent that articles have been written about this experience. 3. When we do cancer surgeries for men (prostate/bladder) we have therapies invented to address the potential quality of life issues afterward. It wasn't until 2024, that the AUA had a course addressing sexual health for women after urologic cancer surgeries 4. We have so much data that HRT is a safe and most effective way to prevent diseases for menopausal people like heart disease, Alzheimer's disease, colon cancer, gynecologic cancers, debilitating symptoms etc. Yet many people experiencing menopause can't find doctors to go to. You can't watch a sporting event without hearing a commercial for testosterone therapy for low T. When they decide to go to a doctor to discuss this, they are rarely dismissed AND there are even whole clinical guidelines on how to make sure they are safe while taking it. 5. We perform open abdominal surgery on pregnant people (C-section) without general anesthesia- I can't imagine how well this would go with if these were male bodies. I am not a gambler but I would bet we would have created new protocols/research to enhance the experience 6. We overwhelm our OB/GYN colleagues with non-sensical consults whenever we have a pregnant person because we feel so uncomfortable. We have so sequestered all of women's health to one specialty despite women making >50% of the population. 7. When a man comes in with bothersome urinary symptoms we have a whole protocol that helps guide us to get down to the root cause. When women present with bothersome urinary symptoms we call it a UTI and give them antibiotics without exploring other options. * This one is wild. I found that up to 88% of people that initially came to my clinic for recurrent UTIs were actually a vulvar condition. We treated their vulva we stopped the infections.* 8. 1 in 4 women/vulva owners will have chronic pelvic pain. Yet it takes 7 years on average to get a diagnosis. I can diagnose these patients in 30 minutes (give or take 10-15 minutes) and that's because I got additional training to learn it. 9. 100% of vulva owners will experience dysfunction and yet most physicians including gynecologists are not taught about the vulva especially as it changes throughout the lifespan Want more surprising stats, click below

Imagine losing your mother, sister, or daughter, because the treatments meant to save her were never designed for women. For decades, women have been underrepresented in clinical trials and medical research, despite clear biological differences that impact how treatments affect us. The result? 🔹Many treatments & drugs considered safe & effective may be far less suitable (or even harmful) for half of the population ↪️ For instance, women metabolize some drugs differently from men, meaning dosages should be adapted, but often aren’t 🔹Conditions like endometriosis or autoimmune diseases (disproportionately affecting women) remain under-researched and underfunded, leaving millions of women suffering without effective treatments As surprising as it may sound, women are twice as likely as men to die from a heart attack. However: 🩵 Until 1993, women were rarely included in clinical trials 🩵 Today, women still make up only 22% of participants in heart disease clinical trials 🩵 Most cells used early on in clinical trials are male cells, and most lab mice are male too 🩵 According to a 2022 report, less than 5% of the money spent researching coronary artery diseases goes to projects focusing on women 𝑇ℎ𝑖𝑠 𝑖𝑠𝑛'𝑡 𝑗𝑢𝑠𝑡 𝑎 𝑔𝑎𝑝: 𝑖𝑡’𝑠 𝑎 𝑠𝑦𝑠𝑡𝑒𝑚𝑖𝑐 𝑏𝑖𝑎𝑠. From heart disease to chronic pain, while we know that down to the cellular level, men and women do differ, gender differences are overlooked, and lives are at stake. 𝐖𝐡𝐲 𝐡𝐚𝐯𝐞 𝐰𝐨𝐦𝐞𝐧 𝐛𝐞𝐞𝐧 𝐞𝐱𝐜𝐥𝐮𝐝𝐞𝐝 𝐟𝐫𝐨𝐦 𝐜𝐥𝐢𝐧𝐢𝐜𝐚𝐥 𝐭𝐫𝐢𝐚𝐥𝐬? ➡️ Hormonal variations during the menstrual cycle were deemed “too complex” to study ➡️ Potential pregnancy risks led to women being sidelined for “ethical” reasons ➡️ Male subjects were seen as the “standard,” with the assumption that results would automatically apply to women 🙅♀️ We can’t accept our healthcare systems to routinely fail to account for half the population. 𝐖𝐡𝐚𝐭’𝐬 𝐭𝐡𝐞 𝐬𝐨𝐥𝐮𝐭𝐢𝐨𝐧? 🧐 Medical research must stop treating men as the default, which means: 1️⃣ 𝐈𝐧𝐯𝐞𝐬𝐭𝐢𝐧𝐠 𝐢𝐧 𝐬𝐭𝐮𝐝𝐢𝐞𝐬 𝐭𝐡𝐚𝐭 𝐩𝐫𝐢𝐨𝐫𝐢𝐭𝐢𝐳𝐞 𝐰𝐨𝐦𝐞𝐧’𝐬 𝐡𝐞𝐚𝐥𝐭𝐡 and conditions disproportionately affecting them 2️⃣ 𝐀𝐧𝐚𝐥𝐲𝐳𝐢𝐧𝐠 𝐠𝐞𝐧𝐝𝐞𝐫-𝐛𝐚𝐬𝐞𝐝 𝐝𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐜𝐞𝐬 in all clinical trials (not just listing gender breakdowns, but investigating how drugs & treatments work for women vs. men) 3️⃣ 𝐄𝐧𝐬𝐮𝐫𝐢𝐧𝐠 𝐝𝐨𝐬𝐚𝐠𝐞 𝐜𝐚𝐥𝐢𝐛𝐫𝐚𝐭𝐢𝐨𝐧 for women vs. men, so treatments are most effective and safe for all 𝐻𝑒𝑎𝑙𝑡ℎ𝑐𝑎𝑟𝑒 𝑚𝑢𝑠𝑡 𝑠𝑒𝑟𝑣𝑒 𝑎𝑙𝑙 𝑜𝑓 𝑢𝑠; 𝑛𝑜𝑡 𝑗𝑢𝑠𝑡 𝑠𝑜𝑚𝑒 𝑜𝑓 𝑢𝑠. But to make that happen, we need systemic change in how treatments are researched, designed, and delivered. 𝐈𝐭’𝐬 𝐧𝐨𝐭 𝐣𝐮𝐬𝐭 𝐚𝐛𝐨𝐮𝐭 𝐞𝐪𝐮𝐢𝐭𝐲; 𝐢𝐭’𝐬 𝐚𝐛𝐨𝐮𝐭 𝐬𝐚𝐯𝐢𝐧𝐠 𝐥𝐢𝐯𝐞𝐬.

Women make 80% of healthcare decisions and have higher rates of certain chronic conditions and live more years with chronic illness than men. Yet less than 4% of digital health funding goes to women's health. The science exists. The demand is clear. The outcomes prove it works. So why do we keep funding the same models built for men? Because for decades, medical research literally excluded women. Women were systematically excluded from clinical trials until 1993. This means the NIH didn't require that women be included in studies until then. We built our entire medical knowledge base on males—then acted surprised when treatments didn't work as well for women. The consequences show up everywhere. Consider the implications: Heart attack symptoms are optimized for male presentation patterns. Women often present with completely different symptoms and experience higher mortality rates as a result. Drug dosing protocols are typically tested on men and scaled by body weight for women, ignoring hormonal cycles, metabolism differences, and how women's bodies actually process medications. Even our wearables and health apps are calibrated for male baseline metrics—resting heart rate, temperature fluctuations, sleep patterns—all optimized for bodies without menstrual cycles. This isn't just an equity issue. It’s a scientific validity issue that impacts outcomes and it's costing lives. Here's what gives me hope: When companies actually design for women's biology from the ground up, they create better science and strong businesses. Maven Clinic built virtual care across the entire reproductive lifecycle—not just pregnancy, but fertility, postpartum, and menopause—and reached a $1.7B valuation. Midi Health created a dedicated menopause platform (a life stage traditionally dismissed by medicine) and secured $60M from Google Ventures. ŌURA Ring raised $200M while building cycle tracking into their core design rather than adding it as an afterthought. Just this week, Peloton Interactive partnered with Respin Health to launch one of the largest real-world studies on menopause—500 members testing how targeted exercise impacts symptoms. The market opportunity? $1 trillion in global output by 2040. Women's health funding hit a record $2.6B in 2024. For every investor and founder building in health tech, the question should be: Did we design this with women's bodies in mind, or did we just haphazardly adapt the men's version? Your answer reveals whether you're building on solid science—or perpetuating flawed assumptions. #womenshealth #healthtech #fractionalCSO #clinicalresearch #healthequity

Women’s health - the system still isn't joining the dots 🤦🏽♀️ Healthcare loves a new workstream! We identitify a need... We respond with a programme... We set up a steering group... We conduct a pilot... We have multiple meetings to discuss how we scale it... We become very busy bees! All of it created with good intentions... All of it led by people who genuinely care about improving outcomes... But... unintentionally building a system that is increasingly fragmented for the people trying to navigate it. As an example, woman don't experience health as separate categories. We don't wake up thinking: “Today I'm going to deal with my cardiovascular risk, then my mental health, then my obesity, then my menopause, then my social circumstances.” But that is exactly how the system is currently organised. Women end up moving between fragmented services, while their conditions are missed, dismissed or treated in isolation. This is why so much of the system feels busy but stuck. And the health outcomes for women speak for themselves: 🔹️CVD: Women are 50% more likely than men to be misdiagnosed after a heart attack. 🔹️Mental health: Women are 2x more likely to be diagnosed with anxiety or depression. 🔹️Menopause: Around 80% of women experience symptoms, but only 1 in 4 receive treatment or support. Imagine... What would it look like if women’s health, prevention, cardiovascular disease and mental health were not all running as parallel policy conversations? What if the system focused on a small number of shared outcomes that deliver real impact for women, instead of disconnected initiatives? What if we spent less time protecting organisational boundaries and more time designing around how women actually live? Is it possible? Because right now the system is exhausting itself with increasing complexity when we need more alignment, less duplication and better communication. We also need to get real about the money... There isn't likely to be any significant new money coming down the line for women's health. No "magic money tree" or transformation fund arriving to fix these problems. So, what are we going to do about it? - What are we brave enough to call out? - What are we going to stop doing and repurpose for women's health? - What would we do differently if healthy life expectancy was the outcome we cared about most? - What are we going to commit to doing, that will look and feel different in 12 months time? In the end, this isn’t about adding another programme. It’s about whether we are willing to redesign what we already have so gender inequity is no longer built into system design. Food for thought... #WomensHealth #HealthEquity

Women’s Health Isn’t Only a Medical Issue. It’s a Research Issue. And a Power Issue. We often talk about women being dismissed in healthcare as if it’s a bedside manner problem. This week on Mindful Mondays with Shudu , Dr Mpume Zenda and I named something more structural: When research fails to fully include women, medicine learns to ignore them. A lack of gender-responsive research doesn’t just create information gaps. It creates a culture where women’s pain is normalized, symptoms are minimized, and people are taught (implicitly and explicitly) to doubt women before they even speak. That’s why the “erasure” conversation matters. Because erasure in research often becomes erasure in care, and eventually, erasure in voice. And representation, in that context, is not one-dimensional. It’s not only race, though race absolutely shapes outcomes. It’s also language, safety, power dynamics, and whether a space is built to hold the full story behind the symptoms. In our episode, we spoke about: Why women’s health cannot be reduced to checklists and clinical timelines How culture and socialization can silence women even when education exists Why self-advocacy is not just a personal practice, but a leadership skill And why systems matter: individual courage is powerful, but system design determines who gets protected at scale The takeaway I’m sitting with is simple: If a system is not designed to understand you, it will not know how to hold you. So yes, empower women to speak. But also: fund the research, change the training, redesign the rooms, shift the incentives, and distribute power. Because women shouldn’t need exceptional confidence to receive basic care.

WHOOP just launched a Women's Health Specialized Blood Biomarker Panel. 11 female-specific biomarkers. From hormonal transitions to thyroid function to bone health. This is not just a product update. This is a signal like we have quite some others by OURA and other health tech companies happily. Because women's health has been systematically neglected for decades. And the data is brutal. Here are some facts: → Only 5% of global R&D funding goes to women's health. Of that, 4% is for cancers. Just 1% covers everything else. A quarter of that 1% is limited to fertility research alone. → Fewer than 30% of participants in early-phase clinical trials are women. The FDA banned women of childbearing age from trials in 1977. The ban was lifted in 1993. The bias never left. → Cardiovascular disease is the number one killer of women. Yet only one-third of cardiac trial patients are female. And only 4% of the NIH's coronary artery disease budget funds women-focused research. → 80% of autoimmune disease cases occur in women. For decades, the standard treatment for frozen shoulder, which disproportionately affects women, was "just wait two years." → Women live on average five years longer than men. But they spend 25% more of their lives in poor health or with disability. → PMS, menopause, endometriosis, and maternal health conditions make up 14% of women's health burden. They received less than 1% of research funding between 2019 and 2023. The medical system was built on male bodies as the default. Women are not small men. Their biology is different. Their symptoms present differently. Their hormones create entirely different health dynamics. And yet, most health tech still treats everyone the same That is why the WHOOP announcement also matters. Their new panel tests biomarkers that dive into cycle regulation, perimenopause, thyroid function, nutrient sufficiency, and bone-metabolic resilience. Layered on top of continuous wearable data. Correlated with recovery, strain, sleep, and stress patterns over time. WHOOP also published a Menstrual Cycle White Paper and launched Hormonal Symptom Insights and Predictions, a feature that builds a personalized model of each member's cycle. Women represent the fastest-growing segment of WHOOP members. 150% year-over-year growth. And women engage with WHOOP AI 30% more than men. The demand is there. The gap is massive. And finally, companies are starting to close it. But this is bigger than WHOOP. We need to start thinking about health gender-specifically. Not as a niche. Not as a nice-to-have. As the foundation. Closing the women's health gap could unlock up to $1 trillion in annual global GDP by 2040. But more importantly, it would give billions of women the health insights and care they actually deserve. The future of health is not one-size-fits-all. It never should have been. Source: WHOOP, McKinsey Health, World Economic Forum, Nature, NIH, AAMC, Harvard Medicine Magazine Picture: whoop