Women's Health

Decades of Ignorance

Even in this modern age, there is a significant gap in health outcomes across gender. The historical neglect of women’s health has roots in societal norms, medical practices, and scientific research biases. For centuries, medicine has been male-centric, often generalizing findings from male subjects to women without accounting for biological and physiological differences across the sexes. This exclusion stems in part from the historical view of men as the default human model, with women’s health relegated to reproduction, limiting the understanding of conditions affecting women beyond pregnancy and birthing.

Women were largely excluded from clinical trials until the late 20th century due to concerns about hormonal variability and potential harm to reproductive capabilities. As a result, knowledge about the prevention, diagnosis, and treatment of diseases in women continues to stray behind. For instance, heart disease—the leading cause of death among women—was long considered a "male disease," delaying research and awareness campaigns tailored to women. The common knowledge of heart disease symptoms reflects the way it presents in men, which differs from how it commonly manifests in women.

Changing Frontiers

The systematic exclusion of women from clinical trials finally prompted significant public and legislative action in the 1990s. It was not until 1993 that the National Institutes of Health (NIH) Revitalization Act was passed, mandating the inclusion of women and minorities in NIH-funded clinical research. This law was driven by growing recognition of the scientific and ethical shortcomings of male-dominated studies, which obviously could not capture the full spectrum of human health by excluding over half of the US population. Excluding women from biomedical studies not only perpetuated health disparities across sex but also compromised the quality and applicability of medical research. The act required researchers to include women of all ages and backgrounds were included in studies (unless, of course, the research was not applicable to them, such as a study on prostate cancer).

Since 1993, significant strides have been made in women’s health research. Studies have shed light on sex-specific symptoms and treatments for diseases like cardiovascular conditions and autoimmune disorders, which disproportionately affect women. Research into breast and ovarian cancer, maternal health, and menopause has expanded, improving diagnosis and care. However, persistent gaps remain, since building a body of research to inform evidence-based care takes many decades and tremendous amounts of money.

While women are now included in clinical trials, some studies still fail to analyze data by sex, limiting insights into gendered health differences. Additionally, conditions primarily affecting women, such as endometriosis, polycystic ovary syndrome (PCOS), and chronic pain disorders, remain underfunded and under-researched. Structural inequities in healthcare systems also exacerbate disparities, with women, particularly women of color, facing barriers to access and disparities in treatment outcomes. Futhermore, the lack of female representation in research leadership and decision-making further perpetuates these problems. Not only is research specific to women's health issues less likely to recieve R01 research funding, but female researchers irrespective of their field of study are less likely to be awared R01 research funding.

Current efforts aim to address these disparities through policies promoting equitable research funding, increased education about women’s health, and the inclusion of diverse populations in studies. The NIH’s Office of Research on Women’s Health (ORWH), established in 1990, continues to advocate for gender equity in research and has developed strategic initiatives to integrate sex as a biological variable across studies. The extent to which these efforts, however, have facilitated meaningful changes in everyday care and broader health outcomes for women remains to be seen.

Looking to the future where I hope to be working towards a PhD in Biostatisics, women's health as an application is a particular interest of mine. I am interested in the unique balance of the female endocrine system, and especially the way hormone balance impacts many different aspects of health in the female body. Why is it accepted as normal for a woman's cardiometabolic health to deteriorate as they age? Why is menopause extremely uncomfortable for some women, but not for others? How can we treat these symptoms with lifestyle and exercise interventions? How can we design trials to measure the efficacy of these treatments? How can we promote behavior based changes to improve health within a community? While these questions may seem basic, the fact is that they do not each have a conclusive answer. When I move on from my time at UWEC and into the next phase of my education and career, these are the questions I hope to work towards answering.