Underfunded and overlooked

Women’s health research, which has been historically understudied and underfunded, is becoming an emerging topic of call for action. In 2020, only 5% of global research and funding was allocated to women’s health research, and 4% went toward cancers affecting women, with the remaining 1% for all other women-specific health conditions. Less than 2.5% of publicly funded research has been dedicated exclusively to female reproductive health, despite a third of women experiencing severe reproductive health problems in their lifetime. Additionally, only about 5% of medicines have been adequately tested for safety and efficacy in these populations. Addressing this requires not only more investment in wet-lab research but also investments in data analysis, clinical researchers, pharmacists, governing bodies, doctors, GPs, and activists to increase the awareness of these overlooked diseases. Despite gains in clinical trial representation, significant gaps remain. These gaps increase the rates of misdiagnosis, drug withdrawal, and are especially risky for pregnant and breastfeeding women.

Known risks but lack of research

Non-sex dysmorphic conditions, such as Type 2 diabetes, are associated with sex differences, but translation to sexspecific care remains inconsistent. Even when diseases are not seen to be different between men and women, risks can be. For example, women have higher bleeding rates than men, which must be accounted for in anticoagulation drug discovery, and have higher procedural complication rates for cardiovascular procedures. While women generally have more side effects from medications than men, sex differences in pharmacokinetics and pharmacodynamics have been inadequately explored and continue to definitively impact diagnoses, treatments and its outcomes.

The gap in resources such as diagnostics, funding and treatments, increases when it diverges from general health complications to more specific conditions, such as menopause and gynaecological issues. Five times more research has been done on male erectile dysfunction, affecting 52% of men, than premenstrual syndrome, which affects 90% of women. A survey done by the Department of Health revealed that only 64% of women were conformable in discussing these conditions, and over 80% of women felt they were not being listened to due to their symptoms being dismissed during assessment leading to delayed diagnoses limiting treatment decisions. Professionals have limited access to women’s health data, for example, only less than 10% for menopause and gynaecological conditions, which explains the neglect in this regard.

Clinical trial representation of women

Drugs for women are 3.5x more likely to be retracted from early research phases of drug discovery compared to men. This underrepresentation is even more pronounced among Black, Asian, and Latina women, deepening existing health disparities.

In 1993, a new federal law was introduced in the US requiring inclusion of women in clinical trials to obtain FDA approval on drugs or medical devices, influenced by the International standards (ICH), who publishes guidelines for carrying out clinical trials, which at present is followed by the countries across the globe. Consequently, the EU began to align to these standards in the 1990s. However, as the EU relied on the ethical principles of carrying medical research involving human participants, ‘Declaration of Helsinki’ which historically was not legally binding. There was a lack of translation of fair clinical trials, resulting in a lack of research on how developing drugs affect women physiology, leading to a lack of sex-specific guidelines.

A call to action

Addressing this gap requires several coordinated steps. Clinical trials must set a threshold for the number of the women to ensure adequate female representation. Funders, regulators, and journals should mandate sex-balanced study designs. Major initiatives, including Advanced Research Projects Agency for Health (ARPA-H) and National Institutes of Health (NIH) directives are now backing this work, though sustained momentum will be critical for real progress. Equally important is education, as women’s health research needs a comprehensive, standardised teaching curriculum that embeds sex as a biological variable from research design to clinical practice.

A more comprehensive investment is needed across healthcare industries and academia, with focus on conditions specific to women, diseases with sexbased differences, and conditions with higher prevalence in women. In particular, government and major funding bodies play a significant role in supporting scientific research along with analysing and publishing data in these areas. Interestingly, a 2024 report from the World Economic Forum in collaboration with the McKinsey Health Institute determined that closing investment gaps in women’s healthcare could boost the global economy by one trillion USD annually by 2040, demonstrating the vast economic potential of equitable healthcare funding. Last, but not to be overlooked, it is important to invest in female representation in workforce and leadership roles, as data shows all-female research teams are 35% more likely to develop medical treatments which serve women’s needs, compared to all-male research teams.

Some success stories

There are some notable success stories in women’s health that highlight the importance of gender equity in scientific research and health. A recent Lancet study found that no women aged 20 to 24 died from cervical cancer in England between 2020 and 2024, which is the first five-year period on record with zero deaths in this age group. This decline aligns closely with a demographic that was old enough to receive the human papillomavirus (HPV) vaccine when the program launched in 2008. Researchers estimate the vaccination programme has already prevented around 200 cervical cancer deaths in England, demonstrating the benefits of investing in women’s health.

Since 1985, the Cancer Research Institute (CRI) has dedicated more than $21 million in grant funding to discover and develop effective immunotherapies to treat ovarian cancer. In 2003, CRIfunded scientists discovered that the presence of the immune system’s T cells in ovarian tumours is strongly correlated with improved survival in these patients. Therefore, women’s health long an underdeveloped area of research, is now attracting growing research and funding.

Although it may seem like we have a long way to go, there have already been some breakthroughs, that in the past, may have not been seen as achievable. It is essential for everyone to do their part in bringing fairness in health accessibility and scientific R&D. It is crucial to take a holistic approach into women’s health research, not only from a wet-lab research point of view, but also from an economic, social, and political perspective, and it is more important than ever to make healthcare and research more equitable and accessible to women who have been enduring the effects of the disparity in women’s health.