5 conditions that highlight the women’s health gap

This article was originally published in October 2023 and last updated in February 2024.

In 2019, a study of almost 7 million people in Denmark found that women were diagnosed with hundreds of health conditions when they were, on average, four years older than men.

Diagnoses for diabetes came four and a half years later, while cancer was diagnosed in women when they were an average two and a half years older.

The researchers surmised that a combination of genetics and environment could be at play but that gender bias might also be partly responsible for the difference.

Lead author Søren Brunak from the University of Copenhagen told NBC News the findings came as a surprise: "Men generally have a tendency to get to the doctor later ... So presumably the difference in onset is even larger."

The same year, British journalist Caroline Criado Perez published her book Invisible Women: Exposing Data Bias In A World Designed For Men, which lifted the lid on the women’s health data gap. Men outnumbered women 3:1 in 31 medical trials for congestive heart failure over 15 years, for example.

“For millennia, medicine has functioned on the assumption that male bodies can represent humanity as a whole,” Criado Perez told the UK’s Evening Standard. “As a result, we have a huge historical data gap when it comes to female bodies. Women are dying, and the medical world is complicit. It needs to wake up.”

The following year, the COVID-19 pandemic disrupted access to healthcare globally, and women were disproportionately affected.

At Davos in January 2024, the World Economic Forum launched the Global Alliance for Women's Health, to change how women’s health is funded and prioritized to close the women’s health gap.

The women’s health gap equates to 75 million years of life lost due to poor health or early death each year. Closing the gap would give the 3.9 billion women in the world today an extra seven healthy days a year, or an average of 500 days over a lifetime.

Not only that, but it could also boost the global economy by $1 trillion by 2040 from fewer early deaths and health conditions, and a greater capacity for women to contribute to the economy and society, finds Closing the Women’s Health Gap: A $1 Trillion Opportunity to Improve Lives and Economies.

In 2020, only 1% of healthcare research and innovation was invested in female-specific conditions beyond oncology, according to McKinsey.

For every $1 invested in women’s health, the report from the Forum and the McKinsey Global Health Institute projects there would be around $3 in economic growth.

Closing the women's health gap means increasing diagnosis of women’s health conditions. Here are just five that have been underdiagnosed:

Women in the UK are around a third less likely to receive a coronary angiogram (which allows doctors to see narrowing or blockages in blood vessels) after a STEMI heart attack, mainly caused by heart disease.

A study published in The Lancet Regional Health – Europe found that women were more likely to die after being admitted to hospital with a severe heart attack, but they were also less likely to be prescribed medication to prevent future heart attacks, such as statins.

Previous research has found women were 50% more likely than men to be given an incorrect diagnosis following a heart attack.

Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist told The Times: “Deep-rooted inequalities mean women are underdiagnosed, undertreated and underserved.”

Endometriosis is referred to as “the missed disease” because so little is still known about it and it’s underdiagnosed.

Globally, it affects 10% of women and girls of reproductive age, but in the US, for example, only two out 10 cases are diagnosed, with diagnosis taking more than seven years – and even longer for Black women.

American filmmaker, lawyer and activist Shannon Cohn recently directed the documentary Below the Belt to shine a light on the condition - and spoke to the Forum’s Radio Davos podcast about her own experience.

Cohn had her first painful symptoms of the condition when she was just 16, but then there was a “yawning 13-year gap of not being believed actually by healthcare providers, being told my symptoms were in my head or part of being a woman, or I was exaggerating”.

Around three times as many boys are diagnosed with autism as girls, and girls are often diagnosed later than boys, or not diagnosed at all, which can lead to mental health problems in adulthood, according to research.

Medical gender bias contributes to this underdiagnosis in women, because girls often don’t present with the same behaviours and symptoms as boys – and they learn to “mask” those that don’t fit with social norms.

“Because females often mask and defy stereotypically autistic presentations, individuals and families must endlessly educate others and advocate for themselves or their children to receive the treatments, supports and accommodations they deserve,” says clinical psychologist, Karen Saporito.

Amira Ghouaibi, Project Lead of the Women’s Health Initiative at the World Economic Forum, believes still more research is needed into why women’s medical needs are not being met before we can achieve gender equality in health.

“Every woman should be able to receive quality care when and where she needs it. We will only be able to achieve this once we examine the state of the women’s health gap, and then identify the biggest disparities to inform strategies and policies towards better women’s health outcomes.”

Another neurobiological condition that frequently co-occurs with autism, and is similarly mis- or under-diagnosed in females, is attention deficit hyperactivity disorder (ADHD). In the US, less than 1% of women have a diagnosis of ADHD, but the number is growing rapidly, according to research.

In 2023, analysis of a data set found the rate of diagnosis among women aged 23 to 49 almost doubled between 2020 and 2022, which the study said supports findings that women tend to be diagnosed later in life than men.

As with autism, ADHD symptoms present differently in women, while historically, research focused on boys with the condition.

The study said the gap between women and men in terms of diagnosis is closing: "While males remain more likely to be diagnosed with ADHD than females, the disparity has decreased over the past 12 years.

"The ratio of males to females diagnosed with ADHD decreased nearly five-fold during that time, from males being 133% more likely to be diagnosed with ADHD than females in 2010 to 28% more likely to be diagnosed with ADHD in 2022."

Autoimmune diseases are those that stimulate the body's immune defences to attack itself and include lupus, psoriasis, multiple sclerosis, rheumatoid arthritis and thyroid diseases.

After cancer and heart disease, they are the third most prevalent disease category.

Women account for the majority of people (80%) with autoimmune diseases, but it takes an average of five years for them to get a diagnosis, according to the American Autoimmune Association.

Recent research in the US highlights why more funding needs to go into research for conditions that tend to affect women more than men.

Scientists at Stanford University have discovered evidence for a molecule – Xist – that exists only in women. It triggers a chemical response that is a hallmark of autoimmune disease and could explain why these conditions are more prevalent in women.

Although potential treatments could be a long way off, Jeffrey Sparks, an associate physician and director of immuno-oncology and autoimmunity at Brigham and Women’s Hospital, who was not involved in the study, told the Washington Post: “The sky’s the limit here ... Once you understand the fundamental mechanisms, you could think about developing therapies, early detection and preventions.”