We know that there is a gender health gap. We know because we still don’t know what causes endometriosis. We know because, according to research database PubMed, while there have been 1,954 clinical trials studying erectile dysfunction, there have been just 393 looking into female sexual pain. We know because there has been five times the amount of research into erectile dysfunction, which affects around 19% of men, than there has been into premenstrual syndrome, which affects 90% of women. We know because we still don’t know what causes PMS.
This problem intersects with race and wealth, too. Black, Asian and ethnic minority women are even less likely to be included in medical research compared to white women. Furthermore, there is a lack of research involving the LGBTQ+ community, which also amplifies health inequalities. Black women in the UK are half as likely as white women to be diagnosed with endometriosis and the British Medical Association has found what it calls "stark healthcare inequalities" based on income and ethnicity.
So while women in the UK have a longer life expectancy than men, the Department of Health and Social Care is now acknowledging that they are spending less of their life in good health.
As Refinery29 reported as part of our Uncharted Bodies series last year, a huge reason for this is that, historically, there has not been as much medical research focusing on women's health problems. Across the board, less than 2.5% of publicly funded research has been dedicated exclusively to reproductive health. This statistic exists despite the fact that one in three – yes, one in three – women will experience severe reproductive health issues in their lifetime, according to Public Health England.
Another reason is that until now – and despite this glaring disparity – the NHS has not been collecting data from women about their health and their experiences of healthcare, which would help to inform treatment and, ultimately, close the gap.
In 2020, Refinery29 submitted a series of Freedom of Information requests to the NHS. We asked the NHS how long women suffering from endometriosis, premenstrual dysphoric disorder (PMDD) and vaginismus were having to wait for specialist referrals. NHS England said that they "do not hold this information" while, at a local level, several NHS trusts said that they do not collect information "at a condition level". This means that while they collect data on 'gynaecology' broadly, they do not specifically record it "at a condition level" – i.e. whether the patient had endometriosis, PMDD or vaginismus. This is despite the fact that these are different conditions, requiring different treatments and specialisms.
Without data, there is no information. Without information, the NHS cannot make informed choices about how to care for women and, in turn, women cannot make fully informed decisions about their health.
This could be about to change. The government has now launched a call for evidence from women. They want women to tell them about their experiences of healthcare in this country, in the hope that it might be able to inform better treatment in the future.
The Department of Health and Social Care says this will form the basis of a landmark government-led Women’s Health Strategy to improve the health and wellbeing of women across England and place women’s voices at the centre of their care. By better understanding women’s experiences, they hope to ensure key parts of the health service are meeting women’s needs as they should be.
The minister for women’s health, Nadine Dorries told Refinery29:
"There can be no doubt our NHS is a phenomenal service. Its workforce is dedicated and determined to deliver world-class care with compassion and empathy. I loved working as a nurse and I am deeply grateful for the times I have been cared for, especially when delivering my three children.
"Although the life expectancy of women in the UK is longer than men, we actually spend less of our life in 'good' health and less is known about conditions which affect only women. We also know not all women experience health and care in the same way and this isn’t good enough.
"To ensure this changes, I have launched a call for evidence, so the first ever government-led Women’s Health Strategy can be built on the good and bad real-life experiences of women, their partners, carers, health experts and women’s service providers. We must ensure we improve the health and wellbeing of women from all walks of life in England.
"I really want to understand the journeys women have gone through in our health and care system, on all aspects of health and care, from mental health to fertility to education and research, so we can listen and learn. I urge women from across the country, of all ages, ethnic groups and sexualities, to use their voices, share this with their family, friends and colleagues and help us deliver something that will effect real change in the health and care system."
The gender health gap won't disappear overnight but if this strategy is properly rolled out, if women are truly listened to and if a commitment is made to take action based on what they say, then progress is possible.