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Opinion: Women don’t need a refreshed health strategy – we need action
By Justyna Strzeszynska, founder of menstrual health platform Joii
The Government’s announcement that it will renew the Women’s Health Strategy is, on the surface, good news.
The original strategy in 2022 was historic – the first time women’s health had been acknowledged as something that required its own plan.
It raised awareness, started conversations and encouraged women to come forward and talk about their health.
But awareness alone hasn’t changed much on the ground.
Women are still waiting years for diagnoses, gynaecology waiting lists are still some of the longest in the NHS and many women are still being told their symptoms are ‘just part of being a woman’, especially when it comes to periods, pain or fatigue.
If the Government is going to refresh this strategy, we need to be honest about what didn’t work last time and what has to change now.
One issue with the previous strategy was the way it focused on specific conditions.
Endometriosis and PCOS were rightly brought forward and the advocacy behind that has been extraordinary. But women’s health can’t work like a spotlight, where each year a new condition is added based on who campaigns most effectively.
Some of the most common and life-disrupting conditions still sit in the background.
Heavy menstrual bleeding affects one in three women. Fibroids affect up to one in three by age 50. Adenomyosis is thought to affect one in ten.
These aren’t rare conditions, they are everyday realities. Yet they receive less attention, less funding and far fewer structured care pathways.
They also disproportionately affect Black women, who are more likely to have severe symptoms and less likely to be believed.
If a renewed Women’s Health Strategy is going to address inequality, then these conditions can’t remain an afterthought.
The other major issue is how diagnosis actually happens.
Right now, if you go to your GP with heavy bleeding or pelvic pain, the first questions are usually ‘how much blood do you think you’re losing?’ and ‘how bad is the pain, on a scale of 1 to 10?’
Most women have never been taught what ‘normal’ bleeding looks like and their pain has become background noise. Many also feel unsure or embarrassed about describing symptoms accurately.
So women hesitate, clinicians hesitate and referrals get delayed. That’s how we end up with eight-year diagnostic journeys.
If we want to reduce waiting lists and speed up diagnosis, we need to fix the front door.
First, we need to give GPs standardised tools to measure menstrual bleeding and symptom impact.
One of the biggest barriers to diagnosing menstrual health conditions is that we still rely on women to estimate their bleeding and pain with no reference points.
Most women, and especially young girls, don’t know what counts as heavy bleeding and many have normalised symptoms that could actually be clinical red flags.
Without standard measurement, clinicians can’t triage effectively and women fall into long cycles of ‘wait and see’.
The renewed strategy should introduce validated digital and clinical tools, so patients and clinicians are working from the same evidence, not guesswork.
Second, expand and standardise Women’s Health Hubs so access isn’t determined by postcode.
Women’s Health Hubs already exist in most of England, which is a strong start, but not all hubs offer the same services, capacity or quality of care.
Some are genuinely transformative while others function more as signposting centres.
To actually reduce the backlog and speed up diagnosis, hubs need to be properly resourced and consistent, with clear referral pathways from primary care.
The refreshed strategy should set national standards for what every hub must deliver so accessing timely assessment isn’t dependent on where a woman happens to live.
Finally, there needs to be a shift towards treating menstrual and pelvic conditions as chronic, not occasional episodes.
Conditions like endometriosis, adenomyosis, fibroids, PCOS and chronic pelvic pain don’t follow single-appointment cycles yet our system is structured as if they do.
Women are often seen once, reassured and discharged, only to start the entire referral process again when symptoms worsen. This wastes NHS time and leaves women feeling unheard.
The renewed strategy needs to support ongoing monitoring and follow-up, recognising these conditions as long-term health issues requiring continuous management, not episodic care.
Most importantly, the refreshed strategy must come with clear timelines, ringfenced funding and actual accountability.
Otherwise, we end up with another web page and a press release, instead of change.
Women are already doing their part by speaking up.
Now the system needs to meet them.
Female sex may not raise stroke risk across all atrial fibrillation (AF) patients, with higher risk mainly seen in women aged 75 and older, a study suggests.
Researchers said stroke prevention for women with the condition should be more personalised, especially for patients under 75.
Dr Amitabh C Pandey, director of cardiovascular translational research at Tulane University School of Medicine, said: “For years, female sex has been included as a risk factor along with other factors such as high blood pressure and diabetes, meaning women were more likely to be prescribed anticoagulants.
“Our study shows younger women may not have as much added stroke risk as previously thought, while older women, particularly those over 75, appear to have a higher risk that deserves close attention.”
The new Tulane University study challenges a long-standing assumption in heart care that being female automatically increases stroke risk for patients with atrial fibrillation.
Atrial fibrillation, often called AF, is a common heart rhythm disorder that causes the heart to beat irregularly.
It is associated with a higher risk of stroke and is often treated with anticoagulants, also known as blood thinners.
The study found that stroke risk did not increase equally across all female patients with AF.
Instead, researchers said being female may act more as a risk modifier, with increased stroke risk seen primarily among women aged 75 and older or those with a greater burden of other health conditions.
Clinicians often use a scoring system to decide whether people with AF should be prescribed blood thinners.
The system gives points for factors including age, heart failure, diabetes, previous stroke, vascular disease and high blood pressure.
Women also receive one point for sex alone.
Researchers said this can mean women with AF become eligible for blood thinners earlier or more often than men with otherwise similar risk profiles.
While blood thinners can help prevent clot-related strokes, they can also increase the risk of bruising, prolonged bleeding, gastrointestinal bleeding and other serious complications.
The researchers analysed approximately 950,000 patients with AF using TriNetX, a large anonymised electronic health record database.
They compared stroke outcomes between male and female patients across three age groups: younger than 65, 65 to 74, and 75 and older.
Male and female patients were matched based on age, other health problems and whether they had been prescribed anticoagulation medicine.
Among patients younger than 75, the study found no significant difference in one-year stroke risk between men and women.
However, among patients aged 75 and older, women had a modest but statistically significant increase in stroke risk compared with men.
In patients aged 75 and older with no additional risk factors beyond age, women had about one additional stroke per 629 patients compared with their male counterparts.
The findings support growing interest in a newer AF risk score, known as CHA2DS2-VA, which removes sex as a standalone risk factor.
However, researchers said more studies are needed and medical guidance remains inconsistent.
Han Feng, assistant professor at Tulane University School of Medicine, said: “This general approach came from women being underrepresented in AFib trials and studies comprising only about one-third of study populations.
“Our study shows not all women with AFib have the same risk profile, and these decisions should be individualised.
Pandey said: “These findings highlight the need for modern tools and approaches that can personalise risk profiles to individuals.
“The goal is not to undertreat patients who need stroke prevention, but to better identify who is most likely to benefit from anticoagulation and who may be exposed to unnecessary risk.”
AI may help speed breast cancer diagnosis for high-risk women after abnormal mammograms, a study suggests.
Women with abnormal mammograms often wait weeks to learn whether they have breast cancer.
Researchers at UC San Francisco and UC Berkeley said an AI-guided workflow could help reduce that wait by quickly identifying those most likely to have the disease. Some women could move from imaging to evaluation, and sometimes biopsy, in a single day.
Dr Maggie Chung, first author of the study, said: “This is a really an exciting time.
“This moves us closer to personalised care, where we can tailor a plan so that each patient gets the right intervention at the right time.”
The study used an open-source AI model called Mirai.
The model was trained on hundreds of thousands of mammograms linked to patients’ cancer outcomes.
A mammogram is an X-ray scan of the breast used to look for signs of cancer. A biopsy involves taking a small tissue sample to test for disease.
The AI tool is designed to detect subtle patterns in screening mammograms and predict a woman’s cancer risk.
Researchers at UC San Francisco and UC Berkeley applied the model to more than 4,100 screening mammograms at Zuckerberg San Francisco General Hospital and Trauma Center.
Mirai identified 525 women, about 12.7 per cent of screened patients, as high risk.
Those patients could receive an interpretation of their mammograms immediately after the scan and have additional diagnostic imaging for suspicious areas on the same day.
Some women who needed biopsies were also able to have them on the same day.
The researchers said Mirai reduced the wait time for diagnostic evaluation from several weeks to about an hour.
For women who were ultimately diagnosed with breast cancer, it reduced the average wait for biopsy from more than two months to fewer than 10 days.
The researchers stressed that Mirai does not replace radiologists or make diagnoses on its own.
Instead, it acts as a triage tool to help physicians identify the patients who can benefit most from accelerated care.
The team analysed more than 114,000 archival mammograms before launching the programme, to ensure the model would capture enough high-risk patients without overloading the clinic with too many expedited evaluations.
The researchers said they hope AI will support a more personalised approach to breast cancer screening tailored to each patient’s breast cancer risk.
Chung said: “Right now, many women follow the same screening schedule but their individual risk can be very different.
“AI risk assessment gives us the chance to identify the women most likely to benefit from expedited care and get them what they need.”
Adam Yala, senior author of the study and a data scientist at UC Berkeley, said: “This is a powerful example of how AI can be a collaborative partner for physicians.
“It shows how we can improve care when we bring clinicians and data scientists together to design these systems.”
Women with primary infertility may face a higher risk of early menopause and reach it about a year earlier, a study suggests.
The findings suggest women with primary infertility may be more likely to enter menopause before the age of 45.
The increased risk appeared most notable among women with unexplained infertility or a history of endometriosis.
Dr Stephanie Faubion, medical director for The Menopause Society, said: “This study shows that women with primary infertility, specifically those with unexplained infertility or a history of endometriosis, were at risk for early menopause.
“Given that early menopause is linked to adverse long-term health consequences, these women may benefit from counselling that they are at risk of early menopause.
“This will allow them to monitor for early menopause and to seek treatment with hormone therapy, if indicated.”
Early menopause is usually defined as menopause before age 45, while premature menopause is menopause before age 40.
Women who experience menopause earlier may face symptoms for longer and have a higher risk of long-term health problems.
These can include cardiovascular disease, osteoporosis and neurocognitive disorders. Osteoporosis weakens bones, while neurocognitive disorders affect memory, thinking or brain function.
The study, highlighted by The Menopause Society, involved nearly 700 people, roughly half of whom had been diagnosed with primary infertility.
It found that women with a history of primary infertility underwent natural menopause about one year earlier than those without such a history.
Researchers found no association between infertility and premature menopause.
Infertility affects around one in six people globally and can have consequences beyond family planning.
Previous research has linked infertility with higher rates of cancer and cardiovascular disease, although causes vary and may involve genetic, hormonal, in-utero or lifestyle factors.
In-utero factors are influences that occur while a baby is developing in the womb.
Earlier studies looking at links between infertility and early or premature menopause have produced mixed results, with some not accounting for different types of infertility.
The new study suggested that women with unexplained infertility or a history of endometriosis may have an increased risk of early menopause.
Endometriosis is a condition where tissue similar to the lining of the womb grows elsewhere in the body. It can cause pain, heavy periods and fertility problems.
Known risk factors for early or premature menopause include tobacco use, low body mass index, not having given birth and starting periods at a younger age.
Women who have had more childbirths and those with a history of oral contraceptive use have previously been linked to later menopause.
The researchers said women with primary infertility may benefit from additional counselling because of the systemic and long-term health effects of early menopause.
They also said women should be encouraged to seek evaluation and treatment if they experience a new loss of menstrual cycles.
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