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Opinion

“The gender pain gap hurts everyone – including the healthcare system and taxpayers”

By Cindy Moy Carr and Tami Wahl

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For decades a lot of ink has been spilled both online and in print about pain treatment disparities between men and women, often by the patients themselves.

One very famous case is that of actress comedienne Gilda Radner, who in her book Its Always Something described how she started experiencing acute exhaustion and pain in her upper legs in 1985 while filming Haunted Honeymoon in the United Kingdom.

She sought medical attention, and over the course of the next year, several doctors, the most of whom were in California, gave her differing diagnoses that ultimately turned out to be false. Several told her it was period pain and Epstein-Barr Virus which Radner herself referred to as fitting to “the Queen of Neurosis.”

For many like Radner, period pain has been blamed for what later turns out to be an unrelated illness or physical condition.

Radner continued to feel abdominal discomfort for 10 months. By the time they finally diagnosed her with Stage IV ovarian cancer in October 1986, the tumour inside her had grown to the size of a grapefruit.

Radner had a hysterectomy along with radiation and chemotherapy. Following remission and relapse, she died three years later at age 43. If only the doctors had listened and investigated all the possibilities sooner.

In November 2022, 33 years after the death of Radner, the first-ever gender pain gap report was released. The report, researched and compiled by Nurofen, based on a survey in the United Kingdom of 5,100 participants, analyses the differences in experience of pain for both men and women in the United Kingdom and found:

  1. 56 per cent of women surveyed, compared to 49 per cent of males, felt their pain was disregarded or neglected.
  2. One in four women vs one in six males reported having feelings that generally, no one took their suffering seriously.
  3. Of those that felt this way, 50 per cent said their GP and 27 per cent said their GP (the UK equivalent of a PCP) ignored or dismissed their pain, with partners/spouses (26 per cent) and friends (21 per cent) reacting in similar ways.
  4. Nearly two-thirds (63 per cent) of women believe that doctors and nurses discriminate against women and treat men’s pain more seriously.

The reasons it took so long for such a study are present in the results. The report states that the gender gap found in this study is probably a product of a “male as default” philosophy and historic practice that pervades research, clinical trials, healthcare policy and services.

It seems Radner wasn’t the only one who thought herself neurotic. The report also states that only 28 per cent of women who experience severe daily pain would seek consultation with their GP.

That trend continues with treatments for pain where 74 per cent of women would choose self-care over seeing an GP due to feeling ignored or dismissed compared to just 60 per cent of men. And almost a quarter (24 per cent) of the women surveyed also reported that pain had led to them feeling depressed, compared to 18 per cent of men.

These results, while shocking, are an everyday experience for most women we know.

The first study definitively proving the existence of menstrual pain was released by Harvard and Apple in March 2021. Women obviously knew menstrual pain existed, the pain simply wasn’t considered important enough to merit research funding.

In 1998 sildenafil citrate, later marketed as Viagra, was tested as heart medication and found to offer total relief for serious period pain over four hours. The review panel refused further research funding because cramps were not a public health priority.

In 2007 sildenafil citrate was found to help hamsters recover from jet lag. In 2013 sildenafil citrate was again shown to relieve menstrual pain but the study ran out of funding. Hamsters get priority over women.

More recently one of this article’s authors sought counselling for hypochondria after numerous doctors told her the mysterious ailments she was suffering, including debilitating migraines, dry eyes and vertigo, were psychosomatic.

It was a nurse who told her it was perimenopause. Simple hormone therapy solved years of symptoms.

Gender pain disparity is a safety issue

In 2020, the First Do No Harm report was published by the Independent Medicines and Medical Devices Safety Review, chaired by Baroness Julia Cumberlege.

The Review team spent two years speaking to more than 700 women and their families who experienced complications linked to three treatments–1) sodium valproate, an epilepsy drug that increases the risk of birth defects; 2) Primodos, a hormonal pregnancy test withdrawn from the market in 1978, allegedly associated with birth defects and miscarriages; and 3) pelvic mesh implants, used to treat prolapse and urinary incontinence, the complications of which can cause debilitating pain “like shards of glass inside the body”.

The 277-page report is an explicit and gut-wrenching read, laying out in minute detail the multitude and shocking ways in which patients – most of whom are women – were treated dismissively by the healthcare system with the resulting outcomes being just as severe, including job loss, breakdown of family life, children or husbands becoming carers for mothers or wives, and for women with children suffering from foetal valproate spectrum disorder, being accused of abuse by poorly educated clinicians.

On page 17 of the report, under the subtitle No-one is listening’ – The patient voice dismissed, the Review team writes: “They spoke of being ‘gaslighted’ and of not being believed, particularly in relation to pelvic mesh and the suffering of pain.

“Women, in reporting to us their extensive mesh complications, have spoken of excruciating chronic pain feeling like razors inside their body, damage to organs, the loss of mobility and sex life and depression and suicidal thoughts.”

The Review team goes on: “Some clinicians’ reactions ranged from ‘it’s all in your head’ to ‘these are women’s issues’ or ‘it’s that time of life’ wherein anything and everything women suffer is perceived as a natural precursor to, part of, or a post-symptomatic phase of, the menopause.”

The Review then explains some of the consequences of this treatment, including the increased costs to the UK taxpayer.

“We know that women who accept a normalisation of their pain tend to seek the help they need far later than they should,” they write.

“This precludes the possibility of early, less invasive treatment with potentially better outcomes. It also takes its toll, physically, mentally and emotionally on the patient and their family and imposes ultimately a far greater cost on the NHS and the healthcare system to treat and attempt to put right.”

What steps can we take to narrow the gap?

Nurofen’s study is a good start. They’ve also launched a website called named See My Pain where the stories of real women are posted.

Their parent company Reckitt Benckiser has also committed to several long-term initiatives that go beyond marketing to finally close the gender pain gap.

For instance, the business will invest in creating new tools to help both men and women describe and articulate their suffering while speaking with medical specialists.

Reckitt has also pledged to include gender balance when planning and analysing its clinical studies, provide training in identifying gender bias and will frequently review the Gender Pain Gap Index Report to monitor progress. (Note: The authors are not affiliated with Reckitt.)

These are all good first steps from a brandholder in the medical ecosystem.

Healthcare professionals could receive training in active listening techniques. Medical school curriculums and continuing education sessions could explore and raise awareness of the gap, which may initiate an openness and curiosity for students and physicians to look beyond defined conditions.

Patients should learn to be their own advocates. Today we have technologies, digital platforms, social media and online communities to better inform and empower an individual.

Perhaps if Gilda’s medical team was more curious or she had a broader support network with similar symptoms she wouldn’t have dismissed herself as “neurotic” and she’d still be here making us all laugh with her wonderful characters.

A longer-term and more involved measure is a comprehensive and macro-review of the healthcare model.

The system has become such a behemoth that medical discoveries and any sense of individualised treatments are ultimately limited if non-existent.

The existing model was built decades prior to the array of digital data and technologies that are available today. Is a complete overhaul needed or can the existing system be reconfigured to utilise and meet contemporary times?

A serious review would reveal best next steps to close the gender pain gap among other improvements.

The Nurofen report concludes on a practical note: “Closing the gap on pain will not only provide immediate solutions for women experiencing pain, but we hope will have a ripple-effect in terms of social and economic gains.”

More importantly, closing the gender pain gap will save lives and will absolutely improve the quality of life for women navigating pain.

 

Cindy Moy Carr is the founder and CEO of Vorsdatter Limited which developed mySysters, an app for perimenopause and menopause. She’s an attorney and journalist who authored the American Bar Association’s Guide to Health Care Law.

Tami Wahl serves as legislative and regulatory counsel for innovators across multiple industry sectors. 

Insight

Why advocacy-orientated CPD matters for the future of cardiology

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By Women As One

At the 2026 Alliance Annual Conference, Women As One presented a poster that asked a powerful question: What if continuing professional development (CPD) did more than teach clinical knowledge— and instead helped shape the future of the workforce itself?

For decades, professional education in medicine has focused primarily on what clinicians know and how they practice. That work remains essential.

But persistent gender gaps across cardiology—from leadership positions to research participation and speaking opportunities—demonstrate that knowledge alone is not enough to ensure equitable advancement.

To truly strengthen the field of cardiology, professional development must also support who clinicians become, the opportunities they access, and the voices that shape the future of cardiovascular medicine.

Our poster, More Than Education: Elevating Equity and Identity Through CPD, explores how a new model of advocacy-orientated CPD can help close these gaps.

Advocacy-orientated CPD expands the traditional model of professional education. In addition to building clinical expertise, it intentionally supports the structural elements that shape career advancement—mentorship, sponsorship, leadership development, visibility, and professional networks.

By integrating these elements into professional education, CPD can become a powerful engine for advancing equity—and ultimately improving patient care.

Why this matters

Gender inequities in medicine are not simply workforce issues. They influence research priorities, clinical trial representation, leadership decision-making, and ultimately the care patients receive.

When women clinicians have equitable opportunities to lead, research, and shape clinical practice, the entire healthcare system benefits.

Yet structural barriers remain. Women physicians often have less access to mentorship, sponsorship networks, and leadership pathways—factors that are critical for career advancement.

This is where advocacy-orientated CPD comes in.

By intentionally designing programs that foster mentorship, build leadership skills, create visibility, and support long-term professional growth, organizations can help ensure that the next generation of cardiovascular leaders reflects the diversity of the patients they serve.

Turning opportunity into impact

Since its founding, Women As One has supported thousands of women cardiologists across more than 100 countries, expanding access to mentorship, research opportunities, and leadership development.

Through programs like CLIMB, RISE, Mentorship Awards, and our global digital community, The Pulse, thousands of women cardiologists have gained mentorship, leadership training, and opportunities that accelerate their careers and expand their influence.

Today, the outcomes of these programs are shaping the field in tangible ways:

  • Women As One alumnae are leading clinical trials and advancing cardiovascular research
  • Clinicians supported through our programs are building registries, launching new care models, and expanding access to specialized care
  • Women cardiologists are gaining greater representation on speaker panels, advisory boards, and leadership pathways
  • A global community of more than 3,000 women cardiologists is strengthening collaboration, mentorship, and visibility across the profession

These outcomes demonstrate what becomes possible when professional development goes beyond traditional education to intentionally support leadership, identity, and community.

A call to the cardiovascular community

Advancing equity in cardiology is not the responsibility of one organization—it requires a collective effort across the entire ecosystem of clinicians, educators, institutions, and industry partners.

For women cardiologists, this means engaging in the programs, mentorship networks, and leadership opportunities that help shape the future of the field. Whether through CLIMB, RISE, research initiatives, or participation in The Pulse community, your involvement strengthens a growing movement dedicated to advancing women in cardiology.

For our partners and supporters, this work demonstrates the powerful impact that strategic investment in equity-focused professional development can have on the workforce and the patients we ultimately serve.

Together, we can redefine what professional development looks like in medicine—not just as a pathway for learning, but as a catalyst for leadership, opportunity, and lasting change.

Explore the poster

We invite you to explore the poster below (click here to download it) to learn more about the evidence, framework, and real-world impact behind this work—and to join us in continuing to expand what professional development can achieve for the future of cardiovascular medicine.

Learn more about Women As One at womenasone.org

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Opinion

What Maternal Mental Health Month reveals about where postpartum support actually breaks down

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By Morgan Rose, chief science officer at Ema, and Lauren Scocozza, vice president of product at Willow

May is Maternal Mental Health Month, and every year it surfaces a familiar set of statistics: 1 in 5 new mothers experiences postpartum depression or anxiety, most go unscreened, and the majority who are screened don’t receive adequate follow-up care.

The conversation is important. But the numbers obscure something that anyone who has worked in this space knows to be true: postpartum mental health distress rarely arrives with a label.

It arrives as exhaustion. As “I’m not sure I’m doing this right.”

As a question about supply, pumping, whether it’s okay to feel this disconnected from something you were supposed to love immediately.

Willow integrated Ema, AI built for women’s health, with the goal of closing the maternal care and data gap.

The pattern mentioned above appears consistently in Ema’s conversational data through the Willow app.

A mother reports mastitis symptoms.

Ema walks her through the clinical presentation, confirms she should keep pumping, and then she questions if she is using her pump correctly. In the same thread, within a few exchanges, she says she’s “feeling too sad.” Then: “I don’t know. I think I’m depressed. I am not enjoying my postpartum.”

She did not come to the app to talk about her mental health.

She came about a breast infection. The mental health disclosure came through the already-opened door.

The Weight Underneath the Technical Question

New motherhood involves an enormous amount of problem-solving at a time when cognitive and emotional reserves are depleted. The pump has to work. The baby has to eat. The body has to recover.

Work comes back. Sleep doesn’t. Feeding their babies requires skill, and the learning curve sits atop it all.

What Ema’s conversation data shows is that the emotional load of navigating these challenges is not separate from mental health. It is mental health.

When a mother writes, “I’m postpartum and overwhelmed and tired,” and then, in the same breath, asks about flange sizing, she is telling us what the postpartum experience actually feels like from the inside.

The technical question and the emotional state are one and the same.

Breastfeeding carries particular weight here.

The desire to breastfeed, the guilt when it doesn’t go as planned, and the identity questions that come with feeding choices are not peripheral to the postpartum mental health conversation.

In our conversations, women navigating supply concerns often reveal deeper anxieties: about whether they are good mothers, whether their bodies are “working,” and whether the difficulty they are experiencing means something about them.

These are the signals worth asking about.

What Screening Looks Like in Practice

Ema is trained on the Edinburgh Postnatal Depression Scale and is equipped to offer the EPDS when a conversation warrants it.

The value is being present for the moment when a woman is ready to name what she’s feeling.

That moment rarely comes as a direct request for mental health support. It comes when someone is already in a conversation about something else, and something shifts.

A woman dealing with mastitis says she feels sad. A woman worried about supply says she doesn’t feel like herself. A woman managing the logistics of going back to work with a wearable pump says she’s not sure she can keep up with it all — and the “it all” isn’t about the pump.

Ema is designed to hear that. She doesn’t stay on the clinical or technical track when the conversation moves. She follows the person.

And when the moment is right, she offers the screening as a natural next step.

In one exchange, a woman was offered the EPDS after disclosing depressive feelings. She declined.

Ema acknowledged that and asked if she wanted to talk about something else. That’s the right response. The offer was made without pressure. The door stays open.

Sometimes what matters most is that someone asked at all.

The Continuity Problem

One of the most persistent structural failures in maternal mental health care is fragmentation.

A woman sees her OB at six weeks postpartum for a brief screening. She may get a call from a nurse. She may be given a referral she never follows up on because she doesn’t have the capacity to navigate a new care relationship while managing a newborn.

The clinical touchpoints are too few, too far apart, and too often siloed from one another.

The postpartum period lasts far longer than the six-week checkup implies. Mental health symptoms can emerge weeks or months after delivery, shift in character over time, and interact with physical challenges in ways that don’t fit neatly into any single provider’s lane.

A lactation concern becomes an anxiety spiral. A supply drop triggers a grief response. A difficult return to work surfaces a postpartum depression that wasn’t fully recognized at six weeks.

Ema sits inside these moments because she’s embedded in the platform women are already using. She doesn’t require a separate appointment, a referral, or the cognitive bandwidth to seek out a new resource.

She’s in the Willow app that mom is already using multiple times a day to manage her pump.

When Ema identifies a woman who may need more support than she can provide, she routes to the right resource — whether that’s a SimpliFed lactation consultant for feeding-related concerns or a clinical professional for mental health follow-up.

The conversation leads to the handoff with someone who can do more.

What the Month of May Means for the Rest of the Year

Maternal Mental Health Month is a useful moment of attention. The awareness campaigns, the social media posts, and the statistics shared in newsletters matter.

But the gap in postpartum mental health care is not really an awareness problem.

Most people in the perinatal space and beyond know the statistics. The problem is access, timing, and continuity.

AI doesn’t close that gap on its own.

What it can do is be present in the spaces where women already are, at the times when they need something, and attentive enough to recognise that a conversation about a pump, a clogged duct, or a supply concern is also a conversation about how someone is doing.

The question behind the question is often the more important one.

For Willow, the conversation data Ema generates is a map of where mothers are struggling, what they reach for when they need help, and when they are ready to say more than they came to say.

That information, used well, shapes better resources, better onboarding, and a more connected experience across the full arc of the postpartum year and beyond.

Building the infrastructure to support maternal mental health is a year-round project.

Willow is doing one part of that, and the conversations happening on the Willow platform every day are evidence that women want support that meets them where they are… in their app, in their moment, without having to ask for it twice.

About the authors

Morgan Rose is Chief Science Officer at Ema, an AI platform for women’s health. Ema partners with healthcare organisations and femtech companies to deliver clinically grounded AI support across the perinatal journey.

Lauren Scocozza is the Vice President of Product at Willow Innovations, Inc. For women by women, Willow is building a maternal care platform to address the interconnected challenges of postpartum.

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Opinion

Femtech’s next chapter: Building a truly equal and comprehensive health tech category

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By Wolfgang Hackl, MD, CEO OncoGenomX, Allschwil, Switzerland

FemTech is moving from a promising niche to a foundational part of modern healthcare.

Over the next decade and beyond, its real promise will not only be better products, but a more equitable system: one where women’s health is treated as an equal area for innovation, investment, clinical care, and public policy.

That shift matters because women’s health has long been under-researched, underfunded, and too often managed through systems that were not designed with female biology and life stages in mind.

The opportunity now is to change that trajectory.

If stakeholders act deliberately, FemTech can become a category that improves outcomes, expands access, and creates measurable value across the HealthTech ecosystem.

From niche to infrastructure

The most important change ahead is a mindset shift. FemTech should no longer be seen as a narrow consumer segment focused only on logging symptoms.

It should be understood as health infrastructure spanning puberty, fertility, pregnancy, postpartum recovery, menopause, pelvic health, chronic disease, mental health, and long-term preventive care.

This broader framing creates a more durable market and a stronger social case. It also encourages innovation that serves people across the full life course, rather than only at highly visible moments.

In practical terms, this means building tools that are clinically relevant, integrated into care pathways, and designed to work for different populations and health systems.

What needs to change

For FemTech to become a truly equal healthcare category and a genuine societal priority, several layers need to move together.

First, the evidence base must deepen. More sex-disaggregated data, more women-inclusive clinical studies, and more research on conditions that disproportionately affect women are essential.

Without stronger evidence, product development, diagnosis, reimbursement, and clinical adoption all remain constrained.

Second, policy and regulation must mature. Privacy protections need to be strong enough to build trust in highly sensitive health data.

Regulatory pathways should be clear enough to help innovators bring safe, effective products to market without unnecessary delay.

Reimbursement frameworks also need to evolve so that useful digital tools are not limited to those who can pay out of pocket.

Third, healthcare systems must become more open to integration. The best FemTech products should not sit outside the care journey as standalone apps.

They should connect with clinicians, diagnostics, telehealth, and care coordination so that patients experience continuity rather than fragmentation.

Finally, society needs a broader cultural shift. Women’s health should be discussed as a mainstream public health and economic issue, not as a side topic or a private concern.

That means normalizing conversations around menopause, miscarriage, postpartum health, chronic pain, infertility, and long-term preventive care.

The role of each stakeholder

A healthier FemTech future depends on the full value chain.

Founders and product teams need to design for clinical relevance, usability, and trust. The strongest solutions will be those that solve real problems, use data responsibly, and fit into everyday life and care.

Investors can help by backing long-term value creation rather than only consumer growth. FemTech deserves capital that supports rigorous validation, regulatory readiness, and scalable business models.

Healthcare providers and systems play a critical role in adoption. By integrating FemTech into clinical workflows, they can reduce delays in care, improve monitoring, and make support more continuous and personalised.

Payers and insurers can accelerate access by recognising the downstream value of early intervention, prevention, and better self-management. Coverage decisions will strongly shape which innovations become standard practice.

Policymakers and regulators should create environments where safety, innovation, and privacy coexist. Clear standards and supportive reimbursement policy can make the difference between isolated success and category-wide growth.

Employers and public institutions also have a role. Women’s health affects productivity, retention, and long-term wellbeing, which means workplace benefits and public programs can help expand access and reduce inequity.

FemTech is not only “women for women.” It is “everyone to solve a health and social issue that has been ignored for far too long.”

When stakeholders across the value chain recognise women’s health as a shared responsibility, FemTech moves from a segmented category to a mainstream force for better outcomes, fairer access, and stronger social impact.

Why the upside is larger than the market

The benefit of getting this right is not only commercial.

Better women’s health tools can improve early detection, support self-management, reduce avoidable complications, and lower the burden on social and healthcare systems.

They can also help close persistent gaps in access and outcomes that affect families, workplaces, and economies.

For HealthTech innovators, this is an opportunity to build products that are both mission-driven and scalable. For health systems, it is a chance to improve care quality and efficiency. For society, it is a way to move women’s health from an afterthought to an equal priority.

Actions that will move the field forward

The right direction will not happen automatically. It requires deliberate action across the ecosystem.

  • Build products around real clinical needs, not only consumer engagement.
  • Invest in women-inclusive research and validation from the start.
  • Design privacy and governance into the product architecture.
  • Create reimbursement models that reward prevention and continuity.
  • Integrate FemTech into mainstream care pathways.
  • Expand education for clinicians, employers, and the public.
  • Expand the category to the invisible concerns to cover the full range of women’s health needs.

When these actions align, FemTech can mature into something larger than a market category. It can become a model for how health innovation should work: evidence-based, inclusive, trusted, and built to improve lives at scale.

A strong FemTech future is not just possible. It is a practical next step if the ecosystem chooses to treat women’s health as what it truly is: a core healthcare priority and a major driver of innovation.

Table: FemTech Focus Areas

FieldApproximate number of active solutions/companies
Reproductive health & fertility120+
Pregnancy & maternal care80+
Menstrual health60+
General women’s health & wellness50+
Diagnostics & monitoring45+
Menopause & perimenopause40+
Pelvic & uterine health30+
Chronic women’s health / integrated care30+
Sexual health & wellness25+

Legend: FemTech is becoming a multi-category healthcare layer. Reports also show that software/apps remain the largest product type overall, while reproductive health continues to dominate as an application area. Best-effort estimates based on category listings, company directories, and market reports, not audited totals.

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