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Opinion

The continued struggle for female representation in drug trials  

Dr Janet Choi, chief medical officer at Progyny

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Dr Janet Choi, chief medical officer at Progyny

The exclusion of women from drug trials undermines efforts to ensure equitable and effective healthcare for all individuals.

In 2002, the Women’s Health Initiative (WHI) was forced to pause its study on hormone therapy’s effect on menopause symptoms due to results showing it increased the risk for breast cancer, stroke and heart disease, and thrombotic events like pulmonary emboli.

Over 20 years later, in May of this year, JAMA published a review of this study and determined that, given current available hormone therapy formulations as well as risk/benefit analysis, younger menopausal women may actually derive significant benefits from menopausal symptom relief with appropriately prescribed hormone therapies.

The initial study had looked at women who were older and typically years post-menopause – the average age of the study participants was 63.3 years – and the age-related changing of blood vessels, among other things, may be the key to shifting from greater risk to greater benefit with hormone therapy.

I wish this more measured summary of the study’s findings and recommendations had been headlined back in 2002 – and I imagine thousands of my OB/GYN colleagues and billions of menopausal women over the years feel the same.

Yet, due to these 2002 over-generalised published findings, doctors and patients shied away from hormone therapy, which led to unnecessary suffering for many symptomatic menopausal women.

The irony of the WHI study is that after decades of women being excluded from clinical research, Congress finally passed an act in 1993 requiring that the National Institute of Health (NIH) enrol women and persons of colour in clinical trials.

On the heels of this landmark decision, the intentions of the WHI study were excellent – a first of its kind for women – but may have unintentionally set back women’s health innovation.

The reality

If you’re wondering why we are just now reevaluating and reinterpreting findings made in a 2002 women’s health study you may (or may not) be shocked to learn that while there is growing inclusion of women into research trials, they are still underrepresented in key therapeutic research areas, such as cancer and cardiovascular disease.

Excluding women from drug trials can have several harmful consequences. First, it can lead to a lack of understanding about how medications affect women differently than men, as their physiological responses may vary due to hormonal and metabolic differences, among other factors.

This can result in ineffective or potentially harmful treatments for women. It can also hinder progress in medical research by preventing the development of sex-specific treatment approaches.

Additionally, while the amount of research conducted on the behalf of women has grown in the past two decades, research involving pregnant women has been restricted.

This leads to a limited understanding of how best to medically care for pregnant women: for example, less than 10 per cent  of prescription medications have been studied enough to understand the impact in pregnancy on both the woman and her foetus.

While the NIH and American College of Obstetricians and Gynecologists (ACOG) both acknowledge pregnancy as a “medically complex” state that can alter metabolism of medications, and the course of various diseases, increased pregnancy-specific data needs to be collected to optimise the care of women in pregnancy.

Another recent, glaring case study: initial COVID vaccination trials did not include pregnant women, which led to restrictions on the availability of the vaccines as well as restrictions of the use in pregnant women with dire consequences – as unvaccinated pregnant women are more likely to develop severe COVID infections requiring ICU admissions and are more likely to develop other pregnancy-related complications like preeclampsia and preterm birth.

How do we move forward?

The exclusion of women from drug trials undermines efforts to ensure equitable and effective healthcare for all individuals.

It’s crucial for the government and pharmaceutical companies to put more resources and funding into women’s health so we can have a deeper understanding of how to treat diseases that impact over half of the population, for more female and diverse talent to enter the medical field – either as doctors, researchers, healthcare executives – and to incorporate how biological sex can affect medical treatment into provider education.

And, for pregnant women, the answer was proposed by ACOG back in 2015: “A more careful examination…points to the need for evidence-based consideration of pregnancy exposure in research rather than broad exclusion of all pregnant women”.

If evidence demonstrates minimal risk to the foetus as well as potential benefit to the pregnant woman, why should she be denied the right to give informed consent to enrol in a clinical trial?

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Opinion

From platforms to people: The next era of femtech

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By Katrina Zalcmane, head of partnerships and growth, Véa

The next era of femtech shifts focus from platforms to people as women rethink how technology fits into wellness and social life.

Women are spending less time on ambient, always-on digital environments and more time in bounded, intentional, in-person settings.

This is not a rejection of technology but a reprioritisation of how and where it belongs. For femtech, this shift is not cosmetic. It signals a structural change in user expectations – one that has implications for product design, engagement models and long-term relevance. 

I explore three key signals underpinning this shift: reduced engagement with social media platforms, the resurgence of in-person, women-led communities and growing fatigue with fragmented digital tools.

Signal 1: Declining Engagement With Social Platforms Among Women

Multiple data sources point to a flattening or decline in engagement with traditional social media platforms, particularly among women:

  • Pew Research Center reports that adults are increasingly “actively limiting” their social media use, with women more likely than men to cite emotional exhaustion and reduced wellbeing as reasons.
  • Ofcom’s Online Nation report shows year-on-year declines in time spent on social platforms among UK women aged 25–44, alongside rising use of messaging and offline coordination tools.
  • Meta itself has acknowledged a shift away from “social graph” engagement toward private, smaller-group interactions in recent earnings calls.

While this is not mass abandonment, it does indicate selective withdrawal: fewer platforms, less ambient presence, more intentional use.

Signal 2: The Rise of In-Person, Women-Led Communities

At the same time, participation in physical, community-based activities has increased. Examples include:

  • the growth of women-led run clubs and fitness collectives across major cities, often operating independently of digital platforms;
  • the expansion of paid, small-scale retreats and circles focused on reflection, creativity or embodiment;
  • increased demand for local, recurring group experiences rather than one-off events.

While women are stepping back from social platforms, they are stepping into real-world communities. ONS data on social capital shows a post-pandemic rebound in in-person participation, particularly among women aged 25-45, with a preference for smaller, repeat gatherings over large social events.

What distinguishes this wave of community-building is intentionality. These spaces are bounded, often invitation-based and deliberately offline.

They are designed to counteract overstimulation rather than add to it.

Signal 3: Tool Fatigue and the Consolidation of Digital Habits

Alongside social media fatigue, there is growing evidence of “tool fatigue” across wellness and productivity categories:

  • App retention rates across health and wellness remain low, with industry benchmarks showing that fewer than 25 per cent of users remain active after 30 days.
  • Deloitte’s Digital Consumer Trends report notes a move toward app consolidation, with users preferring fewer, multi-purpose tools over fragmented stacks.
  • Qualitative studies show women are particularly sensitive to cognitive overload caused by managing multiple apps for mood, cycles, health, reflection and social coordination*.

The implication is not that women want less support but that they want smarter, simpler tools that can actually help manage their inner lives.

What This Means: A Shift in the Role of Technology

Taken together, these signals point to a clear trend: technology is moving from being a primary site of social life to a supporting layer around it.

Women are not asking apps to become communities. They are asking them to:

  • help them reflect and process privately;
  • reduce cognitive and emotional clutter;
  • support real-world relationships rather than replace them;
  • operate in bounded, intentional ways.

This reframes success metrics. Engagement time and daily active use become less meaningful than whether a tool genuinely increases capacity, clarity and presence outside the app.

Implications for Femtech

For femtech, this marks a decisive transition. The first phase of femtech focused on visibility: tracking cycles, symptoms and bodily data that had previously been ignored.

The next phase will focus on integration: helping women make sense of experience in ways that support how they live, relate and gather.

Femtech products that attempt to:

  • replicate community digitally,
  • build social feeds under the banner of wellbeing,
  • position AI as a substitute for real connection,

risk misaligning with where behaviour is actually moving. 

By contrast, femtech that treats technology as infrastructure, not destination, is better positioned for longevity.

Where Véa Fits

Véa was built with this shift in mind.

Rather than attempting to replace connection or build another social layer, Véa focuses on internal processing – neuroscience-backed journaling, emotional pattern recognition and reflective AI support – so that women can show up more clearly in their real lives.

Importantly, Véa is not only a digital tool.

It is designed to extend into physical space, through curated in-person experiences and community gatherings that prioritise presence, embodiment and shared reflection.

The digital layer exists to support the human one, not compete with it. In a context of tool fatigue and selective disengagement, this hybrid model – digital support paired with real-world interaction – aligns closely with how women are choosing to engage today.

Over the next decade, the most resilient femtech products will not be those that maximise time spent inside ecosystems but those that give women back the capacity to return to their lives – with greater clarity, energy and real-world connection.

It’s time to design femtech that empowers presence over engagement.

*Reich-Stiebert, N., Froehlich, L. and Voltmer, J.-B. (2023). ‘Gendered mental labor: A systematic literature review on the cognitive dimension of unpaid work within the household and childcare’, Sex Roles, 88, pp. 475–494.

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Opinion

How Women in Tech Switch Off Without Switching Off

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Modern tech work blurs the boundary between focus and fatigue. Notifications spill into evenings, side projects jostle for attention, and the same screens we use to ship code stream our downtime. The answer is not to disconnect completely. It is to design small, protective rituals that restore energy while keeping a gentle sense of control. Short, low pressure restorative online play can sit alongside other evening habits without draining tomorrow’s focus.

Make Recovery a Feature, Not a Fix

Burnout rarely arrives in a single moment. It builds through micro stresses that never get cleared. Treat recovery as a product feature you ship every evening, simple and reliable rather than grand and rare. Start with boundaries that mark the end of the workday. Close the laptop, write a one line note about tomorrow’s first task, and put your kit out of sight. That single gesture creates a clean edge the brain respects.

Then change the environment. Shift lighting from cool to warm, swap the chair for the sofa, and set your phone to a calmer home screen. These cues matter. They tell your nervous system the mode has changed so you can mix mental rest with light engagement that still feels intentional.

Short, Screen-literate Rituals That Actually Work

  • A ten minute mobility or stretch video resets posture after hours at a desk
  • A tidy loop, like clearing the downloads folder or filing screenshots, reduces digital noise
  • A breath guided practice that ends on the dot gives a measurable downshift
  • A single chapter of a book or a short podcast episode keeps attention light and finite

When energy is low, aim for the smallest possible win. Two minutes of breathing still counts. One drawer tidied is still progress. Preserve the shape of recovery rather than chasing perfection.

Where Light Online Play Fits

Play is a human need, not a teenage phase. In the right dose it helps down regulate stress and restores a sense of agency after a day of reacting to tickets and pings. Keep it light and bounded. Choose modes that resolve in fifteen to twenty minutes, mute work apps, and set a visible stop time before you start. The aim is a calm, finite session that ends cleanly.

Cosy builders, puzzles, or narrative adventures often deliver novelty without social pressure. If you prefer something social, co-op rounds that finish quickly provide connection without dragging the night. Headphones with a gentle volume limit protect shared spaces and evening quiet.

Pair play with tiny chores so life runs smoother. Start a short download, fold laundry while it completes, then enjoy your round guilt free because the house already feels calmer. This is deliberate energy management, not indulgence.

Design a Space That Calms On Sight

  • Put a warm lamp on a simple timer so evenings do not begin under harsh light
  • Keep controllers, headphones, and chargers in one tray so play starts cleanly and puts away fast
  • Use a standing phone dock during dinner to avoid reflex checks
  • Keep the bedroom device light and cool in tone so your brain associates the space with sleep

If you live with others, make the evening rhythm visible. A shared quiet hours note, a soft household wind down alarm, and a last call for dishwashing help everyone respect the boundary between work and rest.

A Weeknight Template That Holds Under Pressure

  • Shutdown: one line for tomorrow, close tabs, quick desk tidy
  • Reset: ten to fifteen minutes to settle the kitchen and lay out morning basics
  • Nourish: simple dinner that keeps cleanup minimal
  • Reward: one short activity on a timer, with light online play as an option
  • Wind down: warm lights, gentle stretch, phone on do not disturb, consistent lights out

If you miss a step, shrink it rather than skipping the whole routine. Small completions compound. Over a month they beat heroic bursts every time.

Leadership Starts With Example

Team norms shape personal wellbeing more than any tool. If you manage others, model sane hours and visible shutdowns. Delay send late emails, publish focus blocks, and praise outcomes over urgency theatre. Encourage short, restorative breaks through the day so evenings do not have to undo quite as much. When leaders normalise humane rhythms, teams follow and results improve because people are not running on fumes.

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Opinion

Why period pain feels worse in winter

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By Ruby Raut, founder and CEO, WUKA

If you have ever noticed that your cramps feel sharper, your mood dips harder, or your energy seems to disappear during the colder months, you are not imagining it. Winter can genuinely make periods feel more painful and more difficult to manage. The combination of cold weather, less sunlight, increased tension in the body, and reduced activity creates the perfect storm for stronger cramps and heavier emotional symptoms.

Understanding why this happens gives you the power to manage your cycle with more confidence. Here is the most digestible explanation of why winter and period pain are so closely linked.

Cold weather tightens blood vessels

When temperatures drop, your body goes into protection mode. To conserve heat, it tightens your blood vessels, especially around your hands, feet, and lower abdomen. While this is a smart survival response, it comes with an unwanted side effect for menstruation.

Your uterus is a muscle. Like any muscle, it needs good blood flow to relax and function smoothly. When the blood vessels around your pelvis tighten, circulation naturally becomes slower. Less blood flow means the uterus has to contract harder to shed its lining, and this can make cramps feel deeper, sharper, and more persistent.

This is why heat has always been one of the most effective comfort tools during a period. Warmth helps blood vessels open again, improves circulation, and relaxes the muscle of the uterus.

Your muscles tense up in the cold

Cold weather does more than chill your skin. It makes your whole body tighten without you even realising it. Think about how your shoulders creep upward when you step into the winter air or how your spine curls slightly for warmth. The same tension can build in your abdomen and pelvic floor.

Tighter muscles mean more resistance against the natural contractions of the uterus. When everything around the uterus is tense, cramps can feel more intense and more difficult to soothe. Even mild pain can feel magnified when the surrounding muscles are already stiff.

This is one of the reasons gentle movement, stretching, and warm baths can make such a difference during winter periods. Anything that eases tension also eases pain.

Less sunlight affects your mood and pain perception

Winter brings shorter days and longer nights, and that naturally reduces your exposure to sunlight. Sunlight plays a key role in regulating serotonin, the hormone that helps stabilise mood and influences how we experience pain.

Lower serotonin can lead to lower energy, stronger mood swings, and more emotional sensitivity. Because serotonin also impacts the way the brain processes discomfort, low levels can make cramps feel more intense.

This emotional shift can make PMS symptoms feel heavier too. Irritability, sadness, and bloating can all feel amplified during the colder months, creating a cycle that feels harder to manage.

Winter usually means less movement

Colder months naturally lead to less physical activity. We walk less, we spend more time indoors, and many people find it harder to stay motivated to exercise. While rest is important, the lack of movement has a direct impact on period pain.

Moving your body improves blood circulation and reduces inflammation. When you sit for longer or avoid movement due to cold weather, blood flow becomes slower and inflammation can rise. Both of these factors contribute to stronger cramps.

Even gentle activity makes a difference. A short stretch, a ten minute walk, or simple breathing exercises that open the chest and abdomen can support circulation and ease pain.

Prostaglandins may spike in colder weather

Prostaglandins are natural chemicals that help the uterus contract during menstruation. Higher levels are linked to stronger cramps and heavier flow. Some research suggests that colder temperatures and lower physical activity may increase the production of prostaglandins, although this varies from person to person.

This means that the natural winter slowdown combined with the physical effects of cold weather can lead to more intense uterine contractions, which again results in more painful periods.

How to make winter periods easier

The good news is that small, accessible habits can make a big difference to how your body feels during winter.

Use warmth generously

Heat patches, warm showers, hot water bottles and cosy clothing help open up blood vessels and soothe the uterine muscle.

Move your body even a little

Short walks, stretching routines or low impact workouts help improve circulation and reduce inflammation.

Support your mood with sunlight

Get outside during daylight hours whenever possible. Sitting near windows or using a light therapy lamp can also support serotonin levels.

Eat warming and nourishing foods

Soups, ginger, turmeric and herbal teas help comfort the body and may reduce inflammation.

Choose period products that keep you comfortable

Secure, breathable period underwear can help you feel more relaxed and confident, especially when your body already feels tense from the cold.

Winter does not have to mean more painful cycles.

With warmth, gentle movement, and an understanding of how your body responds to the season, you can navigate cold month periods with more comfort and control.

Find out more about WUKA at wuka.co.uk

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