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Dame Lesley Regan vows to ‘revamp’ UK’s Women’s Health Strategy – “we’ve let women and girls down”

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The Women’s Health Ambassador for England, Dame Lesley Regan, has promised to overhaul the government’s 10-year strategy, as she revealed the scale and cost of the UK’s gender health gap three years on.

Speaking at Women’s Health Week in London earlier this month, Regan revealed that Health Secretary Wes Streeting has tasked her with “revamping” the government’s Women’s Health Strategy, following the publication of his 10-year plan to reform the NHS.

Promising to “rise to the challenge”, Regan also hinted at plans to streamline pathways for innovators, to fast-track solutions into the NHS, and said that the system must stop “admiring the problem” and start redesigning care around women’s lives.

“We are the only country I know in the world with a national health service free at the point of delivery,” said Regan, during her closing keynote speech on Thursday 16 October.

“Yet we’ve got so complacent about the important things in women’s health that we’ve really let girls and women down.”

Major health challenges for women

A Professor of Obstetrics and  Gynaecology at Imperial College London, Regan painted a stark picture of the state of women’s health in 2025.

As well as huge gaps in care for women and girls experiencing menstrual symptoms such as PMS and menopause, women face a raft of wider health challenges.

Contraception has become increasingly difficult to access, resulting in almost half of all pregnancies being unplanned, and as well as having the highest teenage pregnancy rate in Europe, abortion rates are also rising among women over 32.

Meanwhile, cervical screening uptake is at an all-time low, with marginalised women at greatest risk despite cervical cancer being preventable with HPV vaccination and smear tests.

The number of high-profile maternity scandals in recent years reflects a flawed system, where the annual amount spent on litigation costs by NHS Resolution exceeds the allocated total funding for maternity care.

Maternal mortality is three times higher in Black women and twice as high in Asian women, with suicide now a leading cause of direct maternal death, one in four among teenage girls.

According to Regan, many of those are known to mental health services.

“In the last maternal mortality report, every single woman who died was known to mental health services,” she said.

“I have to conclude that we let them down.”

Regan also highlighted gender disparities and inequalities in chronic health conditions, which often go undetected or misdiagnosed in women.

Conditions like Parkinson’s and Alzheimer’s, for example, present differently in females, who are twice as likely to be diagnosed with dementia.

And while women are twice as likely to die from cardiovascular disease as from cancer (52 per cent deaths annually), they are often diagnosed later than men, due to a lack of understanding of their symptoms.

Major causes of morbidity and mortality, frailty and osteoporosis, also disproportionately affect women.

More than a fifth of females (21 per cent) are affected, compared to six per cent of men, with women typically experiencing twice as many fractures.

There are vast geographical inequalities, too.

Every year, 500,000 fragility fractures occur throughout the UK, but less than 53 per cent of the population can access Fracture Liaison Services in the community, with quality and standards varying significantly.

“Until very recently, most politicians across the globe viewed women’s health as maternity,” said Regan.

“But women spend most of their lives post-reproductive, and we have never really catered for that… We’ve got to look after women’s health across their life course.”

Delivering on women’s health hubs

The Women’s Health Strategy, first published in 2022, was shaped by the largest ever call for evidence in a Department of Health consultation, gathering a total of 100,000 responses. Out of these, 84 per cent of women reported not being listened to by healthcare professionals.

In response, the strategy set out a six-point plan which promised to address these inequalities, including through the establishment of women’s health hubs.

Regan believes hubs are crucial for delivering on the promises of the 10-year plan, including shifting from hospital to community care, moving from analogue to digital, and pivoting from treatment to prevention.

Successful case studies from hubs in some of the most deprived areas of England have demonstrated early benefits of these hubs, including reduced secondary-care referrals, shorter waiting lists, improved access and equity, workforce retention, more specialised training, and fewer adverse outcomes.

But not all Integrated Care Boards across England are offering all core services.

Delivering more Women’s Health hubs is part of a five-point plan moving forward, according to Regan, which also includes improving maternity and menstrual care, tackling inequalities and funding more research.

“We’ve continued to admire the problem, but that’s what we’ve got to stop,” Regan said.

“The most important thing to be able to do things better is that you have to be willing to do it differently.”

A “front door” for change

Building on this, Regan expressed her “frustration” at some of the challenges faced by startups trying to bring solutions to market, hinting at plans for a hub or a “big front door” to streamline regulatory approval processes.

“Almost every time I talk to entrepreneurs or investors, they tell me the same story: ‘We’ve been knocking on the door of government, and we always get pushback’,” she said.

“I want to paint that door bright yellow so you’ll never miss it, and when it opens, I want people to be welcoming. We need to stop sending people off to navigate endless pathways. There should be a hub that sorts it.”

Benefit to the UK economy

There’s a strong economic argument for the UK government to deliver on these promises.

Global life expectancy is increasing, and while women typically live longer than men, they spend more of their lives in poor health.

A woman will experience ill health for an average of nine years throughout her life, impacting her ability to be present and/or productive at home, in the workforce, and in the community.

Regan shared analysis from McKinsey Health Institute, which shows that more than half of the women’s health gap affects women during their working-age years, significantly impacting the UK’s GDP.

At least 56 per cent of Disability-Adjusted Life Years stem from conditions which impact women differently or disproportionately.

Taking this into account, closing the gender health gap in the UK could generate more than £36bn in annual GDP by 2040, a figure that could exceed $1 trillion globally.

A 2024 report published by the NHS Confederation estimates that the economic cost of absenteeism due to severe period pain and heavy periods, alongside endometriosis, fibroids and ovarian cysts, is nearly £11 billion per year, while 60,000 women are thought to be unemployed due to menopause symptoms.

The findings suggest that for every additional £1 invested in obstetrics and gynaecology per woman in England, the return on investment is estimated at £11.

Dutch collaboration

Regan has now been invited to the Netherlands to help officials there develop their own Women’s Health Strategy.

In conversation with Dutch Minister Judith Tielen, Regan highlighted the need for international collaboration to accelerate wider global change when it comes to women’s health.

The Netherlands is already collaborating across ministerial department’s including employment and social security, with education next.

Tielen shared the outcomes from an initiative at Amsterdam University Medical Centre, which offered free gynaecology consultations to female staff to reduce sick leave.

“Hundreds of women signed up in days, and sickness absence dropped significantly,” she said.

“It’s a societal question, not one for women to solve alone.”

Regan agreed, adding: “We cannot afford for women not to be part of the solution.”

Entrepreneur

Flex partners with Clue on HSA and FSA access

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Flex partners with Clue to make Clue Plus eligible for HSA and FSA spending in the US, letting users pay for menstrual health tools with pre-tax funds.

HSAs and FSAs are US pre-tax accounts for eligible health costs. Announced on 16 December 2025, the move makes Clue Plus available via these benefits, with Flex citing potential savings of 30 to 40 per cent.

Clue Plus offers personalised cycle tracking, deeper analysis, advanced predictions and hormone insights, with options for pregnancy and perimenopause. It includes 12-month forecasting and clinician-backed guidance.

“At Clue, our mission is to empower women and people with cycles with trustworthy, science-based information about their menstrual and reproductive health,” said Rhiannon White, CEO of Clue. “Partnering with Flex allows us to make Clue more accessible to the millions of people who rely on our app for insights into their bodies. We’re thrilled to expand access through HSA/FSA eligibility.”

Flex says more than US$150bn is held in HSA and FSA accounts, and the partnership brings reproductive health purchases into standard benefits checkout.

“At Flex, we believe everyone should have affordable access to women’s healthcare,” said Sam O’Keefe, CEO of Flex. “After my own pregnancy and postpartum experience, I saw firsthand how confusing and hard to navigate women’s health can feel. Making Clue eligible for HSA and FSA spending is one way we are helping more people use their pre-tax dollars to access tools that provide meaningful data and insights into their health.”

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Insight

Menopausal hormone therapy may not increase breast cancer risk in women with BRCA mutations

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HRT (hormone replacement therapy) may not increase breast cancer risk in women with BRCA mutations, new research suggests.

Women who inherit harmful mutations in the BRCA1 or BRCA2 genes, which help repair DNA, face elevated risks of ovarian and breast cancer.

They are often advised to have their ovaries and fallopian tubes surgically removed (bilateral salpingo-oophorectomy, removal of the ovaries and fallopian tubes) at relatively young ages to reduce ovarian cancer risk, but this brings on early menopause.

The study was led by Joanne Kotsopoulos, a scientist at the Women’s College Hospital Research and Innovation Institute and a professor at the Dalla Lana School of Public Health at the University of Toronto in Canada.

She said: “We cannot simply recommend a drastic surgery like oophorectomy for young women without offering a way for them to manage the well-established short- and long-term outcomes of surgical menopause.

“I believe we should educate patients and their health care providers on how we can safely balance the risks and benefits of MHT use to ensure longevity and improve quality of life.”

She noted there has been reluctance and misinformation regarding HRT, largely due to studies in the general population showing an association between HRT use and increased breast cancer risk.

The researchers conducted a matched prospective analysis, an observational design that pairs similar participants to mirror clinical trial conditions.

They created 676 matched pairs of women who did and did not use HRT after menopause.

Participants were matched by BRCA1 or BRCA2 status, birth year and age at menopause. The women ranged in age from 22 to 76, with an average age of 43.8.

Patients with a history of cancer, those who had received a bilateral mastectomy (removal of both breasts), and non-menopausal patients were excluded from the study.

After an average follow-up of 5.6 years, breast cancer cases were significantly lower in women who used HRT, with 87 cases in the HRT group compared with 128 cases in the non-HRT group.

Analysis by formulation showed most types of HRT were not associated with breast cancer risk.

However, two formulations were linked to decreased risk. Women who received oestrogen-only HRT were 63 per cent less likely to develop breast cancer than those who did not use HRT.

Of the 43 women who received conjugated oestrogen and bazedoxifene (a selective oestrogen receptor modulator), none developed breast cancer.

“Although based on smaller numbers, this is definitely an exciting and interesting area for future research,” Kotsopoulos said.

“Hypothetically, conjugated oestrogen and bazedoxifene could be used to mitigate breast cancer risk by avoiding progesterone, which is thought to be the breast cancer risk-associated component of MHT. Future trials will be necessary to test this hypothesis.”

There were no significant differences in results between BRCA1 and BRCA2 carriers.

“Our findings suggest that clinicians should take a personalised approach to menopause management for women with BRCA mutations who are suffering from the impact of surgical (or natural) menopause, if there are no contraindications for them,” said Kotsopoulos.

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Motherhood

Most Americans not aware midwives provide care beyond pregnancy, study finds

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Most Americans are unaware that midwives provide women’s healthcare beyond pregnancy and birth, a new survey has found.

The survey of 1,006 Americans found that 93 per cent think midwives only deliver babies and were surprised to learn they can be a trusted partner in all aspects of women’s health.

The research was conducted by The Ohio State University Wexner Medical Center. It found that only one in five Americans are aware midwives can provide women’s annual gynaecology exams.

Michaela Ward, a certified nurse-midwife at Ohio State Wexner Medical Center, said: “We take care of women across the lifespan. We are highly trained and we’re highly skilled.

“We can take care of you even if there is something more complex about you or your health.

“If I need to consult with one of our physicians at Ohio State, I can call them right away and discuss the patient’s case.

“We all work together to provide the best care possible for our patients.”

While services such as pregnancy and birth support and water births were correctly identified as midwife services by over half of adults, other services like medication management, menopause care and annual women’s health exams are known by far fewer.

Both men and women were equally unaware of the full breadth of services provided.

Survey respondents’ knowledge of women’s health services provided by midwives included pregnancy and birth support (93 per cent), water births (69 per cent), medication management including birth control (26 per cent), menopause care (23 per cent), annual women’s health exams including pap smears and STI testing (20 per cent), caesarean sections (13 per cent) and ‘don’t know’ responses (1 per cent).

According to the Department of Health and Human Services, the US is expected to face a significant shortage of obstetrician-gynaecologists in the next five years.

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