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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.”

Diagnosis

Being female not a universal stroke risk factor for patients with AF, study finds

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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.”

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Diagnosis

AI may help accelerate breast cancer diagnosis for high-risk women – study

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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.”

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Menopause

Infertility may be risk factor for early menopause, study suggests

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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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