Providing better care and support for women by recognizing the impact of sex and gender

Women’s health: Beyond diagnosis, inequalities persist

Once the illness is diagnosed, inequalities in the care pathway between sexes persist, revealing deep structural differences. Women are too often faced with the trivialization of their symptoms: 38% declare that their pain has already been minimized, and 20% claim to have been pressured into unwanted interventions. Endometriosis, which affects about 10% of women, illustrates these biases: it takes on average 7 years to diagnose it, despite chronic pain that can lead to up to 31 days of sick leave per year. This delay is not due to a lack of medical knowledge, but to an underestimation of female suffering.¹Femtech Market Size & ; Outlook, 2030. (2025, 20 mai). https://www.grandviewresearch.com/horizon/outlook/femtech-market-size/global

The report of the High Council for Equality between Women and Men (2020), emphasizes that these inequalities result from gender biases deeply rooted in the caregiver-patient relationship. It states that taking sex and gender into account in health policies is not optional but essential to guarantee a fair, effective and truly inclusive medicine.

Why are women, in general, less well cared for than men?

Gender stereotypes and socio-cultural biases

Beyond diagnostic delays, socio-cultural biases and gender stereotypes also have a major impact on the medical care of women. Indeed, these representations influence the choice of treatments, both at the time of prescription and with regard to the place and role that women occupy in the healthcare system.

Gender stereotypes deeply influence medical prescription practices, to the detriment of women. With equivalent symptoms, they more often receive anxiolytics or antidepressants, while men benefit more from technical tests or treatments. These differences, not scientifically proven, reflect a tendency to psychologize women’s complaints. The management of pain is a striking example: perceived as exaggerated or emotional in origin, it is less well treated in women, who wait longer to receive a painkiller, despite more frequent and intense pain. These inequalities reveal a persistent perception bias, with very real clinical consequences.

A societal bias, often discreet but deeply rooted, still predominantly associates women with the role of caregivers: nearly 60% of caregivers are indeed women. This overrepresentation is explained by social expectations that place them “naturally” in caregiving roles, without this implicit norm being truly questioned.²Revue Médicale Suisse, Médecine et genre : quels enjeux pour la pratique ? ; Medicine and gender: which challenges for clinical practice ?, 2018, https://www.revmed.ch/view/421088/3658378/RMS_625_1951.pdf However, this caregiver role is not without consequences on the health of those who assume it. On the one hand, it implies a significant mental, physical and emotional load, rarely taken into account in care pathways: only 13% of caregivers report being questioned about their own health. On the other hand, this commitment can lead to a real abandonment of their own medical follow-up: 31% claim to neglect their own health because of their role.³Matmut. (s. d.). Infographie : cinq chiffres clés sur les aidants en France. https://www.matmut.fr/mutuelle/conseils/cinq-chiffres-cles-aidants-france

Thus, women, who are more exposed to this caregiver role, suffer its effects on their health. It is therefore essential to fully recognize this reality in health policies, so that their commitment is no longer made at the expense of their health.

Little-known or underestimated female diseases and/or specificities

Female specificities are still too often underestimated, not only in treatment research, but also in their clinical application. This is particularly striking in the management of pain. Some painful pathologies, such as fibromyalgia, migraines or musculoskeletal disorders, affect women more. More frequent, more intense pain… and yet less well managed: these chronic pains are often more pronounced in female patients, partly due to hormonal factors. For example, it is suggested that estrogens increase sensitivity to pain, while testosterone, more present in men, play a mitigating role.

Despite these findings, biological differences in painkiller treatments are still ignored. In vivo experiments on animal models, conducted at the Institute of Cellular and Integrative Neurosciences in Strasbourg, have shown  that morphine is less effective in females, which require higher doses and develop tolerance more quickly. This research shows that nociception mechanisms, which regulate the perception of pain, vary according to biological sex.⁴Douleur : la sensibilité dépend du sexe · Inserm, La science pour la santé. (s. d.). Inserm. https://www.inserm.fr/actualite/douleur-la-sensibilite-depend-du-sexe/ It is therefore essential to integrate these differences in the design and administration of painkiller treatments, in order to improve their effectiveness and reduce side effects.

A strong need for multidisciplinary coordination

Women’s health relies on essential but fragile multidisciplinary coordination, due to their hormonal and physiological specificities, often poorly taken into account in traditional care pathways. This necessary multidisciplinarity, however, faces difficulties in practical implementation. Thus, in the follow-up of breast cancer, neuropathic pain requires close collaboration between gynecologists, oncologists and neurologists. Yet this synergy is too often absent, delaying appropriate and effective management. Willebrand disease also illustrates these challenges. Often revealed by heavy periods, it is still frequently underdiagnosed due to the taboos surrounding menstruation. This symptom requires a multidisciplinary approach, with gynecologists on the front line, as they must mobilize hematologists and general practitioners to make the diagnosis. Without coordination between these specialties, the care pathway is unnecessarily prolonged , to the detriment of appropriate management.

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3 initiatives from committed players for fairer health between men and women

Faced with persistent inequalities in women’s care, certain players – institutions, health professionals and pharmaceutical industries – are committed to changing practices. These initiatives, both activist, educational and structural, each respond to a key issue: raising awareness among caregivers, mobilizing public opinion, and adapting medical tools to women’s specific needs. Three concrete examples of this dynamic are presented below.

Initiative n°1: The differentiated approach of HAS to train and raise awareness among caregivers

The memo sheet published by the Haute Autorité de Santé (HAS) in 2025 on the management of overweight and obesity in women illustrates the importance of recognizing physiological specificities (hormonal cycles, menopause, pregnancies) and social factors (aesthetic pressure, mental load, precariousness) in medical practices. Besides the “Sex, gender and health” report published in 2020 and certain targeted initiatives, notably in the field of cardiovascular diseases where differences in care between men and women have been highlighted, it is one of the first HAS recommendations entirely centered on a gendered approach. By encouraging professionals to adapt their communication and treatments, this recommendation marks a turning point in the  thinking around the so-called “mixed” medicine. It shows that even in pathologies common to all, a gendered reading improves care quality.

Initiative n°2: An activist campaign around endometriosis to mobilize public opinion

In 2016, gynecologist Chrysoula Zacharopoulou launched a national campaign to break the silence around endometriosis, long ignored despite its high prevalence. This initiative made it possible to bring the pathology out of the private sphere to make it a public health priority. Her action, relayed by institutions, the political world and even some industrial players, helped bring this disease to light as a real public health issue. This mobilization shows the impact that coordinated commitment can have on collective representations and health policies.

Initiative n°3: Roche’s campaign on lung cancer in women to reinvent representations

Another example of commitment is that of the pharmaceutical laboratory Roche, which led a targeted awareness campaign on lung cancer in women in 2021. This cancer, historically associated with male smoking, is increasingly affecting women. Its principle: go follow as many women aged 25 to 40 as possible on Instagram during No Tobacco Month. The account @lecancerdupoumon, created for the occasion, sends the notification “Lung cancer has started following you”. Roche contributes to a redefinition of collective representations and to better consideration of female clinical realities. This initiative shows that the pharmaceutical industry can also be a lever of transformation, by rethinking its strategies and products around the specific needs of female patients.

Inequalities in care between women and men originate from deeply rooted gender stereotypes, which still influence medical practice today: trivialized pain, psychologized suffering, inappropriate treatments. But these biases, however systemic they may be, can be dismantled. Raising awareness among caregivers, better informing female patients, adapting treatments to female realities: the levers exist, but must be activated. Health industries have a major role to play in this transformation, for example by rethinking their products, their campaigns or their services integrating sex and gender specificities. Because treating fairly also means innovating differently, we can be at your side to support you, do not hesitate to contact our team!

About the author,
Eve, Consultant within the Health team at Alcimed in France