Women’s mental health, long overlooked, has become an increasingly prominent social issue — particularly since the Covid-19 pandemic. According to the Baromètre Santé 2021, 17% of women aged 18 to 75 reported experiencing a major depressive episode, compared with 10% of men in the same age group1https://www.santepubliquefrance.fr/les-actualites/2024/des-inegalites-de-sante-persistantes-entre-les-femmes-et-les-hommes. What are the specific challenges affecting women’s mental health?
In 2021, a study by Santé publique France revealed a 36% increase in depressive disorders compared with 2010 data. These findings highlight the urgency for pharmaceutical companies to place mental health at the center of their industrial and research strategies.
Building on this observation, Alcimed is publishing a series of articles examining the various challenges linked to mental health — focusing on three key areas: obesity, rare and chronic diseases, and women’s health. In this first installment dedicated to women’s health, Alcimed explores the three main challenges associated with improving mental health care for women.
For more than fifty years, mental health has been a growing focus in public health policy. As the use of anxiolytic and antidepressant medications continues to rise (with prescriptions increasing between 5% and 13% since COVID-19)1https://ansm.sante.fr/actualites/usage-des-medicaments-de-ville-en-france-durant-lepidemie-de-covid-19-point-de-situation-jusquau-25-avril-2021, gender as a social determinant of mental health has become a central topic in public policy discussions.
According to a 2022 report from the French National Assembly on women’s mental health, women are on average twice as likely to suffer from disorders leading to the prescription of psychotropic drugs (anxiolytics, antidepressants, hypnotics, etc.): 10.71% of women versus 6.05% of men2https://www.assemblee-nationale.fr/dyn/16/rapports/ega/l16b1522_rapport-information.pdf. This gap is also observed in the workplace — Santé publique France reports that work-related psychological distress affects 6% of women compared with 3% of men.
Several factors contribute to this disparity, including greater hormonal fluctuations in women, the existence of female-specific diseases that remain under-studied, and environmental and societal pressures that disproportionately affect women — such as mental load, sexual violence, and gender-based discrimination.
Female hormones such as progesterone and estrogen play key roles in regulating the menstrual cycle and pregnancy. However, these hormones can also significantly affect mental health throughout a woman’s life. From puberty to menopause — including premenstrual and pregnancy periods — fluctuating hormone levels can cause anxiety and even depression.
Postpartum depression, for instance, is one of the most common complications after childbirth and one of the leading causes of suicide in cases of maternal mortality. Although its causes are not yet fully understood, two biological hypotheses help explain its onset: the fluctuation of steroid hormones (estrogen and progesterone) and abnormal activity of the hypothalamic-pituitary-adrenal (HPA) axis.
During the third trimester of pregnancy, steroid hormone levels increase by a factor of 10 to 50. The HPA axis — responsible for regulating hormonal balance in response to stress — becomes overstimulated. After childbirth, hormone levels drop sharply, disrupting this balance and potentially triggering major depressive episodes that, in severe cases, can lead to suicide.
Recent studies suggest that neurosteroids could be promising treatments for postpartum depression. However, overall mental health support for women during key life stages remains inconsistent. Facilitating early screening and providing targeted mental health support during hormonally vulnerable periods is therefore a major challenge. Automating and reimbursing specific consultations at key ages could represent an important step forward.
Learn more about how our team can support you in your projects related to women’s health >
Several conditions associated with female biology can have significant psychological repercussions — notably endometriosis and polycystic ovary syndrome (PCOS).
Endometriosis, which affects around 10% of women of reproductive age3https://www.inserm.fr/dossier/endometriose/#:~:text=2019-,L’endom%C3%A9triose%20en%20chiffres,de%2050%20ans%20et%20plus, remains insufficiently studied despite its prevalence. Diagnosis is often delayed by an average of seven years4https://sante.gouv.fr/IMG/pdf/strategie-endometriose.pdf, potentially leading to irreversible damage. Symptoms such as painful menstruation, painful intercourse, urinary or digestive disorders, and infertility can all contribute to psychological distress and anxiety.
Beyond physical symptoms, psychological suffering can stem from fear of pain, anxiety about having to justify one’s symptoms, or concerns about infertility. These factors — combined with chronic fatigue — may result in social withdrawal and depression.
Because diagnostic delays are a major cause of this distress, improving knowledge of female-specific diseases is key to better physical and psychological care. Public-private partnerships focused on raising awareness and educating the population about women’s health issues could greatly enhance understanding and, ultimately, patient outcomes.
Read also: Endometriosis research, from breaking the taboo to challenges to overcome
Beyond physiology, societal factors have a significant impact on women’s mental health.
These include mental overload in personal and professional life (often leading to burnout), sexual and domestic violence, economic insecurity, discrimination, and workplace harassment.
Burnout — characterized by physical, emotional, and mental exhaustion — is more common among women due to the dual pressure of professional and personal responsibilities. While women continue to handle most household duties, they also increasingly occupy positions of higher responsibility, which amplifies the risk of exhaustion. Symptoms can include sleep disorders, cramps, migraines, dizziness, and eating disorders such as anorexia.
Other social and environmental factors can also have severe psychological consequences. According to the Baromètre Santé 2016, 19% of women aged 18–69 reported having experienced forced or attempted forced sexual intercourse in their lifetime, compared with 5% of men5https://www.santepubliquefrance.fr/les-actualites/2024/des-inegalites-de-sante-persistantes-entre-les-femmes-et-les-hommes. Such disparities in intimate experiences can lead to long-term psychological trauma.
Economic and social inequalities experienced by women in both their professional and personal lives have a direct impact on their quality of life and mental well-being. Establishing safe spaces for dialogue and support, as well as workplace well-being policies that specifically address women’s mental health, would be key first steps. Additionally, funding free psychological support programs could help women in precarious situations access the care they need.
Although gender inequalities are gradually narrowing, physiological and social differences persist. Due to their biology, women experience hormonal fluctuations that affect their daily lives — from puberty and pregnancy to postpartum and menopause. They also face unique medical conditions such as endometriosis and PCOS. Combined with environmental, economic, and social inequalities, these factors make women’s mental health a major public health issue that requires coordinated, multidisciplinary action.
Comprehensive mental health care must involve all stakeholders — from healthcare professionals and patient associations to pharmaceutical companies, HR departments, and policymakers.
Alcimed supports organizations in developing innovative projects related to mental health and the understanding of female-specific challenges. Don’t hesitate to contact our team!
About the author,
May-Lise, Consultant in Alcimed’s Healthcare team in France
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