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  • Sep 13, 2025

'One Size Doesn't Fit All': The Gender Gap in Medical Research

Have you ever seen or read anywhere that ‘the most common symptom of a heart-attack is chest pain for everyone’? Well, that’s only half-true, because sure, the most common symptom is chest pain for men, but not women. Women are more likely to experience shortness of breath, nausea, or even jaw pain before getting a heart-attack, causing their symptoms of a heart-attack to be misdiagnosed 50% of the time. 

Have you ever heard people saying ‘she’s just being dramatic’ or ‘she’s just too weak’ or ‘it’s just in your head’ about a woman who is in pain, and then dismissing it? Have you, or a woman you know, ever been in a lot of pain (because of cramps, headaches, backaches, etc) and the painkillers don’t help much?

Why is it that women with severe stomach pain have had to wait for almost 33% longer than men with the same symptoms in the ER?

Because of the gender gap in medical research.
Because ‘one size does not fit all’, even in medicine. 

Although women tend to live longer than men, statistics show that women live 25% more of their lives in poor health. This is because historically, there has always been a gender gap in medical research, even though half the population of our world is female. The reasons for this include: people viewing men’s bodies as the ‘norm’ and women’s as ‘atypical’, women being excluded from trials, and the underfunding in women’s research. Another main reason for the under-representation of women in medical research is that even if women were included in the experiments or research, studies would rarely break down the data by sex or gender, so the results would end up not giving much useful information for health impacts on women anyway. 

During the 1970s, new policies were introduced that deterred women from taking part in medical research, and this was because of the sad story of the use of drug ‘Thalidomide’. Thalidomide is a sedative (medication that slows down the central nervous system) and was used widely in the European countries. 

However, women that took the drug while pregnant gave birth to babies with limb deformities. Due to this, the drug was never approved for use in the US, although it is still used for treating cancers. This led to a rise in fear in both women and researchers on the effects of drug trials in medical research for women. People were scared that the drug trials could mess up with their hormones (or that the hormones could mess up with their research results) and cause birth defects. This is why new policies were introduced that advised and deterred women against taking part in clinical trials, and  women were less likely to take part in medical research anyway because of their responsibilities at home, or because their family was against it. The policy recommended all women to be excluded from clinical trials - even women who were taking contraceptions, women who were single, and women whose husbands were vasectomised. 

Although it is understandable why the ‘Thalimodide Story’ would cause researchers and scientists to be more cautious with women in medical research, it doesn’t justify the fact that all women were excluded from clinical trials - even those that could take part in the research, and women should have the choice in taking the risk of participation, just as men did. The policies also don’t justify the fact that women were excluded from trials for decades, just based on the assumption that men are representative, that their results can be generalised, and that ‘one size fits all’.

So why does equal representation of men and women in medical research matter so much? 


Women and men’s bodies are quite different by many factors such as hormones, body composition, metabolism,disease prevalence, and drug responses.
Unlike men, women experience hormonal fluctuations throughout their menstrual cycle and pregnancy, which can affect the risks and impacts of diseases and drugs. Women’s sex hormones (Oestrogen and progesterone) also impact bone density and cardiovascular health. Menopause, a huge physiological transition in a woman’s life, also leads to various health changes such as heart and bone health, brain function, sleep patterns, hormones and more heart diseases, certain cancers, and osteoporosis, yet we still don’t know everything about menopause yet. All of these aspects lead to differences in a woman’s body compared to a man’s, such as:


- Women have a higher % of body fat and lower % of muscle mass, compared to men, which influences metabolism and drug absorption (leading to variations in drug efficacy and side effects)
- Women usually have lower blood pressures than men, and a higher heart rate
- Due to the hormonal fluctuations in women, they are also more prone to developing autoimmune diseases.

Some may argue that there are so many differences in a female’s body that it is hard to conduct research on them anyway, but that is all the more reason as to why there should be more trials that are conducted on women to understand their bodies better. All of these differences in a male and female’s body only emphasise the importance of equal representation of both genders in medicine to improve everyone’s lives, not just half the population.

The good news is, we have made some progress since the 1970s in doing more research on women’s health. Government policies now require the inclusion of women in medical research, however these policies are not strictly enforced.

 Because of COVID-19, it was discovered that male and female immune systems are also different - males were much more likely to ‘die’, while females were more likely to survive but develop ‘Long Covid.’ 

Due to more research, there is also new technology that can quickly detect breast cancer.
In 1991, the Women’s Health Initiative (WHI) study enrolled 161,000 women to study whether menopausal hormone therapy (MHI) could reduce the risk of cardiovascular diseases. Because of this study, we were able to find a bit more about the different effects of different hormones and hormone replacement therapy in a woman’s body. However, Dr Primavera  Spagnolo says, “female-exclusive conditions such as menopause and endometriosis are not the focus of a lot of research, especially translational research where discoveries are translated into products and treatments’, and that menopause is still very under-studied because it is something that only affects women. (Colino, 2024) For example, it take 7-8 years on average for a woman to be diagnosed with endometriosis (another condition that can only affect women).


The NIH (National Institute of Health) has uncovered useful information about how diseases and conditions affect women differently, and how biological and social factors influence multiple diseases, however researchers still neglect separating their results of males and females.

The first step to overcome this issue is changing the mindsets of everyone, including doctors themselves. Unfortunately, there still exists “medical misogyny” as it was uncovered that ‘⅔ of females nationwide have encountered gender bias or discrimination in healthcare’, usually being referred to as ‘hysterical’ when seeking treatment for a range of symptoms, which has even led to some women being misdiagnosed, such as in Nadiah Akbar’s story. (Ritchie, 2024)

The gender bias and belief of ‘delivered by and designed for men’ has been in medicine for centuries, and is still engraved in modern medicine. In the past, women’s pain was attributed to emotional causes rather than biological, and that is something still many people tend to unconsciously think.

A lot more work needs to be done a lot quicker to make up for the decades of lost time. 

Good healthcare for all everywhere is a UN Goal and a global priority. By making sure women are also receiving specialised healthcare can make a huge social and economic impact in countries worldwide, and we can simply resolve this by funding more medical research for women, and enforcing stricter rules on separating results of males and females during clinical trials, rather than generalising.

On more local ground, we can help by standing for equity, putting pressure on governments, spreading awareness and educating about this gender discrimination (as it tends to be overlooked), and calling out gender bias by healthcare professionals. 

We can change this flawed part of our system by working together, and bring a tremendously positive, necessary change. Even if one size doesn’t fit all, an equitable society definitely fits all.

References

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