Medicine Without Women

On the occasion of International Women’s Health Day on May 28, attention is being drawn to the insufficient consideration of the female body in medicine. While women statistically live longer, they spend more years in ill health and suffer greatly from diagnostic gaps. To ensure equitable care, the scientific community, policymakers, and medical professional associations are calling for the deep and structural integration of women’s health into clinical practice and, in particular, into pharmaceutical research.

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The Gender Health Gap: More Than Just Statistics

The term “gender health gap” describes a multidimensional interplay of biological (sex) and sociocultural (gender) differences that are inadequately reflected in current health care. As a result, the situation is different for older women: They are more likely to suffer from chronic diseases, multimorbidity, and a loss of physical function (RKI 2020).

In addition, psychosocial pressures such as the unequal distribution of care work (gender care gap) act as stressors. Intersectional data from the German Center for Integration and Migration Research (DeZIM, 2023) show that women with a migration background or who have experienced racism have a particularly high prevalence of depressive symptoms and anxiety disorders.

“Those who neglect women’s health pay the price twice: in human and economic terms. Every time women are sidelined, it highlights just how critical their health is to the system.”

Milanie Kreutz, Chair of the dbb Federal Women's Council (2026)

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The Role of the Pharmaceutical Industry: From the Male Standard to Personalized Medicine

One of the most serious causes of quality deficiencies in patient care is the so-called gender data gap in pharmaceutical and medical research. For decades, the male body—biologically standardized and free of hormonal cycle fluctuations—was considered the norm in clinical trials.

The result: Many established drugs on the market have not been adequately tested on women. Because women often metabolize active ingredients differently due to differences in metabolism, altered enzyme activity, and a different fat-to-water ratio in the body, this results in a significantly higher rate of drug side effects, some of which are severe (Göring 2022).

The symptoms of common widespread diseases also differ fundamentally: In women, a heart attack often presents with nonspecific symptoms such as nausea or shortness of breath rather than the classic chest pain. This still leads to delayed or incorrect diagnoses in everyday clinical practice.

‍The pharmaceutical industry is facing a profound transformation: The systematic integration of biological sex differences—from the initial preclinical laboratory phase through to market approval—is now evolving from a niche topic into a global quality standard. The shift away from the historically established “male standard” in medicine is increasingly beginning in the early stages. Whereas research used to focus almost exclusively on male cells and animal models, companies today routinely incorporate both biological sexes in a standardized manner. In Germany, this shift is being driven, for example, by the Association of Research-Based Pharmaceutical Companies (vfa) in close cooperation with the Institute for Gender Research in Medicine at Berlin’s Charité, with the aim of embedding gender-sensitive guidelines into everyday practice.

At the same time, regulatory pressure from above is growing, albeit under changed political circumstances: In the U.S., the Food and Drug Administration (FDA), acting under the federal FDORA law, continues to require binding action plans that oblige manufacturers to ensure the representative inclusion of women in clinical trials. Despite the policy shift under the current Trump administration—which has strictly shifted the regulatory focus from societal gender issues to purely biological sex differences—the legal obligation to differentiate medically between men and women remains unaffected.

Companies such as Roche, with its “Advancing Inclusive Research” initiative—which aims to accurately reflect the demographic reality of female patients in clinical trials— demonstrate that the industry has long since shifted its strategic focus in this area. Entirely new business models are even emerging, as evidenced by the Organon spin-off, which is firmly committed to closing gaps in women’s healthcare.

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"... Gender-sensitive health care could reduce the overall costs of the health care system by an estimated 10 percent."

Dr. Daniela Fliegner, physician and expert in gender medicine (Pfizer)

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Political and Medical Demands in 2026

Awareness of the economic and social consequences of the gender health gap reached the highest political levels in 2026. The loss of women from the workforce due to inadequate medical support exacerbates the already acute shortage of skilled workers and results in immense economic costs (dbb frauen 2026).

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Strategies at the EU Level

The European Gender Equality Strategy 2026–2030 elevates the issue of women’s health beyond the narrow confines of gender equality policy. In cooperation with the World Health Organization (WHO), targeted funding is now being channeled into studies on the social and economic impacts of life stages specific to women, such as menopause. At the same time, the Action Plan on Women in Research, Innovation & Startups aims to significantly increase the representation of female researchers in the medical technology sector by 2030.

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Key Areas of Focus in the German Healthcare System

The German Society for Gynecology and Obstetrics (DGGG) and the Professional Association of Gynecologists (BVF) are calling for structural reforms to ensure that women have access to comprehensive care close to home:

• Endometriosis & Menopause: These issues must be understood as distinct medical and scientific challenges and firmly incorporated into treatment guidelines.
• Ensuring Obstetric Care: Adequate funding must guarantee the continuous availability of obstetricians and pediatricians in hospitals. Integrating midwife-led delivery rooms directly into maternity hospitals provides maximum safety in emergencies.
• Prevention and Early Detection: Preeclampsia screening for pregnant women must be established as a universal preventive health service. Furthermore, funding for gynecological cancer screening and preventive vaccinations (such as the HPV vaccine) must not be reduced as part of hospital reforms.

"Women's health requires a medical approach that consistently takes into account the specific health challenges women face."

Prof. Dr. Barbara Schmalfeldt, Second Vice President of the German Society for Gynecology and Obstetrics (DGGG, 2026)

Brief background:

The International Day of Action for Women's Health takes place every year on May 28. It was established in 1987 to raise global awareness of women's specific physical and mental health needs, as well as their right to reproductive self-determination.

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