Defining Women’s Health

Women’s health is designed for all people who need it.

But what does that big, broad statement actually mean? There’s a lot of history behind the effort to provide safe and affirming care to women of all backgrounds.

Much of what we discuss when we address women’s health concerns is rooted in reproductive health, mental health, self-care and equal access to medical services. But is there even more that’s a part of women’s health? And what can you do to be sure you get the best care? Let’s talk about it.

Urogynecologist Cecile Ferrando, MD, MPH, explains more about what women’s health means, who it applies to and ways you can continue to put your needs first.

What is women’s health?

Women’s health is a relatively new area of study. When you consider the great span of medical science, most medical research has been historically centered around male bodies. For some, that may be a little shocking to learn. But it’s only within the last several decades that women have been truly included in clinical research — the methods used to study and advance medical treatments.

Women’s inclusion in clinical research

In 1993, the National Institutes of Health (NIH) passed the Revitalization Act that required the inclusion of women and racial/ethnic minorities in NIH-funded clinical research. The reason is that prior to that passing, women and ethnic minorities were largely excluded from clinical trials even in their earliest stages.

And it wasn’t until 2016 that the NIH passed a policy stating sex was a biological variable that needed to be factored into studies of both animals and humans. This meant that biological sex differences needed to be considered from the earliest stages of developing research questions and designing studies, all the way through analyzing the results and reporting on published work.

Translation: The NIH determined that sex has a direct impact on your overall health and, therefore, should be taken into consideration when we make decisions about how we develop and advance medical treatments.

And yet, research shows that women are still underrepresented in the earliest phases of clinical trials, where men make up 64.1% of the subjects studied.

“Women are just the tip of the iceberg,” says Dr. Ferrando. “Ethnic minorities and individuals of color are really underrepresented in research, too. A lot of studies also exclude those who are trying to conceive or have the potential to become pregnant.”

How sex impacts your health outcomes

“We know physiologically, females and males are different in some respects,” says Dr. Ferrando.

For example, women have an increased risk of breast cancer and Alzheimer’s disease compared to men. Other conditions that affect women differently include:

• Stroke
• Heart disease and heart attacks
• Urinary tract infections (UTIs)
• Chronic pain
• Depression and anxiety

One 2019 study of 6.9 million Danish people found that women were diagnosed much later than men for more than 700 conditions. On average, women were diagnosed with cancer two-and-a-half years later in life than men with the same diagnosis. And for metabolic diseases like diabetes, women received a diagnosis four-and-a-half years later.

The researchers couldn’t determine the direct cause for any delay in diagnosis, and the study looked only at people who were hospitalized who had access to a single-payer healthcare system. But we know that women, especially women of color, have a long history of dealing with healthcare disparities, leading to an increase in undiagnosed or misdiagnosed conditions.

That’s why it remains so important for women to continue to advocate for themselves in the healthcare space. By being direct about how you’re feeling, the symptoms you’re experiencing and the concerns you have when speaking with a healthcare provider, you can help minimize the potential for misdiagnosis.

Who does women’s health apply to — and what services are included?

Historically, women’s health has been designed to fill a gap in healthcare needed by people who were overlooked or excluded due to their sex. Areas covered by women’s health have traditionally included:

• Taking care of the female reproductive system from childhood through adolescence, reproductive ages and postmenopausal ages
• Treating pelvic floor disorders
• Treating cancers of the female pelvic organs (like cervical cancer) and breast cancer
• Providing care for adolescents as they go through puberty
• Reproductive health, pregnancy and postpartum care

Women’s health is also for anyone interested in fertility services, family planning and adoption. Ditto for those interested in birth control and anyone with concerns related to sexual health and sexually transmitted infections (STIs).

You may also be interested in women’s health services if you:

• Need preventive screening for breast cancer and cervical cancer
• Need assistance with hormone management
• Experience abnormal uterine or vaginal bleeding, or menstrual disorders
• Experience pelvic pain, sexual dysfunction, pelvic floor dysfunction and pelvic floor disorders like pelvic organ prolapse, or urinary and/or fecal incontinence
• Desire birth control to prevent pregnancy
• Need family planning and/or counseling about conception
• Are pregnant and need obstetric care
• Have absent or malformed female pelvic organs

A women’s health specialist is someone you can see on an annual basis for regular checkups. They can serve as your primary healthcare provider and address any concerns you have about your healthcare. And if they need to refer you to other specialists who can handle more specific concerns, they can do that, too.

Putting you first and the importance of mental health

Societal and cultural norms have too often dictated that women are caretakers first and individuals second. Often, women feel obligated to put others, children especially, before their own needs. It’s why we so often point out that women should put themselves first and not feel selfish about self-care.

In truth, everyone could use a little bit of self-care more regularly, even in small but powerful ways. By taking care of your mental health, and by advocating for your mental health needs in a healthcare provider’s office, you can improve your relationship with yourself, your healthcare provider and anyone important in your life. And women’s health providers, especially, are positioned to be empathetic and validating to your experiences.

If you have mental health concerns related to stress, depression, anxiety or just need a little bit of direction, a women’s health provider can refer you to a welcoming and affirming behavioral health specialist who can help with whatever you need. Because no matter how you show up in a healthcare provider’s office, you are valid. Your thoughts and your feelings matter.