Bridging the Gap in Women’s Health: The Truth About Hormone Therapy and Menopause Treatment

The Gender Gap in Women’s Health Research and Treatment

For decades, women have been underrepresented in clinical trials, leading to significant gaps in understanding female-specific health concerns and limiting treatment options. [1] ​This disparity has real consequences—women spend 25% more time in poor health compared to men.[2] This lack of representation has particularly impacted hormone therapy advancements, leaving many women without clear, evidence-based treatment pathways.[3]

One striking example is testosterone therapy. Despite its natural role in female health, there are no FDA-approved testosterone treatments for women in the U.S, [4], even though research supports its potential benefits for bone density and muscle mass, cognitive function, mood, sexual function, and energy. [5] In contrast, multiple FDA-approved testosterone treatments exist for men, underscoring the gender imbalance in hormone research and regulatory approval.

A key barrier is the lack of financial incentives. Since testosterone is a generic medication that cannot be patented, pharmaceutical companies have little motivation to fund the long-term, costly studies needed for FDA approval. This has slowed progress in expanding treatment options for women.

The Misunderstood Risks of Hormone Therapy

The Women’s Health Initiative (WHI) study, conducted between 1993 and 1998, enrolled 161,808 racially and ethnically diverse postmenopausal women across 40 U.S. clinical centers. [6] The study assessed the impact of menopausal hormone therapy, diet modifications, and calcium/vitamin D supplementation on chronic diseases like cardiovascular disease (CVD). [6]

In 2002, a WHI study on hormone replacement therapy (HRT) was prematurely halted due to concerns over increased breast cancer and cardiovascular risks. [7] This led to widespread fear, causing many women and healthcare providers to abandon HRT. [8]

However, subsequent research has painted a more nuanced picture. The risks of HRT depend on factors such as age, dosage, delivery method, and timing. For women under 60 or within 10 years of menopause onset, the benefits often outweigh the risks. [9] [14] Additionally, studies suggest that women using estrogen-only therapy did not experience an increased risk of heart disease or breast cancer, though further research is needed to assess the long-term effects fully. [10]

Why This Matters: The Long-Term Health Impact

Beyond symptom relief, untreated menopause symptoms have been linked to osteoporosis [11] and neurodegenerative diseases, including long-term health risks. [12]

Yet, outdated package warnings [13] and misconceptions continue to deter women from considering HRT. Leading organizations, including The Menopause Society, now emphasize that for most women under 60, the benefits of HRT outweigh the risks. For women over 60, individualized risk assessments are essential, as HRT risks may increase with age.

The Bottom Line: Women deserve personalized, evidence-based care, not fear-driven avoidance.

The Future: Bridging the Research and Treatment Gap

The path forward requires:

• Greater representation of women in clinical trials to ensure treatment options reflect real-world needs.
• Clear education on HRT’s true risks and benefits to dispel outdated fears and misconceptions.

In 2024, the documentary “The [M] Factor: Shredding the Silence on Menopause“ spotlighted real-life struggles faced by women navigating menopause. Through personal stories, the film exposes systemic barriers, including racial biases, gender-ignorant care, and research gaps in women’s health.

Shifting the conversation from fear to facts empowers women to make informed health decisions and access the treatments they deserve.