Inadequate Healthcare for Women in the United States

By Grace Loveless

Published Winter 2025

Special thanks to Maile Villaroel for editing and research contributions.

Viewpoints published by Ballard Brief are not necessarily endorsed by BYU or The Church of Jesus Christ of Latter-day Saints.

Summary+

Barriers to adequate healthcare for women stem from a lack of research on their specific health needs, gender-based biases in healthcare, and harmful societal norms. One key aspect highlighting these disparities is the menstrual cycle—a topic unique to women. Menstrual health, defined as a state of complete physical, mental, and social well-being, illustrates the urgent need for greater focus on reproductive health. Despite its significance, the dialogue and knowledge about reproductive health remain limited, exacerbated by societal attitudes of secrecy and shame. These attitudes create barriers that hinder many women in the United States from accessing adequate healthcare. As a result, trust in healthcare providers has diminished, further widening the gap in care. The stigma surrounding menstruation and menopause perpetuates the avoidance of sensitive but necessary discussions, leaving many girls and women unprepared for these life transitions. Combined, these barriers can lead to severe consequences, including disproportionate disease effects and, in extreme cases, death. Addressing these issues requires greater education and open dialogue about menopause and menstruation to help women navigate these critical stages of life.

Key Takeaways+

• In 2007, 21% of adults in the United States experienced delayed care, among other nonfinancial barriers to healthcare. Approximately 51% of those adults who reported delayed healthcare were females.¹
• In an online survey collected in 2020, 42% of participants with polycystic ovarian syndrome reported feeling dissatisfied with their medical care.²
• In an analysis that extracted data from the year 2022, the United States was the leading country in maternal mortality out of thirteen high-income nations, with an average of 22 maternal deaths per 100,000 live births.³
• In an analysis of 266 articles in which reports on sex differences should have shown significance, 60% of articles reported that they found no significant sex differences.⁴
• At least one in four women experience the need for medical intervention regarding their menstrual pain.⁵
• In a survey released by the Female Founders Fund, 64% of respondents reported feeling unprepared for their menopause transition.⁶

Key Terms+

Avoidable Mortality—Deaths that could be prevented through the use of current medical knowledge and technology; also referred to as preventable death.⁷

Endometriosis—A chronic inflammatory disease where tissue similar to the uterine lining grows outside the uterus. This condition is often painful and affects around five to ten percent of the global female population.^8,9

Eumenorrhea/Eumenorrheic—What is considered to be regular menstrual cycles, which is classified as having cycle lengths between 21 and 35 days, 10 or more consecutive periods a year, normal ovulation, and regular hormonal fluctuations.¹⁰

Gynecology and Obstetrics (OB/GYN)—A subset of medicine specializing in women’s healthcare, including diagnosing and treating diseases affecting female reproductive organs. It also addresses other aspects of women’s health, such as menopause, hormone problems, contraception, and infertility.¹¹

Maternal Mortality—The death of women while pregnant or within 42 days of the termination of pregnancy, excluding incidental or accidental causes of death.¹²

Menopause—The stage in a woman’s life when she stops having menstrual periods and can no longer become pregnant.¹³

Menstrual Cycle—A monthly process for females post-puberty in which hormones fluctuate, stimulating an ovary to release an egg and thicken the lining of the uterus.¹⁴

Menstrual Stigma—The negative perception of menstruation and women who experience it.¹⁵

Menstruation—The discharge of tissue and blood from the uterine lining that occurs as part of monthly menstrual cycles in females during and after puberty and before menopause, also known as a period.¹⁶

Reproductive Health—The health of reproductive systems in the body, which include sex organs and hormone-producing glands during all stages of life.¹⁷

Sexual Harassment—Any act, comment, or advancement that disparages an individual or a group of one particular sex.¹⁸

Stigmatization—The labeling of someone to socially alienate them from society and isolate their experience.¹⁹

Context

Q: What specific detriments to women’s health are observed in the United States?

A: Two of the main issues surrounding women’s healthcare can be grouped into biological differences between sexes and social factors affecting gender.²⁰ These challenges are rooted in the lack of women's health research and the systemic sexism prevalent throughout US history.²¹

Biological differences between sexes are often unreported in clinical trials that research physiology and illnesses ranging from the common cold to chronic diseases. One notable example illustrating a lack of equity in healthcare regarding biological differences can be found in pharmacology, particularly in prescribing medicine. To help patients with their specific needs, health professionals must take biological differences into account.²² Specific biological factors include weight, gender, age, and existing conditions such as chronic disease and illness. Adjusting doses of prescribed medications, tailored to the existing conditions of the patient, is a protocol in place for healthcare workers across the United States to protect the life of the patient.²³ A meta-analysis of sex-based differences in pharmacology revealed that 95% of the 86 prescription drugs evaluated did not have appropriate dosage adjustments for sex differences, leading to a higher incidence of adverse drug reactions.²⁴

Gender stereotypes are harmful because they create a conflict between the personal biases of healthcare staff and the real, diverse needs of female patients. According to an article published in the journal Psychological and Cognitive Sciences in 2024, M. Guzikevits stated that stereotypes imply men are regarded as “braver” and women’s experiences are less intense.²⁵ Among five different metrics, this study measured the time men and women spent in emergency care waiting rooms and their pain score records. These researchers found that among the 21,851 participants in this study, females spent an average of thirty additional minutes waiting for emergency care compared to men while waiting for similar ailments. They also observed that nurses were 10% less likely to record female patient pain scores.²⁶

Studies like Guzikevits's highlight how women are stereotyped within the healthcare system, utilizing both real-world and survey data to illustrate these biases. Surveys sent out by public health officials in the same year also found that men are 33% more likely to trust their healthcare provider than women.²⁷ This percentage is due to the higher frequency of negative experiences women have with their healthcare providers.²⁸ Issues associated with male and female biological differences, combined with social factors (including stigma and stereotypes), lead to female patients feeling abandoned by their healthcare professionals.

Q: How is adequate healthcare defined in the United States?

A: Adequate healthcare involves patient-centered care, which includes informing patients about their potential conditions and engaging in frequent doctor-patient discussions. The World Health Organization (WHO) defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”²⁹ Similarly, WHO asserts that health is a right that should be available to every human being, regardless of religion, social condition, economic status, race, or political belief.³⁰

A professor of family medicine defined patient-centered health as care that focuses on communication with the patient and promptly meeting their needs.³¹ In 2007, 21% of adults in the United States experienced delayed care, along with other nonfinancial barriers to healthcare. Approximately 51% of the adults who reported delayed healthcare were females.³² This lack of timely care fosters a growing distrust of doctors among patients.³³ In addition to existing delays in care in the United States, the looming national shortage of healthcare providers threatens to limit women's access to adequate and timely care. Zhang projects that the United States will face a national shortage of 139,160 physicians by 2030.³⁴ These data indicate that an estimated 71,375,865 United States citizens will not have access to physician-based healthcare.³⁵ The ratio of patients to physicians varies from clinic to clinic; however, the American Association for Physician Leadership estimates that one physician sees around 2,000 patients per year.^36,37 According to Health Services Research, this high quantity of visits results in a median of 15.7 minutes covering around six topics per visit.³⁸

Menstrual health includes access to information on the menstrual cycleA monthly process for females post-puberty in which hormones fluctuate, stimulating an ovary to release an egg and thicken the lining of the uterus.¹⁴ and period hygiene,^39,40 affordable care and resources,⁴¹ and a respectful environment regarding the menstrual cycle.⁴²

Q: Which demographic of women has been most affected by healthcare barriers?

A: Women with menstrual disorders such as endometriosisA chronic inflammatory disease where tissue similar to the uterine lining grows outside the uterus. This condition is often painful and affects around five to ten percent of the global female population.^8,9 or polycystic ovarian syndrome (PCOS) have reported feeling dismissed by their healthcare providers.⁴³ A 2020 online survey revealed that 42% of female participants with PCOS reported feeling dissatisfied with their medical care.⁴⁴ As the number of practicing OB/GYNsA subset of medicine specializing in women’s healthcare, including diagnosing and treating diseases affecting female reproductive organs. It also addresses other aspects of women’s health, such as menopauseThe stage in a woman’s life when she stops having menstrual periods and can no longer become pregnant.¹³, hormone problems, contraception, and infertility.¹¹ declines within the healthcare system, women are projected to use more non-specialized doctors to help manage menstrual pain.⁴⁵ As a result of a growing US population and a persistent lack of women’s healthcare providers, the shortage of OB/GYNs will reach around 22,000 providers by 2050.⁴⁶ This OB/GYN shortage proves dangerous for women with menstrual disorders, leading to delayed diagnosis and treatment. These delays are particularly concerning given that women with menstrual disorders often feel dismissed and ignored by non-specialized doctors, implying longer recovery times.^47,48 Other demographics of women also affected within the United States healthcare system include those from the LGBTQ+ community. Regarding fertility health, most doctors do not receive adequate situational training on navigating fertility with their lesbian and bisexual patients.⁴⁹ Interviews were conducted with 39 females who identify as lesbian, bisexual, or queer to assess how they perceived their doctors’ ability to handle their reproductive care visits. Among the 39 women, at least a third of the participants reported inadequate healthcare across a range of topics, including managing menstrual symptoms and menopauseThe stage in a woman’s life when she stops having menstrual periods and can no longer become pregnant.¹³ care.⁵⁰ A 2016 study conducted by the National Institutes of Health found that individuals questioning their sexual identity were more likely to report negative healthcare experiences than those who identified as straight or lesbian⁵¹ Sexual orientation is a social determinant of potential bias in healthcare.

Women of color have varying experiences accessing adequate healthcare. In 2020, non-Hispanic Black or African American women were five times more likely to die from endometrial cancer than Hispanic or Latina and non-Hispanic White women.⁵² A secondary analysis examined the health status of different races in the United States from 1999 to 2018. The study observed that Black individuals’ self-reported health status and healthcare access remained consistently poor throughout the 19-year period.⁵³ Poor health status often results from inadequate healthcare, a disparity more commonly experienced by minority populations in the United States.⁵⁴

While healthcare inadequacies among minority populations have been documented, this brief will primarily focus on the barriers to healthcare faced by all women in the United States.

Q: How does women’s healthcare differ in countries outside of the United States?

A: MenstruationThe discharge of tissue and blood from the uterine lining that occurs as part of monthly menstrual cycles in females during and after puberty and before menopause, also known as a period.¹⁶ is a universal experience for women, affecting all to varying degrees of severity. In recognition of this variation, countries including Japan, Spain, Indonesia, South Korea, Taiwan, Vietnam, and Zambia have passed legislation to accommodate severe menstrual symptoms in workplaces and schools. In contrast, such laws remain scarce in the United States.⁵⁵ Spain is among the most recent countries to approve such measures.⁵⁶ Although controversy and concerns over stigmatizationThe labeling of someone to socially alienate them from society and isolate their experience.¹⁹ surround the legislation, Spain has implemented laws to allow women to work from home while experiencing illness and pain due to menstruation.⁵⁷ In addition, Canada, India, Australia, Kenya, Columbia, and Rwanda have abolished the “tampon tax” as a result of public policy.⁵⁸ The tampon tax refers to the high costs of necessary menstrual hygiene items that are classified as luxury items.⁵⁹ More than half of states in the US have yet to follow suit.⁶⁰

The United States falls behind in several other healthcare metrics. According to a 2022 analysis, the US had the highest maternal mortalityThe death of women while pregnant or within 42 days of the termination of pregnancy, excluding incidental or accidental causes of death.¹² rate among thirteen high-income nations, with an average of 22 maternal deaths per 100,000 live births.⁶¹ In the United States, the maternal mortality rate for women of color was approximately 50 per 100,000 live births.⁶² Additionally, postpartum checkups are underutilized and undervalued by both doctors and women, as indicated by a high percentage of preventable maternal deaths occurring within 42 days following birth.^63,64 A related metric to maternal deaths is the lack of government policies supporting new parents. Among 41 high-income countries, the United States is the only one that does not offer federally mandated paid parental leave.⁶⁵

Contributing Factors

Inadequate Research

The lack of female-based research and female-specific implications in published findings contribute to the barriers women face in healthcare.⁶⁶ A 2014 sports science study analyzing 266 articles revealed that 60% of articles reported no sex differences, despite significant differences being present.⁶⁷ Similarly, an analysis conducted by Safdar focused on gender in emergency medical research. Safdar searched the MEDLINE database by using specific terms to target papers focused on emergency medicine and analyzed the percentage that controlled for gender within their studies. These researchers found that 11% of 2,487 papers controlled for gender, and 2% focused on gender within their hypotheses.⁶⁸ Several presentations of symptoms in certain diseases that differ between females and males remain unknown and under-researched.⁶⁹

Physiology-based research has often misreported notable sex differences due to a lack of specification in the initial experimental design, such as not accounting for gender differences.⁷⁰ When researchers base new studies on misreported literature, their results fail to account for characteristics unique to the female body.⁷¹ Ample evidence suggests that male and female biology differ in several aspects of physiology.⁷² These variations stem from genetic and hormonal variance, particularly in brain organization, temperament and cognition, and pathology.⁷³ Brain organization differs in males and females through brain networking; males show stronger connectivity in the unimodal sensorimotor cortices, while females show stronger connectivity in the default mode network.⁷⁴ In other words, these stronger connections in their respective areas of the brain generally result in better motor and spatial abilities in males and heightened social cognition and memory in females.⁷⁵ Failing to account for these differences contributes to inaccurate and inadequate research.

The omission of accurate reports on female symptoms in research stems from the challenges and lack of knowledge about controlling for menstruationThe discharge of tissue and blood from the uterine lining that occurs as part of monthly menstrual cycles in females during and after puberty and before menopause, also known as a period.¹⁶ during the research process.⁷⁶ Although no meta-analysis currently identifies which variables should be controlled in relation to the menstrual cycleA monthly process for females post-puberty in which hormones fluctuate, stimulating an ovary to release an egg and thicken the lining of the uterus.¹⁴, some studies propose hypotheses about its effects within their research.⁷⁷ These studies aim to disprove common myths about eumenorrheicWhat is considered to be regular menstrual cycles, which is classified as having cycle lengths between 21 and 35 days, 10 or more consecutive periods a year, normal ovulation, and regular hormonal fluctuations.¹⁰ females and explore potential variables that may influence female physiology and response to various topics.⁷⁸

Bias

Negative experiences due to gender biases among healthcare providers contribute to the barriers women face in accessing care. According to the Office of Inspector General, negative experiences with healthcare providers include substandard care, which is rooted in the patient’s perception of the provider’s attitude toward them.^79,80 In the United States, many women reported that they believe their healthcare providers are not sincerely listening to them.⁸¹ Survey data detailing women visiting their OB/GYNA subset of medicine specializing in women’s healthcare, including diagnosing and treating diseases affecting female reproductive organs. It also addresses other aspects of women’s health, such as menopause, hormone problems, contraception, and infertility.¹¹ revealed that females with chronic vulvar pain were 37% more likely to agree with the statement: “Doctors think that people with chronic pain exaggerate their pain.”⁸² This phenomenon is prevalent not only in reproductive healthThe health of reproductive systems in the body, which include sex organs and hormone-producing glands during all stages of life.¹⁷ . but also in other areas such as cardiovascular health, joint pain, and general health.⁸³

Though statistics are sparse, numerous anecdotal reports indicate that women with endometriosisA chronic inflammatory disease where tissue similar to the uterine lining grows outside the uterus. This condition is often painful and affects around five to ten percent of the global female population.^8,9 often feel their symptoms are trivialized and dismissed by healthcare professionals.⁸⁴ Women seeking reproductive healthThe health of reproductive systems in the body, which include sex organs and hormone-producing glands during all stages of life.¹⁷ . advice from healthcare professionals often encounter bias and “one-size-fits-all” responses and suggestions.⁸⁵ The lack of regulation on Continued Medical Education (CME) progress by state licensure boards causes patients to walk away not only feeling lost and discouraged but also unaware of options that might have a greater effect.⁸⁶ A 2017 study surveying over 600 patients recently diagnosed with endometriosis in the United States reported that the average time between endometriosis symptoms onset and time of diagnosis was four and a half years.⁸⁷ During these years of waiting, patient pain and confusion only deepened their hopelessness in the healthcare system.

Despite positive developments within the industry,⁸⁸ perceived pain and feelings of dismissal persist among women receiving healthcare.⁸⁹ According to a study analyzing analgesic treatment of abdominal pain, women were less likely than men to receive analgesia, a pain management medication. This study included 981 participants of varying ages, with 65% being female, excluding those who were pregnant, with abdominal trauma or recent surgery.⁹⁰ While waiting to be treated in the University of Pennsylvania Emergency Room, participants were asked to rate their pain on a 10-point scale. Among patients requiring painkillers, women were 13–25% less likely to receive analgesia or opiates compared to their male counterparts with the same pain score. Women also waited, on average, 16 minutes longer to receive treatment than men.⁹¹ These findings underscore the biases contributing to the lack of timely and appropriate healthcare treatment.

Sexual Harassment

One extreme case of gender bias in the United States healthcare system is sexual harassment. Sexual harassmentAny act, comment, or advancement that disparages an individual or a group of one particular sex.¹⁸ has permeated various settings, including homes, schools, and healthcare. One study that analyzed sexual assault reports within the United States healthcare setting between 2008 and 2015 found that 89.1% of victims were women.⁹² In that same study, 96% of cases involved repeated sexual abuse, and around 40% of abusers were family doctors.⁹³ In 2020, medical review boards added policies to reduce violations between physician and patient.⁹⁴ However, abuse in the medical field subsists, contributing to the inadequate healthcare among women.

Societal Norms

While studies on menstruationThe discharge of tissue and blood from the uterine lining that occurs as part of monthly menstrual cycles in females during and after puberty and before menopause, also known as a period.¹⁶ and menopauseThe stage in a woman’s life when she stops having menstrual periods and can no longer become pregnant.¹³ exist, societal norms influence perceptions, reducing these symptoms to moodiness, hot flashes, and cravings. These perceptions lead to fewer studies being conducted and slower development of treatment plans for women.⁹⁵ In particular, the effects of extreme hormonal fluctuations before and after menopause are understudied, even though women widely perceive them as the primary cause of adverse menopausal experiences.⁹⁶ Approximately one in four women experience the need for medical intervention regarding their menstrual pain.⁹⁷ Societal norms and attitudes surrounding PMS and painful periods can be harmful and undermine the severity of the pain women experience.⁹⁸ In addition to trivializing regular pain, women often feel pressured by social expectations to keep their periods hidden from family and loved ones.⁹⁹ Lack of research and general knowledge on female physiology further perpetuates incorrect societal attitudes.¹⁰⁰

Menstrual pain is particularly common among eumenorrheicWhat is considered to be regular menstrual cycles, which is classified as having cycle lengths between 21 and 35 days, 10 or more consecutive periods a year, normal ovulation, and regular hormonal fluctuations.¹⁰ women.¹⁰¹ A survey of 42,879 participants found that one in three women paused their daily activities due to extreme menstrual symptoms.¹⁰² Because men do not have menstrual cyclesA monthly process for females post-puberty in which hormones fluctuate, stimulating an ovary to release an egg and thicken the lining of the uterus.¹⁴, menstruationThe discharge of tissue and blood from the uterine lining that occurs as part of monthly menstrual cycles in females during and after puberty and before menopause, also known as a period.¹⁶ is often excluded from male-focused educational curricula, resulting in a general lack of awareness. This gap in education may reinforce the perception that menstruation is taboo and should be kept secret in today’s society.¹⁰³ In a 2017 study, 48 men answered questions about their previous exposure to menstruation through their relationships with women. Researchers found that the majority of the 48 men had received most of their knowledge from overhearing conversations between women or from various types of media coverage. Many explained that the information they received about menstruation conveyed that it is “something bad” and “dirty.”¹⁰⁴

Misinformation

Women often feel inadequately informed about menopausal symptoms, highlighting the need for educational interventions to improve their understanding and management of menopauseThe stage in a woman’s life when she stops having menstrual periods and can no longer become pregnant.¹³. A group of 54 women between the ages of 40 and 64 (all in varying stages of menopause) were asked to participate in a menopausal health course. Before and after the course, the women were assessed through the Menopause Rating Scale (MRS), which evaluated active somatic, psychological, and urogenital menopausal symptoms.¹⁰⁵ The women were also tested on their knowledge about menopause using the Menopause Knowledge Evaluation Form (MKEF) and their attitudes toward menopause using the Menopausal Attitude Assessment Scale (MAAS) before and after the course intervention.¹⁰⁶ Upon conclusion of the study, researchers found that scores in all assessments showed a positive shift, with symptoms appearing less daunting and women gaining increased knowledge about menopause after the course.¹⁰⁷

Both teenage girls and boys believe in traditional misconceptions about puberty, which can contribute to attitudes of secrecy surrounding menstruationThe discharge of tissue and blood from the uterine lining that occurs as part of monthly menstrual cycles in females during and after puberty and before menopause, also known as a period.¹⁶. A meta-analysis of 24 stockpiled research articles on menstrual experiences identified three main themes: menstruation as a marker of womanhood, increased sexual vulnerability, and the pressure to keep menstruation a secret.¹⁰⁸ A 2010 study included in this meta-analysis, involving 73 girls aged 11–19, explored participants’ experiences with menstruation. When asked to write a response about why girls menstruate, 30% of the sample wrote that they “don’t know” or “wouldn’t be able to describe it.”¹⁰⁹ The secrecy surrounding menstruation, preserved by traditional societal beliefs, hinders knowledge about menstruation for both sexes.

Enhanced dialogue and knowledge about menopauseThe stage in a woman’s life when she stops having menstrual periods and can no longer become pregnant.¹³ foster a positive shift in outlook and greater awareness surrounding it. The secrecy surrounding menopausal health hinders the potential growth in knowledge, creating harmful barriers to adequate healthcare for women in the United States.

Consequences

Distrust in Healthcare Providers

Inadequate women’s healthcare contributes to diminished confidence in medical providers. Due to the factors delineated above, many women interact with workers who use language that can be deemed dismissive and stigmatizing, rooted in stereotypes perpetuated by society.¹¹⁰ These stereotypes lead women to be suspicious of healthcare professionals, with experiences of sexual harassmentAny act, comment, or advancement that disparages an individual or a group of one particular sex.¹⁸ further exacerbating feelings of distrust.

Distrust in the healthcare system is harmful to patients experiencing pain and chronic illness, resulting in lower self-reported health measures.¹¹¹ Self-reported health measures are crucial as they offer insights into individuals' perceptions of their well-being, often aligning with objective health outcomes.¹¹² In a study involving 2,754 women recently diagnosed with invasive breast cancer, those who reported higher distrust in their doctor were 22% more likely to report treatment discordance or disagreement with the doctor over treatment options.¹¹³ More than half of women in the United States believe that negative gender bias exists from doctor to patient.¹¹⁴ Distrust in the healthcare setting impedes patient health, well-being, and care, as patients perceive their own health to be poor.

Stigmas caused by popular body image standards contribute to patient-experienced shame and miscommunication with healthcare professionals. A patient’s characteristics, such as sex, race, age, and other physical features, often drive unconscious stigma exercised by healthcare professionals.¹¹⁵

Preventable Inequities within the US Healthcare System

Avoidable Mortality

Inadequate research on female physiology, bias in the healthcare system, and societal gender norms combined can result in disproportionate health effects and, in some cases, death for women in the United States. In 2022, the Centers for Disease Control reported that 80% of pregnancy-related deaths from 2017-2019 were preventable, meaning the deaths could have been avoided or treated using current medical knowledge and technology.

Women with adverse menstrual cycles, meaning any menstrual cycleA monthly process for females post-puberty in which hormones fluctuate, stimulating an ovary to release an egg and thicken the lining of the uterus.¹⁴ outside of what is considered eumenorrheicWhat is considered to be regular menstrual cycles, which is classified as having cycle lengths between 21 and 35 days, 10 or more consecutive periods a year, normal ovulation, and regular hormonal fluctuations.¹⁰, are at risk of premature death. A recent 24-year longitudinal study from the Harvard School of Public Health, which followed 79,505 premenopausal women, found that those who reported irregular periods were 39% more likely to die prematurely. The specific metrics of death were cardiovascular risk and cancer.¹¹⁶

Major Health Complications

Menstrual disorders, including endometriosisA chronic inflammatory disease where tissue similar to the uterine lining grows outside the uterus. This condition is often painful and affects around five to ten percent of the global female population.^8,9, cause major health complications.¹¹⁷ Endometriosis leads to infertility and is linked to several chronic diseases such as cancer, asthma, cardiovascular disease, and autoimmune diseases.¹¹⁸ Although research on endometriosis has increased, many women have unknowingly lived with endometriosis for years and are told by others that they are just experiencing painful periods.¹¹⁹ Data from a 2017 study estimate that one in every ten women (or around 10–15%) suffer from endometriosis globally.¹²⁰

Financial Disparities

Although women have consistently had lower all-cause mortality rates than men worldwide,¹²¹ women spend more on healthcare, including primary care, specialty care, and emergency visits.¹²² Health-related quality of life scores show how a patient perceives their own health and well-being. Studies show that socioeconomic factors, such as income, correlate with health-related factors.¹²³ In aggregated funds, US women spend $15 billion more on healthcare costs per year than men.¹²⁴ Individually, this results in U.S. women spending an average of 18% more on healthcare annually than men.¹²⁵ Along with this higher expenditure, studies often show that women score lower on health-related quality of life measures.¹²⁶ These dips in health-related quality of life could be due to understudied menopausal symptoms occurring in all women.¹²⁷ Health-related quality of life scores are important to take into account when examining adjustments to the healthcare system.

Taboo Reproductive Health and Education Gaps

A consequence of healthcare barriers for women is the taboo surrounding reproductive healthThe health of reproductive systems in the body, which include sex organs and hormone-producing glands during all stages of life.¹⁷ ., as limited access to information, resources, and services often leads to misinformation and stigma. Menstrual stigmaThe negative perception of menstruation and women who experience it.¹⁵ manifests in various ways, including women feeling anxious about potentially staining their clothes due to an unexpected period,¹²⁸ inappropriate commentary or humor surrounding tampons and other menstrual necessities,¹²⁹ and inaccessible menstrual hygiene or pain management supplies.¹³⁰ These instances of menstrual stigma, combined with limited access to education, reinforce a taboo culture around menstruation, perpetuating the silence around these topics at home, in schools, and within the medical field.^131,132

While young girls might be unaware of what is happening when they menstruate, women going through menopauseThe stage in a woman’s life when she stops having menstrual periods and can no longer become pregnant.¹³ often face similar uncertainty about their bodies. Due to inadequate healthcare for women, specifically the lack of training that physicians have on menopause, women are uncertain entering this new phase of life, as evidenced by a survey from the Female Founders Fund. Out of over 250 respondents, 64% of women reported feeling unprepared for their menopause transition.¹³³ This study also identified over 20 different symptoms of menopause that indicate extreme changes in a woman’s life. Studies have found higher levels of stress among women beginning menopause. Stress has been shown to compound if a physician fails to educate the patient about their own body's symptoms.¹³⁴ Further education on menopause and menstruation from healthcare providers is a necessary factor for women to feel prepared for these life transitions.

Although the scientific rhetoric about menstruationThe discharge of tissue and blood from the uterine lining that occurs as part of monthly menstrual cycles in females during and after puberty and before menopause, also known as a period.¹⁶ has improved over time, social stigma surrounding periods and menopause still exists.¹³⁵ The lack of adequate education about menstruation for both men and women, coupled with the hesitancy to express period pain to loved ones, hinders women from seeking professional healthcare.¹³⁶ The fact that the topic of menstruation is taboo is also a negative consequence of inadequate healthcare and continues to perpetuate the lack of adequate research on female physiology.¹³⁷

Practices

Many institutions have advocated for the inclusion of and focus on women in physiological and medicinal research. Other entities aim to reduce the taboo surrounding menstruationThe discharge of tissue and blood from the uterine lining that occurs as part of monthly menstrual cycles in females during and after puberty and before menopause, also known as a period.¹⁶ and menopauseThe stage in a woman’s life when she stops having menstrual periods and can no longer become pregnant.¹³ through podcasts, books, and documentaries. While it is impossible for these institutions and individuals to change each person’s perspective, information regarding menopause and menstruation is now more widely accepted than it was a decade ago.¹³⁸

One such organization currently working to eliminate bias in the healthcare system is the Sex and Gender Women’s Health Collaborative (SGWHC).¹³⁹ SGWHC was formed in 2012 by the American Medical Women’s Association (AMWA), the American College of Women's Health Physicians, and the Society for Women's Health Research.¹⁴⁰ Since 2012, AMWA and SGWHC have formed one entity to help further medical education for doctors and patients alike.¹⁴¹ SGWHC advocates for the inclusion of biological processes in current and forthcoming curricula for medical schools and other Continuing Medical Education courses. In 2019, this organization implemented sex and gender-based training in several medical residency schools across the US.¹⁴² The goal of this gender-based training is to help prospective doctors better communicate with their patients. Along with the training, SGWHC has developed its own continued medical education online courses, offering around ten hours of sex- and gender-specific health education to practicing doctors.¹⁴³ Health professionals can obtain this certification by purchasing and completing the courses on the SGWHC website. To further support education, SGWHC has also partnered with PubMed to compile a database of sex-specific symptoms available to both the public and healthcare professionals.¹⁴⁴ The database aims to provide further education to women who want to know more about their specific menopausal or menstrual symptoms. Additionally, any research accessed through the database can also be counted toward Continued Medical Education credits for practicing doctors.¹⁴⁵

SGWHC also aims to celebrate outstanding female scientists and doctors in their respective fields. This recognition comes through collaboration with the RAISE project (Rebuilding American Infrastructure with Sustainability and Equity), which grants funds to current studies promoting female health each year. In January 2025, the RAISE program gave $1.32 billion in grants to over 100 projects across the United States.¹⁴⁶

Impact

Though the number of practitioners that completed the sex-specific health training through SGWHC is not disclosed, it is public knowledge that the website receives around 1,440 visitors per month.¹⁴⁷ Compared to other online health databases, these SGWHC visitors make up only 0.0004% of the monthly visits that a larger database, such as Healthline, receives.¹⁴⁸

While sex-specific information is difficult to find in popular databases such as Healthline, PubMed, and WebMD, SGWHC provides users with a plethora of articles specifying female-specific symptoms. The SGWHC database contains over 11,000 studies analyzing sex differences from various illnesses and health conditions. The abstracts in this database provide doctors and patients with information regarding women's health and wellness.¹⁴⁹ This database includes over 200 clinical categories of sex-specific symptoms.¹⁵⁰ These clinical areas include cardiovascular diseases, autoimmune disorders, mental health, pharmacology, overall physiology, and more. Within each area, articles and research covering female-specific symptom presentation, disease etiology, and illness prevention are identified.¹⁵¹

Since its launch in 2018, the RAISE Project has given over 1,900 awards and around $10.5 billion in grant money.¹⁵² This program, administered through the US Department of Transportation, has provided more than 46,000 female scientists and doctors with funding and recognition to continue their work and promote women in STEM-related fields.¹⁵³

Gaps

While the work of the Sex and Gender Women’s Health Collaborative provides necessary training to healthcare professionals and vital health information to the public, there are some limitations to the assistance it offers. The link to their database is listed as an insecure site, making it inaccessible to users with certain firewalls on their computers.¹⁵⁴ Furthermore, the database lacks a search-by-topic feature, requiring users to rely on Google Scholar and specific search mechanisms within the articles to find relevant information. Additionally, some portions of their website have not been updated since 2016, despite ongoing collaboration with programs such as RAISE to continue providing grants to scientists. Moreover, feelings of neglect persist despite these institutions' attempts to make healthcare professionals aware of caregiving shortcomings¹⁵⁵

While SGWHC's efforts to dismantle barriers to women's healthcare and enhance health knowledge are commendable, they remain inadequate in meeting the needs of the broader public. SGWHC as an organization is also unknown by women seeking help with reproductive health and doctor’s seeking more training. Going forward, more accessible and user-friendly resources are needed to enhance public education on menopause and menstruation.¹⁵⁶

Preferred Citation: Loveless, Grace. “Inadequate Healthcare for Women in the United States.” Ballard Brief. March 2025. www.ballardbrief.byu.edu.

Viewpoints published by Ballard Brief are not necessarily endorsed by BYU or The Church of Jesus Christ of Latter-day Saints