Opinion
“The gender pain gap hurts everyone – including the healthcare system and taxpayers”
By Cindy Moy Carr and Tami Wahl

For decades a lot of ink has been spilled both online and in print about pain treatment disparities between men and women, often by the patients themselves.
One very famous case is that of actress comedienne Gilda Radner, who in her book It’s Always Something described how she started experiencing acute exhaustion and pain in her upper legs in 1985 while filming Haunted Honeymoon in the United Kingdom.
She sought medical attention, and over the course of the next year, several doctors, the most of whom were in California, gave her differing diagnoses that ultimately turned out to be false. Several told her it was period pain and Epstein-Barr Virus which Radner herself referred to as fitting to “the Queen of Neurosis.”
For many like Radner, period pain has been blamed for what later turns out to be an unrelated illness or physical condition.
Radner continued to feel abdominal discomfort for 10 months. By the time they finally diagnosed her with Stage IV ovarian cancer in October 1986, the tumour inside her had grown to the size of a grapefruit.
Radner had a hysterectomy along with radiation and chemotherapy. Following remission and relapse, she died three years later at age 43. If only the doctors had listened and investigated all the possibilities sooner.
In November 2022, 33 years after the death of Radner, the first-ever gender pain gap report was released. The report, researched and compiled by Nurofen, based on a survey in the United Kingdom of 5,100 participants, analyses the differences in experience of pain for both men and women in the United Kingdom and found:
- 56 per cent of women surveyed, compared to 49 per cent of males, felt their pain was disregarded or neglected.
- One in four women vs one in six males reported having feelings that generally, no one took their suffering seriously.
- Of those that felt this way, 50 per cent said their GP and 27 per cent said their GP (the UK equivalent of a PCP) ignored or dismissed their pain, with partners/spouses (26 per cent) and friends (21 per cent) reacting in similar ways.
- Nearly two-thirds (63 per cent) of women believe that doctors and nurses discriminate against women and treat men’s pain more seriously.
The reasons it took so long for such a study are present in the results. The report states that the gender gap found in this study is probably a product of a “male as default” philosophy and historic practice that pervades research, clinical trials, healthcare policy and services.
It seems Radner wasn’t the only one who thought herself neurotic. The report also states that only 28 per cent of women who experience severe daily pain would seek consultation with their GP.
That trend continues with treatments for pain where 74 per cent of women would choose self-care over seeing an GP due to feeling ignored or dismissed compared to just 60 per cent of men. And almost a quarter (24 per cent) of the women surveyed also reported that pain had led to them feeling depressed, compared to 18 per cent of men.

These results, while shocking, are an everyday experience for most women we know.
The first study definitively proving the existence of menstrual pain was released by Harvard and Apple in March 2021. Women obviously knew menstrual pain existed, the pain simply wasn’t considered important enough to merit research funding.
In 1998 sildenafil citrate, later marketed as Viagra, was tested as heart medication and found to offer total relief for serious period pain over four hours. The review panel refused further research funding because cramps were not a public health priority.
In 2007 sildenafil citrate was found to help hamsters recover from jet lag. In 2013 sildenafil citrate was again shown to relieve menstrual pain but the study ran out of funding. Hamsters get priority over women.
More recently one of this article’s authors sought counselling for hypochondria after numerous doctors told her the mysterious ailments she was suffering, including debilitating migraines, dry eyes and vertigo, were psychosomatic.
It was a nurse who told her it was perimenopause. Simple hormone therapy solved years of symptoms.
Gender pain disparity is a safety issue
In 2020, the First Do No Harm report was published by the Independent Medicines and Medical Devices Safety Review, chaired by Baroness Julia Cumberlege.
The Review team spent two years speaking to more than 700 women and their families who experienced complications linked to three treatments–1) sodium valproate, an epilepsy drug that increases the risk of birth defects; 2) Primodos, a hormonal pregnancy test withdrawn from the market in 1978, allegedly associated with birth defects and miscarriages; and 3) pelvic mesh implants, used to treat prolapse and urinary incontinence, the complications of which can cause debilitating pain “like shards of glass inside the body”.
The 277-page report is an explicit and gut-wrenching read, laying out in minute detail the multitude and shocking ways in which patients – most of whom are women – were treated dismissively by the healthcare system with the resulting outcomes being just as severe, including job loss, breakdown of family life, children or husbands becoming carers for mothers or wives, and for women with children suffering from foetal valproate spectrum disorder, being accused of abuse by poorly educated clinicians.
On page 17 of the report, under the subtitle ‘No-one is listening’ – The patient voice dismissed, the Review team writes: “They spoke of being ‘gaslighted’ and of not being believed, particularly in relation to pelvic mesh and the suffering of pain.
“Women, in reporting to us their extensive mesh complications, have spoken of excruciating chronic pain feeling like razors inside their body, damage to organs, the loss of mobility and sex life and depression and suicidal thoughts.”
The Review team goes on: “Some clinicians’ reactions ranged from ‘it’s all in your head’ to ‘these are women’s issues’ or ‘it’s that time of life’ wherein anything and everything women suffer is perceived as a natural precursor to, part of, or a post-symptomatic phase of, the menopause.”
The Review then explains some of the consequences of this treatment, including the increased costs to the UK taxpayer.
“We know that women who accept a normalisation of their pain tend to seek the help they need far later than they should,” they write.
“This precludes the possibility of early, less invasive treatment with potentially better outcomes. It also takes its toll, physically, mentally and emotionally on the patient and their family and imposes ultimately a far greater cost on the NHS and the healthcare system to treat and attempt to put right.”
What steps can we take to narrow the gap?
Nurofen’s study is a good start. They’ve also launched a website called named See My Pain where the stories of real women are posted.
Their parent company Reckitt Benckiser has also committed to several long-term initiatives that go beyond marketing to finally close the gender pain gap.
For instance, the business will invest in creating new tools to help both men and women describe and articulate their suffering while speaking with medical specialists.

Reckitt has also pledged to include gender balance when planning and analysing its clinical studies, provide training in identifying gender bias and will frequently review the Gender Pain Gap Index Report to monitor progress. (Note: The authors are not affiliated with Reckitt.)
These are all good first steps from a brandholder in the medical ecosystem.
Healthcare professionals could receive training in active listening techniques. Medical school curriculums and continuing education sessions could explore and raise awareness of the gap, which may initiate an openness and curiosity for students and physicians to look beyond defined conditions.
Patients should learn to be their own advocates. Today we have technologies, digital platforms, social media and online communities to better inform and empower an individual.
Perhaps if Gilda’s medical team was more curious or she had a broader support network with similar symptoms she wouldn’t have dismissed herself as “neurotic” and she’d still be here making us all laugh with her wonderful characters.
A longer-term and more involved measure is a comprehensive and macro-review of the healthcare model.
The system has become such a behemoth that medical discoveries and any sense of individualised treatments are ultimately limited if non-existent.
The existing model was built decades prior to the array of digital data and technologies that are available today. Is a complete overhaul needed or can the existing system be reconfigured to utilise and meet contemporary times?
A serious review would reveal best next steps to close the gender pain gap among other improvements.
The Nurofen report concludes on a practical note: “Closing the gap on pain will not only provide immediate solutions for women experiencing pain, but we hope will have a ripple-effect in terms of social and economic gains.”
More importantly, closing the gender pain gap will save lives and will absolutely improve the quality of life for women navigating pain.
Cindy Moy Carr is the founder and CEO of Vorsdatter Limited which developed mySysters, an app for perimenopause and menopause. She’s an attorney and journalist who authored the American Bar Association’s Guide to Health Care Law.
Tami Wahl serves as legislative and regulatory counsel for innovators across multiple industry sectors.

News
We built Ema like a nurse: Here’s why that matters

By Claire Pettengill, science intern and Jade Anstine, clinical AI intern, Ema EQ
Every year, Gallup asks Americans which professions they trust most. Every year, nurses win. Not doctors. Not scientists. Nurses. And if you spend any time thinking about why, the answer is not hard to find.
Medicine runs on the nurse noticing first. In other words, the diagnosis follows the nurse sounding the alarm. They ask questions that feel human, not procedural. They explain what is happening in language you can understand.
And, critically, they know when something is beyond their scope and get you to the right person without making you feel like a burden for needing more.
That is the model we built Ema on.
When we set out to build an AI companion for women’s health, we could have just built something that answers questions efficiently. Pattern matching. Fast retrieval. Clinically accurate outputs.
Those things matter, and Ema does all of them. But accuracy alone does not build trust, and trust is the entire game in healthcare.
A woman asking about her postpartum recovery, her fertility, or her breastfeeding supply is not looking for a search engine. She is looking for someone who will take her seriously.
Women’s concerns don’t just need to be ‘validated’; they also need to be believed. Dismiss a woman’s pain as anxiety once, and you’ve taught her to doubt her own body.
The nursing model of care is built on exactly that premise. It is care that is shaped by her story. It asks about context and symptoms.
It treats the person as a whole, and it recognises that the right answer is sometimes a referral, not a response.
We trained Ema to escalate. That may sound like a small thing, but in AI, it is a deliberate design choice.
Most AI systems are optimised to answer and maintain engagement. Ema is optimised to help, and sometimes helping means saying “you need to speak to a clinician” and making that path easy.
This matters especially in women’s health, where the clinical trust gap is well-documented.
In a 2022 nationally representative survey of over 5,000 women, nearly 1 in 3 reported that their doctor had dismissed their concerns, and 15 per cent said a provider simply didn’t believe them.
Women are more likely to have their symptoms dismissed, their concerns minimised, and their pain undertreated. Among women under 35, nearly half reported at least one of these experiences.
They have had to learn how to advocate within systems designed for efficiency, built on men’s health.
With Ema, every conversation is an opportunity to make a woman feel heard, informed, and directed to the right level of care, neither over-triaged nor undertreated.
The goal is not to replace clinicians. It is to create a trustworthy first point of support that listens carefully, explains clearly, recognises limits, and helps women move toward appropriate care.
The nurses who top those Gallup rankings every year earn that trust through consistency. They show up, listen, follow through, and know their limits.
Ema is simply that trust, built into technology. That is the standard we hold Ema to: a trustworthy presence that knows when to answer and when to hand off.
Medicine spent a long time teaching women not to expect to be believed. Ema is built by the people who never stopped listening.
Bios
Claire Pettengill is a psychiatric nurse and DNP-PMHNP candidate at Columbia University School of Nursing, specialising in women’s mental health across the lifespan and algorithmic justice – ensuring the AI tools shaping women’s care are built to actually listen. She joined Ema EQ as a science intern focusing on clinical safety standards for evaluating AI in women’s health.
Jade Anstine is a senior nursing student at Gustavus Adolphus College looking to bridge the gap between frontline medicine and digital health innovation. He joined Ema EQ as a Clinical AI Intern to assess the Ema AI model across different clinical populations, specifically pediatrics and LGBTQ+.
News
The technology exists: Why are women still waiting?

By Jane Lewis, chief operating officer, chief financial officer and women’s health lead, ABHI
For years, the conversation around women’s health has rightly focused on recognition.
Recognition that women wait longer for diagnosis. Recognition that symptoms are too often dismissed or normalised. Recognition that healthcare systems have historically been designed around male biology, leaving gaps in research, evidence and care.
That recognition matters. But awareness alone will not improve outcomes.
The challenge facing women’s health today is no longer simply identifying the problem. It is acting on the solutions already available.
At ABHI’s Women’s Health Summit earlier this year, leaders from across healthcare, government, academia and industry came together to discuss the future of women’s health.
One message emerged repeatedly throughout the day: we do not have an innovation problem.
Across medical devices, diagnostics, digital health and genomics, there are already technologies capable of transforming outcomes for women.
From self-sampling approaches for cervical screening and non-invasive diagnostics to AI-enabled tools and advanced imaging, innovation is happening. The question is whether healthcare systems can adopt it quickly enough.
Too often, promising technologies become trapped in pilot programmes, fragmented procurement processes or lengthy implementation pathways. Evidence generation, commissioning and adoption are frequently treated as separate challenges rather than part of a single journey.
The consequence is that innovations capable of improving quality of life and reducing pressure on health services take years to reach the women who could benefit from them.
This matters because women’s health extends far beyond reproductive health.
Historically, many discussions have centred on fertility, pregnancy and gynaecological conditions. These remain critically important, but they represent only part of the picture.
Women experience cardiovascular disease differently to men. They are disproportionately affected by autoimmune conditions. They face distinct health challenges throughout their lives, from adolescence to healthy ageing.

Jane Lewis
Yet healthcare systems often continue to approach these issues in isolation.
A woman does not experience her health in separate compartments. Pregnancy, cardiovascular risk, menopause, mental health and musculoskeletal conditions are interconnected.
Healthcare systems need to reflect that reality through more integrated, life-course approaches to care.
There has never been a better opportunity to do so.
Across the NHS, the shift towards prevention, community-based care and digital transformation aligns closely with the needs of women’s health.
Women’s Health Hubs are already demonstrating the benefits of bringing services together around the needs of women rather than organisational boundaries. Digital technologies are helping to identify risk earlier and support more personalised care.
Innovation can help deliver all three of the NHS’s major transformation ambitions: moving from treatment to prevention, from hospital to community, and from analogue to digital care.
But innovation alone is not enough.
Closing the women’s health gap also requires us to address longstanding gaps in research and evidence.
Women remain underrepresented in many areas of clinical research, and sex-disaggregated analysis is not always applied consistently. The result is that clinical pathways and treatment decisions are often based on evidence that does not fully reflect female physiology.
Better data, stronger research participation and greater focus on female-specific and female-predominant conditions will be essential.
There is also a compelling economic case for action.
Women’s health is often framed as an equality issue, and equality remains central. But poor health affects workforce participation, productivity and economic growth.
Improving outcomes for women benefits not only patients, but employers, healthcare systems and wider society.
Yet despite this, women’s health innovation continues to attract only a fraction of the investment directed towards other areas of healthcare.
That is beginning to change.
Across the UK and internationally, momentum is building. Governments, investors, researchers and innovators increasingly recognise that women’s health is both a societal necessity and an economic opportunity.
The conversation has moved on significantly in recent years. Topics that were once overlooked are now firmly on the policy agenda.
The next challenge is ensuring that awareness translates into action.
The technologies exist. The evidence is growing. The policy direction is increasingly clear.
ABHI is increasingly taking this agenda beyond national boundaries. Through our engagement with international industry associations, policymakers and healthcare leaders, we are working to ensure that women’s health is recognised as both a health and economic priority.
We are helping to shape discussions on innovation, regulation, investment and adoption, while sharing lessons from the UK with partners around the world.
Whether addressing the gender health gap, improving access to diagnostics or accelerating the uptake of new technologies, international collaboration will be essential.
The challenge now is not recognising the need for change, but delivering it.
Women have waited long enough for acknowledgement of the problem. They should not have to wait any longer for the benefits of the solutions that already exist.
ABHI is the UK’s leading industry association for HealthTech. Its members, ranging from multinationals to small and medium-sized enterprises (SMEs), develop and supply technologies spanning everything from syringes and wound dressings to surgical robots, diagnostics, and digitally enabled healthcare solutions. ABHI’s 400 member companies represent approximately 80% of the UK HealthTech sector by value.
Opinion
Women’s Health has waited long enough for innovation

By Dr Fran Conti-Ramsden, clinician at Guy’s and St Thomas’ NHS Foundation Trust, academic at King’s College London, and chief medical officer of MEGI Health.
A woman gives birth. A few days later she goes home, often with a bag of medication for her blood pressure, and then, very often, very little structured follow-up for her heart (cardiovascular) health.
In my clinical work, and through our collaboration with Action on Pre-eclampsia, I see and hear about this postnatal cliff edge again and again, and it still shocks me.
We invest a lot of medical care and attention whilst a woman or birthing individual is pregnant, then, at the very moment emerging evidence suggests we have a window of opportunity to modify long-term health, the support falls away.
That cliff edge is a symptom of a deeper issue: we have come to treat “women’s health” as a synonym for reproductive health. Pregnancy, periods and fertility, important as they are, have crowded out everything else.
Yet the conditions that do most to shorten and limit women’s lives are not reproductive at all.
Cardiovascular disease is the leading cause of death in women worldwide, and it is still too readily thought of as a man’s problem.
Heart disease in women is more likely to be missed and under-treated, in part because for decades women were under-represented in the research that built our knowledge.
Pregnancy makes this vivid.
Conditions such as pre-eclampsia are not only risks to be managed for nine months; they are early warnings about a woman’s future, markers that she is more likely to develop heart disease and high blood pressure in the years to come.
We have the knowledge to act on that. What we mostly do instead is discharge her and look away.
This is exactly the kind of problem better tools should help us solve: spotting risk earlier, supporting women and their clinicians through the vulnerable postnatal window, and providing continuity where the system currently provides a drop due to lack of capacity.
Artificial intelligence and digital health have real potential here; in risk prediction, in monitoring blood pressure at home, and in helping stretched clinicians know who needs attention and when.
And yet this is not where most of the energy is going.
It is far easier to build, fund and scale an app that tracks a cycle than a tool that changes the trajectory of a woman’s heart.
So, innovation clusters at the lighter, lower-risk end of innovation, while the conditions that actually kill and disable women, and moments like the postnatal cliff, stay under-served.
Closing the women’s health gap could add at least a trillion dollars to the global economy each year, the World Economic Forum estimates, but the bigger prize is women living longer, healthier lives.
None of this means technology is a cure in itself. It is a tool, and a tool built carelessly can do harm.
Because women have been under-represented in medical data, systems trained on that data can quietly carry the same blind spots forward, deepening inequalities rather than closing them.
Responsible innovation, with clinical-grade evidence, privacy and equity designed in from the start, and tools built around real clinical pathways rather than bolted on afterwards, is not a brake on progress.
It is the only version of progress worth having.
I am optimistic, because a serious community is forming around exactly these questions and the appetite to get it right is real.
It is why, at MEGI, we are bringing clinicians, researchers, founders, regulators and investors together for our AI × Women’s Health summit on 25 June.
If we keep our focus on the conditions that matter most to women’s lives, and build the tools to meet them responsibly, the postnatal cliff edge could become something else entirely: the moment the system finally catches her and delivers preventative healthcare.
AI × Women’s Health: Innovation, Challenges and Opportunities summit is taking place on Thursday 25 June 2026 at the London Institute for Healthcare Engineering. The event is free and is fully booked and operating a waiting list. Join the waiting list here.
About Dr Fran Conti-Ramsden
Dr Fran Conti-Ramsden is a UK Obstetrics and Gynaecology registrar and Chadburn Clinical Lecturer at KCL passionate about transforming women’s health through technology and innovation.
Combining NHS clinical experience with an MRC-funded PhD, recent NHS Clinical AI fellowship and commercial role as Chief Medical Officer at Megi health, she works at the intersection of clinical medicine, data science, technology and AI.
Her current programme of research focuses on the intersection of healthcare and technology; leveraging advances such as smartphone based vital signs capture and large language models to drive forward scalable innovation in maternal cardiovascular care.
She has published over 20 peer-reviewed manuscripts (See gScholar, h-index 12), including award-winning work recognized by Hypertension Journal.
She was awarded an AI visionary award in 2025 by Health Innovation KSS was the recipient of the 2024 International Society for the Study of Hypertension in Pregnancy Zuspan prize.
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