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Opinion

Education as the missing element in the misdiagnosis of menopause symptoms

By Terry Weber, CEO at Biote

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Terry Weber, CEO at Biote

As the CEO of a company breaking new ground in our collective understanding of hormone optimisation, I am continuously confronted with evidence of the profound impact menopause education can have on women’s health.

At Biote, we currently have approximately 6,400 US providers in our network, primarily family practitioners and OB/GYNs, and are training hundreds more each month to understand the complexity of hormones.

With only 20 per cent of OB/GYN residency programmes providing menopause training – and those mostly through elective courses – there is a huge gap in professional health education that has had a deleterious impact on women for generations.

Furthermore, this gap in medical school syllabi is mirrored in the curriculums of public elementary schools where girls learn about the onset of menstruation in health class but are not taught about the natural end of this phase.

Social media, innovative tools, and an inquiring new generation of women have brought us to a key point in time where consumer awareness and desire for knowledge has never been higher.

Unfortunately, this hasn’t been matched by strides in medical education. Providers come to us hungry for information.

What is so complicated about menopause?

What the average person knows about menopause is often limited to the knowledge that menstruation ends and hot flashes begin.

In reality, perimenopause and menopause symptoms potentially span a decade or more with unpredictable symptoms that appear, evolve, or manifest sporadically.

Over 30 symptoms are associated with menopause, but their severity and frequency varies for each individual and can be influenced by family history, lifestyle factors and concurrent conditions.

Further, the range of menopause symptoms spans women’s physical, emotional, cognitive and mental wellbeing and many overlap with signs of other conditions. For example, fatigue, anxiety, sleep and mood disturbances are all potential symptoms of menopause but are also associated with depression.

Unfortunately, it is quicker and easier for providers to treat menopause symptoms with a short-term band-aid solution.

True treatment requires providers to understand a complex topic and treat the root cause through a personalised and long-term care plan.

How we work to close the gap

Our network providers have performed over three million hormone replacement therapy pellet procedures to date, collecting data that helps inform providers since they often have not received education about menopause in medical school.

Our clinical decision support software analyses lab results, patient history, symptomology and other relevant information to guide providers as they diagnose and treat, enabling them to get the optimal personalised dosage for each individual patient. There are no easy, specific guidelines so having access to robust, real-life data is incredibly helpful.

Last year we released a retrospective study of real-world data involving 2,337 patients over nine years that found that women treated with testosterone pellet therapy had a nearly 36 per cent lower incidence of invasive breast cancer compared to expected age-adjusted rates.

A recent patient case study showed a remarkable reversal of osteoporosis in a patient after one year of pelleted testosterone therapy.

Studies have shown a correlation between low hormone levels and conditions such as heart disease and breast cancer with emerging research pointing to a link to cognitive diseases such as Alzheimer’s and dementia.

Collectively, we must put our focus on more studies, on more research, and on getting those studies to providers where they can help patients.

The provider ecosystem 

In addition to educating providers about the wide range of ways that symptoms of hormonal imbalance can present, training that addresses what patients look for in treatment, how to ask patients the right questions, and how to listen is also important.

Soft skills are crucial in fine-tuning a treatment that must be tailored to the individual to achieve optimal results.

Empathy has tremendous importance when you consider that many patients suffering from menopause symptoms have already been ignored, dismissed, or misdiagnosed – sometimes for years – before finding a provider that understands how to treat them effectively.

Because various staff members will interact with patients differently, we believe in training not just the provider but the full staff, from the front desk to mid-level clinicians.

They are the ones asking initial questions and helping patients, developing relationships and being privy to comments that patients might not feel are important or are hesitant to share with their provider. We need to get the entire healthcare ecosystem to new levels. 

The view from the tip of the iceberg

Striving for a higher level of understanding is difficult in a category where there are not yet established mainstream treatments.

However, providers who decide to invest the time and effort to learn about hormone optimisation say that it has truly altered their practice.

Treating the root cause and balancing hormones gives their patients great outcomes and long-term results, improving overall health and happiness.

 

Terry Weber is the CEO of the preventative healthcare company Biote.

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The technology exists: Why are women still waiting?

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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.

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Opinion

Women’s Health has waited long enough for innovation

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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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Why advocacy-orientated CPD matters for the future of cardiology

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By Women As One

At the 2026 Alliance Annual Conference, Women As One presented a poster that asked a powerful question: What if continuing professional development (CPD) did more than teach clinical knowledge— and instead helped shape the future of the workforce itself?

For decades, professional education in medicine has focused primarily on what clinicians know and how they practice. That work remains essential.

But persistent gender gaps across cardiology—from leadership positions to research participation and speaking opportunities—demonstrate that knowledge alone is not enough to ensure equitable advancement.

To truly strengthen the field of cardiology, professional development must also support who clinicians become, the opportunities they access, and the voices that shape the future of cardiovascular medicine.

Our poster, More Than Education: Elevating Equity and Identity Through CPD, explores how a new model of advocacy-orientated CPD can help close these gaps.

Advocacy-orientated CPD expands the traditional model of professional education. In addition to building clinical expertise, it intentionally supports the structural elements that shape career advancement—mentorship, sponsorship, leadership development, visibility, and professional networks.

By integrating these elements into professional education, CPD can become a powerful engine for advancing equity—and ultimately improving patient care.

Why this matters

Gender inequities in medicine are not simply workforce issues. They influence research priorities, clinical trial representation, leadership decision-making, and ultimately the care patients receive.

When women clinicians have equitable opportunities to lead, research, and shape clinical practice, the entire healthcare system benefits.

Yet structural barriers remain. Women physicians often have less access to mentorship, sponsorship networks, and leadership pathways—factors that are critical for career advancement.

This is where advocacy-orientated CPD comes in.

By intentionally designing programs that foster mentorship, build leadership skills, create visibility, and support long-term professional growth, organizations can help ensure that the next generation of cardiovascular leaders reflects the diversity of the patients they serve.

Turning opportunity into impact

Since its founding, Women As One has supported thousands of women cardiologists across more than 100 countries, expanding access to mentorship, research opportunities, and leadership development.

Through programs like CLIMB, RISE, Mentorship Awards, and our global digital community, The Pulse, thousands of women cardiologists have gained mentorship, leadership training, and opportunities that accelerate their careers and expand their influence.

Today, the outcomes of these programs are shaping the field in tangible ways:

  • Women As One alumnae are leading clinical trials and advancing cardiovascular research
  • Clinicians supported through our programs are building registries, launching new care models, and expanding access to specialized care
  • Women cardiologists are gaining greater representation on speaker panels, advisory boards, and leadership pathways
  • A global community of more than 3,000 women cardiologists is strengthening collaboration, mentorship, and visibility across the profession

These outcomes demonstrate what becomes possible when professional development goes beyond traditional education to intentionally support leadership, identity, and community.

A call to the cardiovascular community

Advancing equity in cardiology is not the responsibility of one organization—it requires a collective effort across the entire ecosystem of clinicians, educators, institutions, and industry partners.

For women cardiologists, this means engaging in the programs, mentorship networks, and leadership opportunities that help shape the future of the field. Whether through CLIMB, RISE, research initiatives, or participation in The Pulse community, your involvement strengthens a growing movement dedicated to advancing women in cardiology.

For our partners and supporters, this work demonstrates the powerful impact that strategic investment in equity-focused professional development can have on the workforce and the patients we ultimately serve.

Together, we can redefine what professional development looks like in medicine—not just as a pathway for learning, but as a catalyst for leadership, opportunity, and lasting change.

Explore the poster

We invite you to explore the poster below (click here to download it) to learn more about the evidence, framework, and real-world impact behind this work—and to join us in continuing to expand what professional development can achieve for the future of cardiovascular medicine.

Learn more about Women As One at womenasone.org

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