Opinion
“The lack of transparency around HRT cost and supply is yet another barrier to menopause treatment”
By Katie Beaton, head of product at Phlo Connect

Disconnected prescribing and medication dispensation pathways are preventing clinicians and patients from accessing vital information about the availability and cost of HRT medication. We need to prioritise the connecting of databases and systems in order to inject transparency into every step of the HRT pathway.
Around 13 million people in the UK are estimated to be currently menopausal or perimenopausal – a state of physiological transformation often accompanied by debilitating symptoms.
For much of history, people were left to self-manage menopause without medical support. However, in the 1960s a novel treatment called Hormone Replacement Therapy (HRT) was made available. For the first time, menopause symptoms could be successfully controlled, and millions could return to living their lives.
Following recent high-profile awareness campaigns, and an ever-evolving understanding of the condition, public demand for HRT is soaring.
UK prescriptions have doubled in the past five years, but the manufacturing and supply chains have failed to keep pace. As a result, several major HRT products have been in critically short supply – leaving millions of people struggling to access their essential medications.
As summarised by Rose George in the Guardian, “HRT is not a lifestyle choice but a lifesaver”.
However, a chronic lack of transparency in the prescription and dispensation process is making it increasingly difficult for doctors and pharmacists to offer appropriate treatment for menopause symptoms without enduring additional stress, frustration and expense to procure HRT.
It’s key that public health leaders, manufacturers, healthcare providers and pharmacists work together to build the transparent, reliable systems that patients deserve.
Why is transparency around HRT supply levels so important?
When a patient goes to their doctor for their HRT prescription, doctors will typically prescribe one of several different types of medication. However, the doctor and the patient have no way of knowing how easy it will be for the patient to obtain this from a dispensing pharmacy.
This means that a patient might have to travel between several local pharmacies to find one that has been able to obtain stock from their suppliers. This presents an obvious barrier to medication access for those who live in rural areas, those who rely on public transport, or those who are time-poor.
In addition, medication consistency is very important in menopause treatment, and not all types of medication work for every person.
This means that switching between different medications – or taking unplanned breaks – limits the effectiveness of symptom management. What patients really need is a consistent, reliable supply of their prescribed medication.
Why does transparency in pricing matter?
When a patient chooses to use a private healthcare provider to obtain an HRT prescription – even if they still collect the item from an NHS pharmacy – NHS medication pricing protections do not apply.
As a result of fluctuating stock availability and insufficient wholesaler quotas, the costs of obtaining privately prescribed medications can also fluctuate significantly depending on the pharmacy visited.
There is no way for women to check or monitor these costs, meaning that during the current cost of living crisis, many simply can’t afford HRT.
What would a system that works for patients and providers look like?
Whilst there are critical manufacturing and distribution issues in the HRT supply chain, there are key areas of responsibility that can be effectively addressed by pharmacies and system reform.
Investment in better digital integration between the system’s multiple moving parts could transform the HRT prescription and procurement experience for all stakeholders.
Firstly, consider supply chain visibility. If a clinician, when generating a patient’s prescription, was informed by pharmacies regarding the availability and forecasted future availability of the different medications, then they could choose to prescribe an HRT medication that the patient would definitely be able to access.
If the patient has access to an app that offers full visibility of the price and availability of their prescribed medication, they are able to make an informed choice.
With the right integrations and digital infrastructure, a more connected, transparent ecosystem could become reality. This would be an ecosystem that would empower women, their doctors, and their pharmacists with reliable and affordable access to HRT medication.
Katie Beaton is the head of product at the London-based digital pharmacy, Phlo.
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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