For most of the twentieth century, the reference human body in medicine was male. Drugs were tested mostly on men, diseases were studied mostly in men, and what was true for a 70-kilogram man was quietly assumed to be true for everyone else. In 2024 that legacy got a price tag. A report from the McKinsey Health Institute and the World Economic Forum estimated that women spend, on average, about 25% more of their lives in poor health than men — a gap that, if closed, could add more than US$1 trillion to the global economy every year by 2040 [source: World Economic Forum, 2024]. That headline number is now quoted in boardrooms and health ministries alike, and it has helped turn a slow-burning inequity into a policy priority.
This article maps the "women's health gap" — the historic underrepresentation of women in medical research and the funding, diagnosis and treatment gaps that followed — and why it is suddenly driving executive orders, national strategies and a femtech investment boom. Throughout, it keeps three layers separate, because they are easy to blur: the research and clinical facts (what studies measured), the economic projections (what models estimate the gap is worth), and the market and company claims (what a growing industry is selling). None of this is medical advice; if a symptom is being dismissed, that is a conversation for a clinician, not a checkout cart.
Table of Contents
- What the "women's health gap" actually means
- Why the science has a blind spot
- The diagnosis gap: endometriosis and menopause
- Why now: the policy turn
- The femtech boom: promise and skepticism
- What to watch
What the "women's health gap" actually means
The phrase bundles together several different things, and it helps to unbundle them. There is a research gap (women were long excluded from studies), a funding gap (money has not tracked how much certain diseases burden women), a diagnosis gap (conditions that mainly affect women take longer to identify), and a care gap (treatments are less well understood because the underlying science is thinner). The McKinsey–WEF report tried to size the whole thing at once. Its central finding — that women live about 25% more of their lives in poor health, largely during their working years — is the human core of the story [source: World Economic Forum, 2024].
The trillion-dollar figure deserves a careful reading. It is a modeled economic estimate, not a measured invoice: it projects how much global GDP could grow by 2040 if the health gap were closed, based on assumptions about productivity and participation. The report analyzed nine conditions — including ischemic heart disease, breast and cervical cancer, maternal hypertensive disorders, menopause, migraine and endometriosis — and estimated that closing the gap on those nine alone could add roughly US$400 billion in annual GDP by 2040, with about US$295 billion of that in the United States [source: World Economic Forum, 2024]. These are directionally powerful numbers that have moved real decisions. They are also sensitive to their assumptions, and they should be cited as estimates, not facts on a balance sheet.
Why the science has a blind spot
To understand the gap, start with a piece of regulatory history. In the United States, a 1977 FDA guidance recommended keeping "women of childbearing potential" out of early-stage drug trials — a caution rooted in the thalidomide era that hardened into a habit of studying men [source: AAMC, 2024]. The result was decades of what critics call "bikini medicine": the assumption that women's health differs from men's only in the organs a bikini covers, leaving sex differences in the heart, brain and immune system largely unstudied [source: MDLinx, 2023].
The correction came late and remains incomplete. After a government audit found that federal research was not adequately including women, the NIH created its Office of Research on Women's Health in 1990, and the NIH Revitalization Act of 1993 made the inclusion of women and minorities in NIH-funded clinical research a legal requirement [source: National Academies Press, 1994]. That law changed the rules but not, fully, the reality. A 2024 analysis of large cardiovascular trials found that women still made up only about 29% of participants, well below their share of the disease burden [source: JAMA Network Open, 2024]. Underrepresentation is deepest, researchers note, in oncology, neurology and cardiology — exactly the areas where sex differences matter most.
When the dose is wrong
The consequences are not abstract. Because women were understudied, some approved drugs turned out to behave differently in female bodies than the trials assumed. The sharpest example is the sleep drug zolpidem: about two decades after approval, the FDA in 2013 cut the recommended starting dose for women in half, after evidence that they cleared the drug more slowly and faced greater next-morning impairment [source: HealthCentral, 2013]. More broadly, women experience adverse drug reactions at roughly twice the rate of men, a disparity that reviews link partly to doses calibrated on male physiology [source: Frontiers in Pharmacology, 2023].
Money follows attention — unevenly
Funding tells a parallel story. A 2021 analysis in the Journal of Women's Health compared NIH funding with each disease's burden and found a consistent tilt: in most cases where a disease predominantly affects one sex, the funding pattern favored diseases that mainly affect men, with the author concluding that the NIH "applies a disproportionate share of its resources to diseases that affect primarily men" [source: Journal of Women's Health, 2021]. Funding is not the only lever, but when research money lags disease burden, the knowledge gap compounds.
The diagnosis gap: endometriosis and menopause
The research gap shows up in clinics as a diagnosis gap, and two conditions illustrate it. Endometriosis, in which tissue similar to the uterine lining grows elsewhere in the body, affects an estimated 10% — about 190 million — of reproductive-age women and girls worldwide, according to the World Health Organization [source: World Health Organization, 2025]. Yet the WHO notes that the average time to diagnosis runs between four and twelve years, and that "the general public, family members and most health and care workers are not aware that the chronic pelvic pain" it causes "is not normal" [source: World Health Organization, 2025]. A 2024 systematic review put the average delay at around 6.6 years, with wide variation between countries [source: University of York, 2024].
Menopause is the other emblem of the care gap, and its scale is easy to underestimate: by 2030, more than one billion women worldwide will be in perimenopause or menopause. Advocacy and industry analyses frequently claim that a large majority of women seeking menopause care go untreated — a striking figure that reflects real unmet need but is derived from surveys and market analyses rather than a single authoritative trial, and is best read as an estimate. What is firmer is the policy response: in November 2024 the UK's National Institute for Health and Care Excellence updated its menopause guidance to recommend a wider menu of options, including non-hormonal approaches alongside hormone therapy [source: UK Parliament, 2024].
Why now: the policy turn
If the gap is old, the political attention is new — and that is the "why now." In March 2024, President Biden signed an Executive Order on Advancing Women's Health Research and Innovation, building on the White House Initiative on Women's Health Research launched the previous November [source: The White House, 2024]. The order came with money and asks: the NIH committed to direct US$200 million in fiscal 2025 toward new interdisciplinary women's health research, the health-focused agency ARPA-H launched a US$100 million "Sprint for Women's Health," and the President asked Congress for US$12 billion to create a dedicated women's health research fund [source: The White House, 2024]. A change in administration makes the durability of any single commitment uncertain — another reason to watch appropriations, not just announcements.
Europe has moved on a parallel track. England's Women's Health Strategy, first set out in 2022, named menopause a priority and drove the rollout of "women's health hubs" — one-stop clinics for conditions from heavy periods to menopause. By March 2025, 41 of England's 42 integrated care boards reported having such a hub [source: UK Parliament, 2024]. The common thread across countries is a shift from treating women's health as a niche to treating it as system infrastructure — a reframing the McKinsey–WEF report explicitly encouraged.
The femtech boom: promise and skepticism
Where policy leads, capital follows, and "femtech" — technology aimed at women's health, from period-tracking apps to menopause telehealth and fertility diagnostics — has become one of health's buzziest categories. Here the layering matters most, because three very different numbers are routinely blurred.
The first layer is venture funding, which is tracked deal by deal. By this measure the sector is real but small: analysts estimate women's health startups pulled in on the order of US$1–2.6 billion in 2024 depending on how the category is drawn, still only about 2% of all healthcare venture capital [source: Deloitte, 2024]. Standout rounds — a period-and-fertility app reaching a US$1 billion "unicorn" valuation, a menopause-care company closing a nine-figure round in early 2026 — are company and financing claims, not audited health outcomes, and private valuations can move sharply in either direction.
The second layer is market-size projections, and this is where caution is essential. Estimates of the femtech "market" range from around US$9 billion to nearly US$40 billion for the mid-2020s, with 2030s forecasts running far higher [source: Grand View Research, 2025]. These figures measure consumer spending on devices, apps and services — a fundamentally different thing from venture funding — and they vary enormously because firms define the category differently. A market forecast and a funding total are not interchangeable, however often they appear in the same paragraph.
The third layer is the evidence question. Femtech's promise is genuine: better data, earlier detection, and care for conditions long ignored. But the skeptical case is equally serious. Regulation is uneven, many consumer tools make wellness claims that are not clinically validated, and privacy — especially around reproductive and cycle data — is a live concern. Investors' enthusiasm for a "US$1 trillion opportunity" can also outrun the evidence: the economic projections that justify the boom are models, the diagnostic gaps they promise to close are real, and the products sold into that gap range from clinically rigorous to lightly tested. All three can be true at once, which is exactly why they belong in separate columns.
What to watch
The women's health gap is one of the better-documented inequities in modern medicine. The research exclusion is a matter of record, the diagnosis delays are measured in years, and the funding tilt has been quantified. That solid foundation is now carrying a great deal of enthusiasm — economic projections in the trillions, a femtech market measured in tens of billions, and political commitments still working their way through budgets. The useful posture is neither cynicism nor hype, but the habit of asking which layer a number lives in.
A few things are worth watching from here. Will trial representation finally catch up with disease burden, or will the 1993 law's unfinished business drift into a fourth decade? Will public funding — the US$12 billion ask, the NIH and ARPA-H commitments, Europe's health hubs — survive changing governments and tight budgets? Will femtech mature into clinically validated, well-regulated care, or settle for wellness branding on unproven tools? And will the trillion-dollar framing keep motivating investment without being mistaken for a measured fact? The gap is real and, for the first time in a long time, widely acknowledged. Closing it will be decided less by the size of the headline number than by whether the research, the funding and the products underneath it actually deliver.