The Shocking History Of Women's Health Research, From An M.D.

From medical gaslighting to the gaps in breast cancer research and hormone replacement therapy, the ways in which medicine has let women down are more widespread than we'd like to admit.

In a powerful new episode of the mindbodygreen podcast, award-winning physician and oncologist Elizabeth Comen, M.D.—author of the best-selling book All In Her Head—unpacks the shocking history of women’s health and the research that’s failed them, along with practical steps for a better future.

Exercise physiologist Stacy Sims, Ph.D., once told us on the mindbodygreen podcast, "Women are not small men," emphasizing that women shouldn’t be treated as such in research. Comen echoes this sentiment, diving into the reasons behind it.

“Women are not small men. We present differently with diseases. It's not just about our breasts and our uterus,” Comen explains. 

It's about neurological symptoms, markers of heart disease, autoimmunity symptoms, and so much more. The differences between men and women go far beyond body size and reproductive organs.

Historically, women and minorities weren’t even required to be included in clinical trials until 1993, Comen points out. Before then, major studies on chronic disease and medications like Aspirin were conducted exclusively with male volunteers.

“The assumption was that we would just dose it differently for women,” she says, highlighting a gross underestimation of the physiological differences between men and women.

Due to the lack of research on women’s health, many physicians struggle to recognize diseases or health conditions in women, often missing critical diagnoses. But as Comen emphasizes, giving up when the obvious tests come back negative isn’t an option.

“I think part of it comes from a human instinct in physicians, even with the best of intentions, to want to label something when they don't have an answer for it,” Comen explains.

This can lead to misdiagnosis or even medical gaslighting, where physicians downplay a patient's symptoms, suggesting they aren't as severe as reported simply because the tests don’t provide clear answers.

Heart disease1 is the leading cause of death among women in the United States, yet it doesn't receive the attention or advocacy it desperately needs.

“When I was in medical school, we were taught that women's symptoms of heart attack were atypical. That's absolutely ridiculous—to teach students and future doctors that the way women present is the atypical version of how men present when it is the number one killer of women.”

Comen explains that women have distinct biology when it comes to heart disease. “A lot of what we present with is more small vessel disease, which is different to visualize than what you might see in a man. So there's a lot of work that needs to be done, not just in research, but also in terms of who has a seat at the table and who the doctors are that treat patients.”

Reflecting on the situation, the lack of heart disease research specifically focused on women often leads to missed diagnoses, which directly cost lives. We need to understand the unique signs of heart disease in women, rather than assuming they mirror those in men or deeming them "abnormal."

Women have been neglected in medical research for far too long, which has resulted in countless missed diagnoses and lives lost—but we’re moving towards a brighter future. To learn more about the history of women’s health, exciting new strides in women’s research, and hear Comen’s powerful personal story, tune in to the latest episode.