For 25 years, the world has made significant progress in advancing women's right to health, particularly in sexual and reproductive care. Women are living longer than ever before - but they are not living better.
Across the world, UN data shows, women are still less likely to be taken seriously, accurately diagnosed, or appropriately treated. From misdiagnosis to entrenched medical bias, gaps in healthcare systems continue to affect women's health, safety and quality of life.
Although healthcare is a fundamental human right, it's still not guaranteed for all - and inequality persists in one of the most critical areas of everyday life.
Women are more likely to have their pain dismissed, their symptoms misread and their conditions diagnosed too late. According to gender equality agency, UN Women , this reflects a "medical system historically designed without women in mind".
From the tools used in examinations to the data that shapes diagnosis and treatment, these gaps are embedded in healthcare systems, with real consequences.
What the data shows
There has been measurable progress, says UN Women. Between 2000 and 2023, maternal mortality declined by 40 per cent, from 328 to 197 deaths per 100,000 live births.
Adolescent fertility rates fell from 66.3 to 38.3 births per 1,000 girls aged 15-19 between 2000 and 2024. Skilled birth attendance rose from 60.9 to 86.6 per cent, and the proportion of women using modern family planning methods increased from 73.7 to 77.1 per cent.
Yet these gains are uneven. In the least developed countries, adolescent births increased from 4.7 million in 2000 to 5.6 million in 2024.
Women are also living longer than men - 3.8 years compared to 68.4 - but they spend more years in poor health. In 2021, women spent an average of 10.9 years in poor health, compared to 8.0 years for men.
This includes chronic conditions such as musculoskeletal disorders, gynaecological diseases, migraines and depression.
Six uncomfortable truths
1. Outdated tools remain in use
The speculum, widely used in pelvic examinations, has changed little since its design in the 19th century. Despite advances in medicine, many diagnostic tools have not evolved to prioritise women's comfort, dignity and safety.
Efforts to redesign such tools are emerging, particularly through women-led innovation, but adoption across public healthcare systems remains limited.
2. Longer lives, poorer health
Although women live longer, they spend a greater proportion of their lives in poor health ; around 25 per cent more than men.
This often means prolonged experiences of chronic pain, fatigue and untreated conditions, alongside higher rates of misdiagnosis.
3. Research and funding gaps persist
Conditions affecting women are often under-researched and underfunded. Premenstrual syndrome (PMS), which affects a majority of women and girls, receives comparatively less attention than conditions such as erectile dysfunction.
For decades this imbalance has shaped how women's pain is understood, or misunderstood, dismissed, and too often normalised and left unaddressed.
Policy changes are emerging. In 2023, Spain introduced paid menstrual leave, joining several countries including Japan, Indonesia and Zambia. However, stigma and limited awareness continue to affect uptake.
4. Delayed diagnosis is common
Endometriosis affects around 1 in 10 women and girls globally - approximately 190 million people. Yet diagnosis can take between four and 12 years .
Delays reflect a broader pattern in which women's pain is normalised or dismissed, resulting in prolonged suffering and late treatment.
5. Historical exclusion from research
Until 1993, women were largely excluded from clinical trials. As a result, many treatments were developed based on male biology.
This has had lasting effects. Women are more likely to experience adverse drug reactions, and symptoms can be misinterpreted. Conditions that primarily affect women, including autoimmune diseases, remain under-researched.
Gaps persist today, including in emerging technologies such as AI, where datasets may still underrepresent women.
Recent research has highlighted the importance of integrating sex and gender into clinical studies - including during the COVID-19 response - to ensure that treatments are safe and effective for everyone.
Another issue is that women are underrepresented in healthcare leadership. This matters because female doctors and leaders often prioritize patient-centred care, evidence-based practices, and policies that improve women's health outcomes.
6. Symptoms that don't match the model
Heart disease is the leading cause of death among women. However, widely recognised symptoms are based largely on male patterns.
Women may experience different warning signs, including fatigue, nausea, shortness of breath and pain in the jaw or back. These differences can lead to delays in diagnosis and treatment, increasing the risk of death.
Because the signs are less recognised, women are in some cases sent home instead of treated.
The way forward
Addressing these disparities requires healthcare systems that reflect women's realities. This includes more inclusive research, better data, improved diagnostic tools and greater recognition of women's symptoms and experiences.
Strengthening leadership by women is also critical. Evidence shows that greater inclusion can improve patient outcomes and reduce mortality rates.
