At first glance it may seem like women’s health is finally enjoying its moment. Femtech startups are landing sizable venture capital rounds. Employers are touting fertility benefits as a sign that they’re progressive-minded and woman-friendly. New treatments for conditions like postpartum depression and menopause are making headlines.
But once you get past the press releases and cheery posts on social media, the cracks are everywhere.
Take postpartum depression. In 2023, the Food and Drug Administration approved the first oral treatment to treat the condition. But while this represents a true milestone, its $15,000 list price and limited insurance coverage render it inaccessible for many women. Similarly, while IVF is more commonly covered in corporate benefit packages than it was a decade ago, women without employer-sponsored health coverage face out-of-pocket costs exceeding $20,000 per cycle.
The pattern is clear: Innovation in women’s health may be increasing, but access is not. And innovation without access is a dead end.
In conditions like endometriosis or PCOS (polycystic ovary syndrome), where women can go decades without a diagnosis even when they do seek out medical help, treatment options are limited. Too often, women are handed birth control pills or dismissed entirely. Other common conditions, including fibroids, hormone-related mood disorders and heavy bleeding, remain underfunded and misunderstood.
We are mistaking symbolic wins for structural progress. In the process, we’re creating a two-tier system: One in which some women benefit while many more are left behind.
Part of the problem is that we define women’s health narrowly. Women’s health is reproductive health, but it’s also cardiovascular, metabolic, autoimmune, musculoskeletal and sexual health. It encompasses the full spectrum of care across a woman’s lifespan, not just during pregnancy or menopause.
Yet the healthcare system writ large and the market surrounding it continue to focus on reproduction, all while conditions like perimenopausal depression and autoimmune disease remain under-researched and largely ignored in the current wave of investment. Thus if we want to make real progress, we must expand our definition of women’s health.
Simply put, the U.S. is failing its women. It has the highest maternal mortality rate of any high-income country, with Black women nearly three times more likely to die from pregnancy-related causes than white women. These are not anomalies; they are structural and systemic failures.
And still we pour resources into neonatal care while postpartum women struggle to access mental health care or even follow-up visits after childbirth. If we’re going to have a real conversation about prioritizing women’s health, we must first reckon with this maternal health crisis.
The way we design, fund and deliver women’s health care hasn’t meaningfully changed this century. Clinical trials still default to male biology; women, especially those who are older, are vastly underrepresented in research. Conditions that affect women in greater numbers than men, such as IBS and hormone-linked mood disorders, remain misunderstood and often trivialized. Mental health care remains siloed from reproductive care.
Even organizations that start with bold, noble missions to improve women’s health sometimes struggle to stay the course. Pipeline programs for endometriosis, PCOS and other conditions have stalled for any number of reasons: reimbursement uncertainty, a lack of ROI models and trial designs that fail to capture real-world outcomes, among others.
Some companies have reallocated resources toward supposedly safer categories that are seen as more commercially viable. Others—such as TherapeuticsMD, which once focused on menopause and contraception—have downsized, restructured or sold off assets in the face of rising investor pressure and payer headwinds.
The intent is there, but the incentives are not. Additionally, the current political environment in the U.S. has only complicated matters. Since the Supreme Court’s decision in Dobbs vs. Jackson Women’s Health Organization, reproductive care in the U.S. has become more fragmented, dangerous and confusing. While companies may fear political backlash, their silence won’t protect patients (or the industry) in the long run.
Inaction, after all, has a cost. Too often it goes unstated that, when women are unable to access safe, evidence-based care, the burden doesn’t fall on them alone. It ripples through families, communities and even entire economies. It affects every aspect of their lives, from productivity to mental health to financial security.
Meanwhile, from a purely business perspective, the healthcare industry leaves billions on the table by continuing to treat women’s health as a niche. Women make the majority of healthcare decisions in most households and comprise half the population. If that’s not a market worth investing in, it’s hard to imagine a market that is.
If life sciences companies and other healthcare-adjacent organizations genuinely want to lead the industry back from the brink in women’s health, they need to acknowledge a handful of uncomfortable truths. That women’s health encompasses far more than just reproductive health. That innovation without access and equity isn’t likely to take root. That silence on political issues equals complicity, not neutrality.
Those organizations must also be willing to back up their talk with action. They must design trials that reflect the needs and challenges of real-world women; prioritize affordability and access; invest in assets that address unmet health needs, rather than buzzy conditions; and speak up during times when the access is under siege.
We already know what it looks like when women’s health is deprioritized, because we’re living it. The question isn’t whether we can do better. It’s whether we will do better—and for all women, not just the ones who can afford it.
Meg Rivera was previously SVP, U.S. market president at Organon; CMO, head of commercial at Akili Interactive; and SVP, head of women’s health sales and marketing at AMAG Pharmaceuticals.
