Women often face barriers when trying to navigate healthcare systems, which influences the quality of healthcare they receive – if, indeed, they receive care at all. 

The kinds of blockers women face can include not feeling listened to by medical professionals, or having their symptoms or pain dismissed, which can lead to delayed diagnosis for serious conditions such as heart attacks and cancer. In fact, a Danish study found that in over 770 different diseases, women are diagnosed later than men due to medical bias.¹

Female health conditions such as endometriosis and menopause can also have a huge impact on a woman’s day-to-day life – and therefore career – resulting in more days off sick, worsening productivity, and even leading to career dropout.

By encouraging and supporting women to advocate for their health and navigate the healthcare system effectively, multinationals can boost the health and wellbeing of female employees. Not only will this aid their performance at work, and their career prospects – it can lead to better productivity and business output.

In this month’s Viewpoint, we’ll explore how you can support your female employees.  

Before we dive into what you can do, it’s important to understand the scale of the challenge and why women face medical bias. Women’s health concerns being dismissed or taken less seriously than men’s is a trend that persists across various medical conditions and in different healthcare settings all around the world.

And there are a few reasons why. Women face medical bias because lots of medical research, diagnostic tools and treatments have been designed around men as the default. Until recently, women have been excluded from clinical trials of drugs because of concerns around fertility and the interference with their potential to have children in the future, often referred to as ‘anticipatory motherhood’. Even today, researchers will often leave women out of trials due to the changes that happen to their bodies during the menstrual cycle.²

Since 2007, the US National Institutes of Health has required that women are included in the research that it funds so that it is representative of women as well as men.³ However, women are still not adequately represented in the individual testing phase of trials run by the pharmaceutical industry, with a 2018 study finding that just 29-34% of participants in early-stage US trials were female,⁴ with the majority of trials still carried out on men and male mice.⁵  

As a result of being underrepresented in clinical trials, women are more likely to have serious adverse reactions to drugs. MAXIS data from 2021 shows that 75% of adverse medication reaction paid claims were for women, and in 2022 it was 59%.⁶

Historically, female health problems would often be blamed on ‘hysteria’, and the notion continues to this day, with 2021 research by University College London finding that women’s pain is often ‘routinely underestimated’, due to beliefs that women are oversensitive to pain and tend to exaggerate it. This can lead to women to be under-treated for pain, with it being falsely blamed on psychological reasons.⁷

Nurofen’s 2024 Gender Pain Gap Index Report has shone a light on the disparity between female and male healthcare, revealing that 62% of women feel their complaints of pain have been ignored. The report found that female pain is ignored or dismissed in girls as young as ten, all the way through to retirement age.

The report surveyed medical students about the gender pain gap, revealing that they’re all too aware of it, but don’t feel they are receiving formal teaching about it during their medical degrees.⁸

Let’s look at some of the conditions where women face dismissal or late diagnosis.

Heart conditions: Heart disease is a leading cause of death in women, but it continues to be misdiagnosed, and women are more likely to die from heart attacks than men. Women are 50% more likely than men to receive the wrong diagnosis for a heart attack.⁹

Female heart attack symptoms present differently in women than in men – while men may exhibit the ‘classic’ symptoms of chest pain and pain along the left arm, women may present with pain between the shoulder blades, nausea or vomiting and shortness of breath or anxiety.

Heart attack symptoms in women often aren’t picked up because medical students are still taught to recognise a heart attack based on the symptoms of the ‘typical’ 70kg man.¹⁰ Sex differences are often not spoken about.

A 2018 study of around 3,000 female and male patients at more than 100 US hospitals shows that women are more likely to have their heart disease symptoms dismissed as anxiety or stress, rather than being taken diagnosed as indications of cardiovascular problems.¹¹

Cancer: On average, cancer is diagnosed two-and-a-half years later in women than men.¹²

MAXIS claims data from 2017-2023 reveals the conditions women were diagnosed with in the year before they were diagnosed with cancer, showing early warning signs of cancer in women that might be missed. These include digestive/abdomen concerns, back and joint pain and pelvic conditions.¹³ 

There are many cancers where women receive a late diagnosis, including:

• Ovarian cancer: This cancer is often referred to as a ‘silent killer’ because its symptoms are vague and can be missed. Many women report being dismissed by doctors when they express concerns about bloating, pelvic pain or frequent urination. A UK study by Target Ovarian Cancer found that more than a quarter of women with symptoms saw their GP three times or more before they got a referral for tests.¹⁴  
• Breast cancer: Studies have found that women under 40 with breast cancer are frequently dismissed by doctors due to their age, resulting in delays in diagnosis, leading to a later diagnosis of breast cancer in younger women.¹⁵
• Cancers prevalent in both sexes where women often receive a later diagnosis than men, include pancreatic, rectal, lung, bladder, gastric and lymphoma.^16,17,18 

Endometriosis: A 2024 study from the University of York found that women with endometriosis (approximately 1 in 10), wait on average 6.6 years for a diagnosis, despite reporting symptoms like pelvic pain, infertility and heavy periods.¹⁹ This delay in diagnosis is partially due to the assumption that women’s complaints about menstrual pain are exaggerated or something that should just be put up with.

These dismissals and delays can have a huge impact on your employees’ lives and careers, which has knock-on effects for the productivity of your business. Symptoms of undiagnosed or badly managed conditions can affect a female employee’s ability to concentrate and manage stress or can even lead to them quitting their jobs.

A Dutch study of 32,000 women found that one in seven had to take time off work due to period pain, with eight out of ten women coming into work despite feeling unwell, leading to presenteeism.²⁰ Presenteeism increases the likelihood of poor performance, errors, mental health conditions, stress, and burnout and it can also cause poor employee retention.

Endometriosis can have detrimental effects on mental health and cause fatigue, leading to more days off sick. In the UK, endometriosis costs the economy £8.2 billion per year in days off work and healthcare costs.²¹ Data from 52 countries has shown that 41% of women with endometriosis have given up their job or become unemployed due to the condition.²²

Meanwhile, menopause can have a hugely disruptive effect on women’s lives and careers. Up to a third of women experience severe side effects, which can include hot flushes, poor concentration, tiredness, poor memory, feeling low/depressed and lowered confidence.²³ A poll by the Fawcett Society of 4,000 women in the UK aged between 45 and 55 found that one in ten had quit their job because of menopause symptoms.²⁴

A good place for you to start when it comes to prioritising female health is with your employee benefits (EB) programme. By helping your female employees with their health, you can build a happier, healthier workforce, and increase retention of your valued female staff – a real win-win for multinationals.

1) Encourage women to advocate for their health

In terms of patient-advocacy, education and empowerment is key. Here are some quick tips you could share with your female employees to help them advocate for their health and get the care they need and deserve.

Before an appointment:

• Prepare a list of past medical conditions, surgeries, medications and allergies.
• Write down any symptoms, including changes in sleep, appetite, weight, energy levels, or periods.
• Write down any questions in advance.

During an appointment:

• Be assertive and speak up.
• Ask for clarification on anything that’s hard to understand.
• Write down notes of any key points that came up during the appointment.
• Ask about any potential side effects of treatments prescribed.

Advocate for yourself:

• Bring a friend or family member to provide support.
• If something feels off physically, don’t be afraid to speak up.
• Don’t be scared to ask for a second opinion.

For more tips for employees, download our free flyer to distribute to your people.

2) Run an educational campaign in your workplace

Continuing on the theme of education, you can use internal campaigns to raise awareness on female health issues among employees. Consider marking different health awareness days throughout the year (like Women’s Health Month, Endometriosis Awareness Month and Breast Cancer Awareness Month) and talk about the health issues where women are under-diagnosed.

MAXIS clients can download our menopause awareness toolkit, giving you everything you need to run a menopause campaign.

3) Work with leading local insurers

Healthcare starts locally, so it is important to work with leading insurers that have the best range of coverage, understand local challenges and have relationships with top providers and hospitals.  

4) Use your captive to ensure you’re providing equitable benefits

Using a captive to write EB could be a great way to help advocacy. You could consider reinvesting underwriting profits from the captive into global solutions that provide virtual, tailored support for women’s health, fertility and menopause.

5) Engage men as allies

While we’ve talked a lot about women’s health, this is an issue for all. Men can be allies in this space, helping the women in their life advocate for themselves and tackle any unconscious bias they may see.