Until the 1990s, women were largely absent from medical research. Not as patients, but as the people studied to work out what is safe and what works.
How it happened
In 1977, after the thalidomide tragedy, regulators recommended keeping women of childbearing age out of early-stage drug trials. Thalidomide, prescribed for morning sickness, had caused devastating birth defects. The instinct that followed was protective: to shield women, and potential pregnancies, from drugs whose effects were not yet understood.
That instinct was understandable. The problem was the scale of it. The rule was applied so broadly, and for so long, that women were effectively left out of research well beyond pregnancy-related studies. For the better part of two decades, the default body in medical and nutritional research was male.
It was not until 1993 that including women in research became standard practice, written into law in the United States. The science is still catching up on those lost decades.
Why it still matters: heart disease
The clearest example is heart disease, the leading cause of death for women.
For decades it was studied mainly in men. So the “classic” warning signs most of us learned, the crushing chest pain, the pain shooting down the left arm, are really the classic signs in men.
Women more often experience a heart attack differently. Nausea. Pain in the jaw, neck or back. Sudden fatigue. Breathlessness. Because these signs do not match the textbook picture, women's heart attacks are still more likely to be missed or diagnosed late. That is a direct, ongoing consequence of research that did not include enough women.
A pattern, not a one-off
Heart disease is the clearest example, but it is not the only one. Women's needs differ from men's in specific, measurable ways.
Iron requirements are higher across most of a woman's life. Calcium and magnesium needs shift across the decades, particularly around menopause. Protein needs per kilo of body weight are not lower simply because women are, on average, smaller. And the nutritional needs tied to the natural rhythms of a woman's body have only recently started getting the research attention they deserve.
So if generic health advice has never quite seemed to fit you, this is part of why. A lot of it was not built with you in mind.
The encouraging part
This is not a story without hope. Since the 1990s, the picture has been changing. Including women in research is now the standard. Studying how findings differ between women and men is increasingly expected. Women's health is, at last, a serious and growing field.
There is ground to make up. But it is being made up. And in the meantime, the most useful thing you can do is to be a little discerning. Ask whether the advice you are following was designed with women in mind. Know your own numbers. Choose the things made for your body, not a scaled-down version of someone else's.
The takeaway: for decades, medical research was done mostly on men, originally to keep women safe. It left real gaps, heart disease being the clearest. The field is catching up, and in the meantime it is worth choosing advice and products built specifically for women.
References
- Merkatz RB, et al. (1993). Women in Clinical Trials of New Drugs - A Change in Food and Drug Administration Policy. New England Journal of Medicine, 329(4), 292–296.
- Institute of Medicine. (1994). Women and Health Research: Ethical and Legal Issues of Including Women in Clinical Studies. National Academies Press.
- NIH Revitalization Act of 1993, Public Law 103-43.
- Mehta LS, et al. (2016). Acute Myocardial Infarction in Women: A Scientific
- Statement From the American Heart Association. Circulation, 133(9), 916–947.
- Heart Foundation. Women and heart disease. heartfoundation.org.au