The Greatest Risk Factor in Women’s Health

A 45-year-old woman goes in for her annual exam. She mentions heart palpitations, fatigue, and trouble sleeping. The clinician reassures her: “It is probably a hormone imbalance.”

She leaves with an order for labs to check her estrogen and progesterone and a referral to a gynecologist. No clear answers, and no plan. Months later, she lands in the emergency room with a cardiac event that might have been preventable.

Her story is not rare. It illustrates a deeper problem: the greatest risk factor in women’s health isn’t estrogen, progesterone, or menopause—it’s research and ultimately clinical neglect.

Why Conventional Wisdom Gets It Wrong

For decades, women’s health outcomes have been explained—and too often dismissed—through the lens of hormones.

Hot flashes? Hormones imbalance.

Migraines? Hormones imbalance.

Mood changes? Hormones imbalance.

This reflex narrows diagnostic thinking and masks conditions that could and should be addressed.

Here’s the ugly truth: the scientific foundation beneath women’s health is startlingly thin. Until 1993, women were routinely excluded from clinical trials in the U.S. Even today, women remain underrepresented in research on cardiovascular disease, autoimmune disorders, and neurology—despite bearing a disproportionate burden of these conditions. And conditions that primarily or only affect women receive only 5-9% of public or private funding.

The result? Symptoms that differ from what men experience (like heart attack signs) are overlooked. Chronic conditions (like endometriosis or autoimmune disease) remain underfunded and understudied. And when in doubt, medicine falls back on hormones as a catch-all explanation. Women’s hormonal changes have a regular pattern that has been so understudied, we have little idea about which variations are truly the cause of symptoms and disease.

The Alternative View: Center Women in Research

What if we stopped blaming women’s hormones and started addressing the real gap—knowledge?

• Invest in research parity. Women need to be represented in studies not just on reproductive health, but across every system of the body.
• Train clinicians in sex- and gender-specific medicine. Recognizing that “normal” values may differ by sex prevents missed diagnoses.
• Expand diagnostic frameworks. Instead of stopping at hormones, clinicians must explore cardiovascular, metabolic, autoimmune, and social determinants of health when women present with what seem like vague or overlapping symptoms.

This shift doesn’t deny the role of hormones. Instead, it restores balance—acknowledging hormones as only one part of female physiology.  As a result of increased research on women,  women will stop being medical mysteries and start being understood as whole people.

A Call to Action

It’s time to stop using the catch all “hormone imbalance”  to bypass women’s symptoms and start confronting research neglect as the real barrier to better women’s health.

With this in mind, I created Access Diagnosis—a tool designed to help clinicians move beyond shortcuts, integrate evidence, and expand the questions we ask when women present with “nonspecific” symptoms. We can’t single-handedly fix decades of research gaps—but we can prevent them from becoming diagnostic gaps today.

If you’re a clinician, educator, or health leader ready to build a future where women’s symptoms aren’t dismissed or