Women’s Health Investment Reaps High Return, Report Suggests

Women’s health problems are being sidelined and not treated effectively, resulting in individual distress and significant costs to the economy from lost working days and lower productivity, according to a report from the NHS Confederation published earlier this month.

Examples of ineffectively treated problems include heavy and painful periods, endometriosis, fibroids, and ovarian cysts. 

The authors of the report estimated that the cost to the UK economy was approaching £11 billion annually from work absenteeism, including a direct economic impact from unemployment of £1.5 billion per annum.

They said “escalating costs” of neglecting the health of 51% of the population were being borne by the NHS and wider society.

Investment Could Generate Economic Returns 

The report makes the case to the UK Treasury and the department of health and social care that every additional £1 per woman invested in obstetrics and gynaecology services in England could generate a return on investment of £11, with an estimated £319 million total gross value added to the economy.

The analysis leveraged data from the British Cohort Study and the Reproductive Health Survey. It found that nearly half of women with long-term physical or mental health conditions reported that their conditions left them unable to engage in education or informal work, and 83% reported they had a detrimental impact on everyday activities. 

In terms of employment, around 60,000 women in the UK are unable to work because of the impact of menopause symptoms alone, with a direct economic impact from unemployment of £1.5 billion per annum. 

In addition, the annual cost in lost productivity from severe perimenopause and menopause symptoms was estimated at £191 million per year, while absenteeism with severe period pain cost the UK £3.7 billion annually. 

Insufficient and Fragmented Investment

Dr Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists, told Medscape News UK that the “important” new report presented a “compelling economic case for investing in women’s health”.

“Currently, insufficient and fragmented investment means women are not accessing the diagnosis and treatment they need when they need it,” she said. “This includes over 750,000 women in the UK waiting for hospital gynaecology care and, as the report highlights, thousands of women leaving work due to menopause symptoms.”

Investment in new technology and in the FemTech industry– such as apps, services, medical devices, wearables, and software – will help to support the transformation of women’s health services, she believes. FemTech has the potential to improve diagnostic times and so speed access to any additional support needed, she added.

However, “The government must set out an ambitious vision for women’s health, putting women and girls at the heart of their policies.” Thakar was not involved in the report. 

Fewer Absences in ‘High-Investor’ Health Systems 

The report authors blamed a “gender health gap” on women in the UK spending on average 3 more years in ill health and disability compared with men – the largest such gap among the G20 nations. 

A “male default” permeates research, clinical trials, education and training, and the design of policies and services, they said. The gap is also responsible for avoidable harms that particularly impact women, such as those highlighted in the Cumberlege report on harmful side effects from vaginal surgical mesh, sodium valproate in pregnancy, and the oral hormone pregnancy tests that were used until the 1970s, they said.

The report also demonstrated the extent to which inadequate treatment of obstetric and gynaecological conditions affects NHS staff, 76% of whom are female according to the latest figures. The authors found that local health systems with high investments in obstetrics and gynaecology reported fewer staff sickness absences than those with low investments. This highlights the positive impact of investing in women’s health, they said. 

Caution on Reinforcing Negative Stereotypes

Myra Hunter, emeritus professor of clinical health psychology at King’s College London, who was not involved in the report , told Medscape News UK there is “a clear need for more funding to be allocated to women’s health problems”. She added that the report’s emphasis on the gaps in research and care provision “should certainly be supported”.

However, she cautioned that its suggestions that menopause is a key driver of women older than 50 leaving the workforce may have negative effects on views of menopausal women in the workplace. While it may be the case for some women, and this conclusion may bring funding to help women at work, it also reinforces negative stereotypes, such as the notion that 45- to 55-year-old women are “beset by symptoms” and likely to leave employment due to them, she explained. 

Hunter pointed out that the main data drawn on by the NHS Confederation report involved many women who were not yet perimenopausal and few who were postmenopausal. Yet the report made assumptions that women were not in work due to menopausal or perimenopausal symptoms. “There is a problem listing symptoms and asking women if they have them and then attributing these to the menopause, when many have other causes,” Hunter said.

For example, the causes of low mood, anxiety, sleep problems, loss of sexual interest, joint aches/pains, memory, and concentration issues are multifactorial – and many can be caused by psychosocial factors. There are bidirectional relationships of mood and stress with hot flushes and sleep problems. The association of menopausal symptoms with mental health may depend on whether depressed mood and anxiety are included as menopause symptoms. 

“Care needs to be taken not to interpret associations as causes,” she stressed. “The focus on menopausal symptoms may also divert attention away from workplace factors.” In fact, the most common reasons given for leaving paid work for adults aged 50-54 in the Office for National Statistics Over 50s Lifestyle Study published in 2022 were stress, redundancy, feeling unsupported at work, wanting a change in lifestyle, caring roles, and illness; in that order, she said.

Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.