Scientists have been studying menopause for decades, seeking to understand how this natural part of aging affects women’s health and longevity and whether it might contribute to disease or age-related declines. Further, researchers have been searching for treatments of symptoms, some of which can be debilitating, while others are just downright exhausting.

With more than 1 million American women experiencing menopause each year, this is a great place for dedicated research funding — for starters. But when it comes to their health, women are defined by much more than menopause and they deserve to have science address their health in all its dimensions.  

Unfortunately, beyond menopause, women are getting short shrift in the research department. And if we’re being honest, even when it comes to studying menopause, the situation might not be so hot.

A 2022 study from Harvard Medical School showed women represented the majority (51%) of the U.S. population in 2019, with only an estimated 40% participation in clinical trials for cancer, cardiovascular disease, and psychiatric disorders.

Depending on data sources, those U.S. gender-specific population statistics are still running neck and neck more or less. A recent report, published online in 2024, by Statista.com claims “in terms of population size, the sex ratio in the U.S. favors females, although the gender gap is remaining stable.”

“Despite being half the population, women have long been underrepresented in clinical trials, and this legacy still echoes through today’s research landscape,” said Holly E. Johnson, PhD, chief science officer at the American Herbal Products Association (AHPA).

According to Pelin Thorogood, co-founder and executive chair of Radicle Science, an AI-driven health tech pioneer, “Women have been systematically underrepresented in clinical research — and we’re still living with the consequences. From side effects missed in trials to nutrient gaps ignored by science, we’ve been designing products and protocols around the wrong default.”

If you’re wondering how we got into this pickle, Susan M. Kleiner, PhD, RD, owner and founder of High Performance Nutrition, LLC, noted that “history is the reason.” Women were viewed, and may still be, as second-class citizens. “All biology that was ‘normal’ was male, female was ‘abnormal,’” said Kleiner.

It’s problematic for health research when women are not represented in studies because, as Kleiner explained, “Female biology is different than male biology. Even if there are overlaps, we can’t know where those overlaps are if we don’t study women. We are just making things up and promoting creative writing as facts.”

Underrepresented Beyond Medical Research

The lack of inclusion of women in medical trial populations is compounded by the historic invisibility in related areas. Kleiner noted that “women couldn’t go to medical school, were not decision makers, and were very limited in the sciences.” All this adding to the problem of research not being conducted to understand a woman’s body, she added.

That seems to be changing. Today, more women are becoming doctors, with more than one-third (38%) of active physicians being female. From 2004 to 2022, women in the active physician workforce rose by 97% compared to the 13% increase for men.

The percentage of women as active academic health researchers in the U.S. rose from 30% in 2000 to 42% in 2022, comparable to global statistics.

It’s clear that representation matters “not only for equity but also because it influences research priorities and patient care,” said Johnson.

Whether as scientific researchers or medical doctors, nurse practitioners, or other healthcare professionals, Johnson explained that women bring diverse perspectives that have historically been underrepresented. As more women “enter and lead in these fields, we see a shift toward asking different questions, designing more inclusive studies, and advocating for research in areas that were previously overlooked,” she said.

Johnson isn’t alone in saying that more women in research is essential for truly advancing women’s health in a holistic and impactful way.

Kleiner, for one, credited the addition in 1991 of Bernadine Healy, MD, the first female director of the National Institutes of Health, who established the Women’s Health Initiative, the largest randomized clinical trial in history to be fully focused on only women, as instrumental in moving women’s research forward. 

With women now in leadership and decision-making roles, and prominent in the sciences and medicine, Kleiner said, “it’s not surprising that we are studying women’s health.” 

Correcting Underrepresentation

The inequities for women in the nutraceutical industry and health research, led to the rise of a new advocacy organization — Women in Nutraceuticals (WIN) — which Heather Granato, president of WIN, explained was “founded specifically to address the need for gender equality within the industry, focusing on how to empower women to achieve personal and professional success and support their healthcare needs.”

One issue of particular importance for WIN is the need for more women in science and research in female populations, which Granato said “is foundational to driving innovation in our industry.”

Two of WIN’s long-term objectives are particularly relevant here: first, increasing the number of women in science and research, and second, increasing the amount of funding for research on women’s health issues — “research for, by, done on and led by women,” said Granato.

Research Gaps, Concerns About Funding

One of the first steps in addressing women’s health is to identify where research gaps exist. Unfortunately, those gaps may seem as wide as moon craters.

Moreover, as Kleiner pointed out, despite the recent gain of “greater amounts of data and broader understanding of women’s health issues,”  these gains “are currently in jeopardy of funding losses,” unless there is a public outcry and demand to continue research in support for the needs of women.

Although it’s not just women’s health research that is potentially being impacted in the Trump Administration, for women it is perhaps all the more bittersweet having been given a sample of good things to come.

As reported last year, the Biden Administration established the first White House Initiative on Women’s Health Research at the end of 2023. Last February, as part of this initiative, First Lady Jill Biden announced $100 million in federal funding towards research and development for women’s health.

At his State of the Union, Biden called on Congress to invest $12 billion in funding for women’s health research and announced initial investments of $200 million for the effort to begin in FY 2025.

With slashes across the board of federal workers (including scientists) and medical research funding as the new administration attempts to shrink the federal budget and align to its policy shifts, it’s unlikely that any of the new women’s health research initiatives will happen.

The federal funding cuts initially decimated the Women’s Health Initiative, shocking the medical community and generating pushback. The Trump Administration reversed its decision and is reportedly “working fully to restore funding to these essential research efforts,” according to a spokesperson for the Department of Health and Human Services, who further stated that “these studies represent critical contributions to our better understanding of women’s health.”

Developing a Research Agenda

Prioritizing research can be daunting because so many areas of women’s health have been neglected. As Kleiner, who is also the chief scientific officer at Electrolyte Boost, advised: “Throw a dart at a dart board labeled with health issues and it [all] needs research relative to women. The gaps are that broad.”

The gaps “are both biological and social, and filling them requires research that reflects the full spectrum of women’s lived experiences,” said Johnson.

With a chasm that seems all-encompassing, where do you start creating a roadmap for women’s research?

“We can’t forget perimenopause,” according to Andrea Wong, PhD, senior vice president, scientific & regulatory affairs, Council for Responsible Nutrition (CRN). Perimenopause comes with a wide range of physiological and psychological changes that can affect quality of life and put women at increased risk of cardiovascular disease and other serious issues, she explained. Even with added awareness, Wong noted a need for “additional research to determine the best approaches to address the changes.”

“Women don’t want to just live longer, we want to live stronger,” she added.

Johnson would like to see more focused research on perimenopause as well. Beyond that, other female-focused health areas starving for research include fertility, menstrual health, endometriosis, and polycystic ovarian syndrome (PCOS), areas that “affect millions but remain poorly understood or supported by robust evidence,” she said.   

There is a pressing need for more robust research on women on the specific nutrient demands following childbirth, said Wong, regardless of whether they are breastfeeding. Despite the postpartum phase being a time of “immense physical recovery and psychological adjustment,” Wong said that “scientific research and public health resources remain disproportionately focused on infant outcomes rather than maternal well-being.”

Wong also noted that “pregnancy significantly depletes a woman’s stores of nutrients that are vital not only for lactation but also for maternal mental health and physical recovery.” 

Beyond Health Conditions that Focus Solely on Women

Granato emphasized that “the women’s health gap is a $1 trillion opportunity with a massive disparity in research funding and clinical trial participation.”

The gaps are not limited to conditions that are only female-centric, such as menopause, PCOS, or fertility, said Granato, who is also president of her own consulting and communications firm, Nutrachievement. Both Granato and Johnson called out the need to prioritize research in women with conditions such as autoimmune disorders that disproportionately affect women.

Susan J. Hewlings, PhD, RD, senior vice president of scientific affairs for Radicle Science, identified priority areas for women’s health research beyond menopause as including menstrual cycle health, mental wellness, cardiometabolic health, bone density maintenance, perimenopause, and immune resilience.

“Many women suffer from menstrual cycle issues which can impact quality of life and ultimately fertility, yet they have traditionally been told these issues are ‘normal’ and ‘part of being female,’” said Hewlings, “leaving them under-studied.” 

Hewlings followed up with what might arguably be the biggest issue omitted from women’s research: cardiovascular disease. “Notably, cardiovascular disease is the leading cause of death in women, yet remains under-researched in female populations, especially across life stages,” she said.

“Depending on the region of the world, needs may be different. But universally, understanding how female biology impacts growth, development, life stage transitions, and aging, is fundamental and relatively poorly understood compared to male biology,” said Kleiner.

“From there,” she continued, “a focus on lifestyle practices like diet, sleep, exercise, stress, social milieu as well as education impact puberty, fertility, perimenopause, menopause, and disease risks throughout the life stages, is critical.”

Some of what should be basic is often data that isn’t available on women. For example, prescription medications are used by 70.9% of women ages 18+ compared to 58.4% of men, yet, Kleiner said, “we don’t have data on how most prescription medications work on women. Recommendations for women are extrapolated from data collected on men.”

Further, Kleiner is concerned that “sometimes we don’t even have diagnostic criteria based on female-centric data. We have learned this through poor diagnoses of heart disease in women. Brain and other cancer symptoms are often misdiagnosed initially as menopausal symptoms and not tested.”

As for the herbals market, Johnson said she likes what she’s seeing in the research arena. There’s momentum, she said, with increased interest in botanicals traditionally used to support women’s health, such as black cohosh and ashwagandha. While RCTs remain important, they are not the only path to meaningful evidence, she noted.

For example, Johnson said, “we have been pleased to see some credible contract research organizations offering alternate clinical research trial designs including case-control studies, cohort studies, and observational studies.” She added that “observing and documenting real-world evidence can provide valuable insight, particularly when studying complex, individualized areas like menstrual cycle support or stress resilience.”

Time for a New Scientific Paradigm

Despite the importance of identifying the research gaps for women, there’s another concept to consider. “Focusing solely on specific conditions may be an outdated paradigm,” said Hewlings.  

She suggested that “women’s health should instead be approached holistically, taking into account the lifespan perspective and interconnected physiological systems — where hormonal changes, nutrient demands, stress resilience, and inflammatory pathways interplay dynamically.”

That leads to the idea that randomized controlled trials haven’t necessarily provided the best platform for studying nutrients or dietary supplements, for a variety of reasons.

Thorogood noted, “Traditional RCTs have often failed to deliver meaningful results for dietary supplements, especially for women. But it’s not because the ingredients don’t work. It’s because the system wasn’t really designed to find out.”

The clinical trial model was designed to study pharmaceutical drugs that “target disease, not natural products that aim to maintain and optimize health,” said Thorogood. “Trials have been prohibitively expensive, painfully slow, and often designed without real-world relevance. The result? One-size-fits-all conclusions that overlook the very populations — like women — who are most affected by nutrient gaps and deserve better answers.”

Radicle Science is pioneering a new model of clinical research, one that Thorogood said is “radically affordable, scalable, and inclusive.” And it’s also one she said provides “the supplement industry [with] a massive opportunity — and responsibility — to fill the research gaps that have historically failed women.”

Thorogood is not alone in suggesting that “too many products are launched with marketing claims, but no real evidence, especially for women’s unique biological and behavioral contexts.”

Here’s one avenue to get away from the idea that traditional RCTs are the only standard. According to Thorogood, “By combining rigorous RCT methodology with advanced analysis, we can detect nuanced effects that traditional trials miss — like which subgroups benefit most, under what conditions, and how different health outcomes interconnect.”

From there, said Thorogood, “those exploratory findings can deliver findings for future trials with a higher likelihood of success, and help in effectively positioning a product to its target audience. This goes beyond the binary placebo comparison, instead helping brands understand which product works for whom, how and why.”

Not only has this approach been put into practice — Radicle has already run “the largest clinical trials in history on certain supplements” — but it’s a roadmap that Thorogood believes achieves gender parity: 25% non-white participation, and 20% of participants from rural areas. And, she added, “we’ve done so in months, not years.”

Radicle’s research model is able to address the void in women’s research “by integrating virtual trials recruiting large groups of diverse participants from across the U.S. leading to real-world evidence collection at scale,” said Hewlings.

“With the rise of AI and radically accessible research models like ours,” Thorogood said, “we can now generate high-quality, personalized evidence at a fraction of the traditional time and cost. We can move from generic wellness to proven, precision wellness.”

“By focusing on nutrient gaps, lifestyle relevance, and subpopulation responsiveness, Radicle’s model can deliver statistically powered, clinically meaningful health outcomes,”
added Hewlings.

“This paradigm shift enables the supplement industry to generate data that is actionable for women, advancing both scientific credibility and public health impact.”

The concept of upending the traditional gold standard for scientific proof for supplements is intriguing, and companies engaging in outside-the-norm thinking deserve credit for harnessing the promise of AI and using lateral vision that can expand the way the industry addresses science that could work better for consumers and companies.

What Else is Needed?

At the same time, there are other issues to be addressed to overcome disparity in health research for women. 

For example, “regarding dosing, metabolic assumptions are made typically based on body composition and body weight, and perhaps age. It’s possible that these assumptions,” said Kleiner, “established from male-centric research, don’t transfer linearly
to females.”

Here’s something else on Kleiner’s wish list. “We need educational programs in medical schools focused on how to communicate with women in a healthcare setting.”

It’s become common for women of all ages “to experience gas lighting by their practitioners when they report health issues,” said Kleiner, being told “that they are fine and should just ‘get over it.’” Unfortunately, complaints are not addressed, and so disease progresses and symptoms worsen until hopefully someone finally listens, she said, however, by that point, “the case is much more difficult to treat.”

For Hewlings, “Women’s health is not a niche or a trend — it is foundational to population health. Bridging the research gap is both a scientific imperative and an ethical obligation.”

As Granato pointed out, the quality of healthcare women receive has socioeconomic repercussions.

When women’s health isn’t taken seriously nor studied sufficiently, it’s not just the individual woman who suffers. It’s her children, her family, her friends, and yes, the men in her life who want women to be healthy and thrive.