Breaking the Silence on Women's Health

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"Women's health research has been systematically under-studied for decades, creating profound healthcare inequities that affect diagnosis, treatment, and outcomes. Ultimately, affecting quality of life. We're finally breaking the silence on women's health through research, on conditions such as iron deficiency, which affects millions of women daily. This isn't just about filling research gaps—it's about dismantling gender biases in healthcare and transforming how we approach women's health from the workplace to the clinic. The data is telling a story we can no longer ignore, and the solutions are within reach." - Dr Cory Dugan, Co-Guest Editor of the Special Collection Iron Deficiency in Women's Health: From the Cellular to Population Level Iron deficiency (ID) is one of the most common micronutrient deficiencies worldwide, affecting approximately one-third of the human population. The burden falls disproportionately on women of reproductive age, yet the clinical and functional impacts remain underrecognised and under-treated. Women in this demographic experience the highest prevalence of ID, reflecting not only biological vulnerability but also structural and socioeconomic inequities. While menstrual losses and reproductive physiology contribute substantially to iron depletion, women's susceptibility to ID is further shaped by dietary patterns, caregiving and professional responsibilities, socioeconomic disadvantage, and barriers to accessing timely and adequate healthcare. These determinants intersect, contributing to delayed identification and management of early iron depletion in women. At the cellular level, ID compromises mitochondrial bioenergetics, forcing cells to rely on less efficient anaerobic glycolytic pathways to meet energy demands. This deficiency also alters mitochondrial morphology, reducing cristae volume and ultimately leading to DNA fragmentation and cellular damage. Systemically, ID weakens musculoskeletal integrity leading to reduced tissue oxidative capacity, exacerbates heart failure risk and impairs myocardial metabolism, and negatively influences neurocognitive development, cellular signalling, and immune responses. The effect of ID on women's biochemical functioning results in a degradation of overall quality of life. Subjective symptoms experienced typically include fatigue, impaired cognitive function and attention, irritability, and depression. On a macroscopic scale, the widespread under-recognition and normalisation of ID creates a profound socioeconomic and public health burden due to absenteeism and productivity. Because the condition disproportionately impacts women of reproductive age, underdiagnosis perpetuates gender-based healthcare inequities and places a continuous financial strain on global economic and healthcare systems. The HMB-ID negative cycle Topics will include: - Digital health in HMB-ID management is my favourite as it includes some of the solutions we are looking at to break the silence - Bleed Better and the IHMB day on 11th May Iron Deficiency and Anemia in Women: Bridging Awareness, Diagnosis, and Treatment Gaps Iron deficiency (ID) and iron deficiency anemia (IDA) silently affect millions of women, eroding energy, exercise capacity, and quality of life. Heavy menstrual bleeding (HMB) accounts for up to 50% of cases in reproductive-age women, yet symptoms like fatigue are often normalized or misattributed. Overlooked symptomatology has real Impacts: (1) Physical: 20-30% drop in VO$_2$max; exercise intolerance. (2) Mental: Depression risk up 2x; cognitive slowdown. (3) Economic: 10B+ US productivity loss yearly. To improve the quality of life of affected individuals, we must improve the quality of the research concerning it.

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