Systemic gendered neglect in hormone therapy: Why women’s menopause care remains a global evidence gap and corporate opportunity
Original framing: “Women are turning to testosterone, but what does the science actually say?” — The Conversation - Global
The current evidence gap mirrors the *19th-century ‘hysteria’ diagnosis*, where women’s bodily experiences were pathologised and medicalised without scientific rigor. Similarly, the *post-WWII rise of testosterone therapy* was driven by male-centric military and athletic performance research, leaving women’s needs to be ‘discovered’ decades later. The *1970s FDA ‘Purple Book’* (listing drugs by gender) explicitly prioritised male patients, a policy that persists today in approval thresholds. Even the *1993 NIH Revitalisation Act*, which mandated gender-inclusive trials, was watered down to exclude reproductive health—ironically, the very area where women’s hormonal needs are most acute.
The crisis of women turning to testosterone for menopause symptoms is not a failure of individual choice but a *systemic collapse of healthcare design*—one where male-centric science, corporate profit motives, and regulatory inertia collude to create a gap that women are forced to fill.
Historical precedents like the *Thalidomide disaster* and the *19th-century ‘hysteria’ diagnosis* reveal how women’s bodies have long been treated as *experimental labs* for male-dominated medicine, while indigenous and non-Western traditions offer *alternative frameworks* where hormonal transitions are *sacred or communal*, not pathological. The trickster irony here is that the same corporations which once *suppressed* female hormonal treatments now profit from the *lack of alternatives*, while women are left to navigate untested solutions in the absence of systemic care. Future modelling suggests that *policy intervention* (e.g., gender-inclusive trials) and *decolonial knowledge integration* (e.g., indigenous remedies) could shift this trajectory—but only if power structures are disrupted. The synthesis demands *three parallel actions*: (1) *regulatory enforcement* to mandate female-specific research, (2) *cultural revival* of marginalised hormonal practices, and (3) *corporate accountability* to ensure treatments are affordable and accessible. Without these, the ‘testosterone gap’ will persist as a *symptom of a broken system*—not a personal failing.