Companies are jumping on the feminist health trend by selling unproven gadgets, tests and treatments, experts warn.
Women are at risk of harm if their health is ‘hijacked’ by vested commercial interests, the researchers add.
Dr. Tessa Copp writes in The BMJ that marketing that tries to capitalize on the push for equality and empowerment can lead to inappropriate medicalization, overdiagnosis and overtreatment.
The University of Sydney academic calls for greater caution against simplistic health messages that claim all knowledge is power.
And she urges health professionals and governments to ensure that easy-to-understand, balanced information is available, based on high-quality scientific evidence.
The anti-müllerian hormone (AMH) test, which measures AMH levels in the blood, linked to the number of eggs in a woman’s ovaries. However, experts warn that there is clear evidence that the test cannot reliably predict a woman’s chances of becoming pregnant
Dr. Copp and her colleagues emphasize that companies have historically abused messages about female autonomy to encourage women to smoke and drink alcohol.
But they say this phenomenon has now expanded to women’s health care and includes breast cancer screening, hormone replacement therapy, menstrual tracking apps, sexual dysfunction medications and elective egg freezing.
The problem, they point out, is not with all applications of health technologies, tests and treatments, but with the way commercial interests push such interventions to a much larger group of women than is likely to benefit from them, without being explicit about the limitations of it.
They discuss two current examples to argue how feminist discourse is co-opted to promote non-evidence-based health care for healthy women.
The first is the anti-müllerian hormone (AMH) test, which measures the levels of AMH in the blood, linked to the number of eggs in a woman’s ovaries.
Despite clear evidence that the test cannot reliably predict a woman’s chances of becoming pregnant, fertility clinics and online companies market and sell the test to the general public, using phrases such as “Information is power and you take charge of your fertility’.
Dr. Copp argues that misleading marketing using feminist rhetoric that encourages women without signs or symptoms of infertility to undergo AMH testing to monitor their fertility or inform their reproductive planning “ultimately undermines empowerment and informed decision-making, as the evidence to date shows that the test is invalid for these purposes’.
The second is the view that all women undergoing screening should be informed about their breast density, one of several independent risk factors for breast cancer.
Arguments emphasize women’s “right to know,” but the authors note that reports of breast density are currently used to promote additional screening without robust evidence that it prevents breast cancer deaths.
Reporting breast density may also increase women’s fear, confusion and intention to seek additional screening, while the unreliability of breast density measurement is another concern, they add.
Some have argued that technological advances, more information, and increasingly individualized care can still advance women’s knowledge and health, even if there is no clear evidence that the benefits outweigh the harms.
However, while the authors are fully in favor of stronger patient autonomy, they suggest that marketing and campaigning for interventions and providing information without mentioning limitations or unclear evidence of benefits ‘risks causing more harm than good and therefore may conflict with the empowerment that is sought’.
The UK government’s 10-year Women’s Health Strategy aims to tackle a culture of ‘medical misogyny’ that is causing women to struggle to access the same quality of care as men.
Ministers have set the ambition to ensure that ‘women and girls feel heard and their concerns are taken seriously at every stage of their journey’, from discussions about symptoms to treatments and aftercare.
Its launch, in July 2022, came after 84 percent of people responding to an official consultation said women often feel ignored or unheard when seeking help from the NHS for their health.
Dr. Copp said: ‘Feminist narratives about increasing women’s autonomy and empowerment over their health care, which first emerged through early women’s health movements, are now increasingly being adopted by commercial entities to market new interventions for which robust evidence is missing or the available evidence is ignored.
Some believe that all women undergoing screening should be informed about their breast density, one of several independent risk factors for breast cancer. But researchers say breast density reporting is currently being used to promote additional screening without robust evidence
‘Greater awareness and advocacy for women’s health are critical to overcoming gender disparities in health care, including the need for better resources for under-researched conditions, and to overcome historical biases that prevent optimal stand in the way of treatments for women, to reverse.
‘However, promoting healthcare interventions that are not supported by evidence, or while evidence is hidden or downplayed, increases the risk of harm to women.’
In conclusion, she wrote, “We must ensure that the goals of feminist health care are not undermined by commercially driven use of feminist discourse that encourages non-evidence-based care.”
In a linked editorial, Sarah Hawkes of University College London argues that women should use the power of ‘collective action’ to stand up to the companies that profit.
She says such an approach “can be both successful and replicable as a strategy for protecting and improving all aspects of women’s health, promoting women’s health rights as a matter of social justice rather than corporate profits.”
The BMJ study highlights content on the website of UK fertility and health clinic Hertility, which says: ‘You’re not working on the ovaries. Understand your hormones and fertility, own your symptoms, and get the expert care you deserve – every step of the way.”
It adds: ‘Whether you’ve been trying for a while, or are just starting to think about options for your future family, you deserve to know exactly what’s going on in your body – ovaries and all.’
It also links to the London Women’s Clinic website, which says: ‘We hope that by helping you understand your fertility level, you will be in a better position to make informed decisions about your future.’
The Women’s Health Clinic did not respond to a request for comment, but Hertility told the Mail: ‘Our tests are clinically and scientifically sound and to suggest otherwise would be extremely harmful.
‘Hertility adheres to the highest standard of regulatory approval in the UK and Europe, including government Care Quality Commission approval to diagnose, treat and prescribe.
‘At Hertility we do not recommend testing AMH levels alone.
‘We test up to ten hormones and our tests are always based on an individual’s medical history, age, symptoms, past or current health conditions, medications and lifestyle.
‘This approach provides a more accurate and meaningful assessment of reproductive health, beyond the limited range of a single hormone level.’