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This lack of research goes some way to explaining why women are much more likely to experience side effects from drugs—some of them fatal. Over the last couple of decades, greater effort has been made to include people with ovaries and uteruses in clinical research. But we still have a long way to go.
Women are also often subjected to medical advice designed to protect a potential fetus, whether they are pregnant or not. Official guidelines on how much mercury-containing fish it is safe to eat can be different for “women of childbearing age,” according to the US Environmental Protection Agency, for example. And in 2021, the World Health Organization used the same language to describe people who should be a focus of policies to reduce alcohol consumption.
The takeaway message is that it’s women who should be thinking about fetal health, says Cattapan. Not the industries producing these chemicals or the agencies that regulate them. Not even the men who contribute to a pregnancy. Just women who stand a chance of getting pregnant, whether they intend to or not. “It puts the onus of the health of future generations squarely on the shoulders of women,” she says.
Another problem is the language itself. The term “women of reproductive age” typically includes women between 15 and 44. Women at one end of that spectrum will have very different bodies and a very different set of health risks from those at the other. And the term doesn’t account for people who might be able to get pregnant but don’t necessarily identify as female.
In other cases it is overly broad. In the context of the Zika virus, for example, it was not all women between the ages of 15 and 44 who should have considered taking precautions. The travel advice didn’t apply to people who’d had hysterectomies or did not have sex with men, for example, says Cattapan. “Precision here matters,” she says.
More nuanced health advice would be helpful in cases like these. Guidelines often read as though they’re written for people assumed to be stupid, she adds. “I don’t think that needs to be the case.”
Another thing
On Thursday, president-elect Donald Trump said that he will nominate Robert F. Kennedy Jr. to lead the US Department of Health and Human Services. The news was not entirely a surprise, given that Trump had told an audience at a campaign rally that he would let Kennedy “go wild” on health, “the foods,” and “the medicines.”
The role would give Kennedy some control over multiple agencies, including the Food and Drug Administration, which regulates medicines in the US, and the Centers for Disease Control and Prevention, which coordinates public health advice and programs.