Companies are joining the feminist health trend to sell unproven devices, tests and treatments, experts have warned.
Women risk harm if their health is allowed to be “hijacked” by vested commercial interests, researchers add.
In an article in The BMJ, Dr Tessa Copp says marketing that seeks to capitalize on the push towards equality and empowerment can lead to inappropriate medicalisation, overdiagnosis and overtreatment.
The University of Sydney academic calls for greater caution in the face of simplistic health messages that claim that any knowledge is power.
And it urges health professionals and governments to ensure that balanced and easily understandable information based on high-quality scientific evidence is available.
The anti-Müllerian hormone (AMH) test, which measures AMH levels in the blood, is related 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 conceiving.
Dr. Copp and her colleagues point out that companies have historically abused messages about female empowerment to encourage women to smoke and drink alcohol.
But they say this phenomenon has now expanded to women’s health to include breast cancer screening, hormone replacement therapy, menstrual tracking apps, medications for sexual dysfunction and elective egg freezing.
The problem, they emphasize, is not in all the uses of health technologies, tests and treatments, but in the way in which commercial interests push such interventions to a much larger group of women than they are likely to benefit without being explicit about their limitations.
They analyze two current examples to argue how feminist discourse is being co-opted to promote non-evidence-based healthcare for healthy women.
The first is the anti-Müllerian hormone (AMH) test, which measures AMH levels in the blood, related to the number of eggs in a woman’s ovaries.
Despite clear evidence that the test cannot reliably predict a woman’s chances of conceiving, fertility clinics and online companies market and sell the test to the general public, using phrases such as “The information is power and allows you to take charge of your fertility.
Dr. Copp argues that misleading marketing using feminist rhetoric that encourages women without signs or symptoms of infertility to seek AMH testing to monitor their fertility or to inform their reproductive planning “ultimately undermines empowerment and decision-making.” of informed decisions, as the evidence to date shows that the test is effective. invalid for these purposes.”
The second is the view that all women undergoing screening should be notified about their breast density, one of several independent risk factors for breast cancer.
The arguments emphasize women’s “right to know,” but the authors note that breast density reporting is currently used to promote additional testing without strong evidence that it prevents breast cancer deaths.
Breast density reporting may also increase women’s anxiety, confusion, and intentions 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 improve women’s knowledge and health even when there is no clear evidence that the benefits outweigh the harms.
However, while the authors fully support greater patient autonomy, they suggest that marketing and campaigning for interventions and providing information without indicating limitations or unclear evidence of benefit “risks causing more harm than good.” and, therefore, can go against the empowerment that is sought.
The UK government’s Ten Year Women’s Health Strategy aims to tackle a culture of “medical misogyny”, which leaves women struggling to access the same quality of care as men.
Ministers have set an ambition to ensure that “women and girls feel heard and that their concerns are taken seriously at every stage of their journey”, from discussions about symptoms to treatments and follow-up care.
Its launch, in July 2022, came after 84 per cent of people who responded to an official consultation said women often feel ignored or unheard when seeking NHS help for their health.
Dr Copp said: “Feminist narratives about increasing women’s autonomy and empowerment regarding their healthcare, which first emerged through the early women’s health movements, are now increasingly most adopted by commercial entities to market new interventions that lack strong evidence or ignore available evidence.
Some believe that all women who undergo screening should be told about the density of their breasts, one of several independent risk factors for breast cancer. But researchers say breast density reporting is currently used to promote additional screening without solid evidence.
‘Increased awareness and promotion of women’s health are vital to overcoming sexual inequalities in healthcare, including the need to improve resources for under-researched diseases and reverse historical biases that prevent optimal treatments for women.
“However, promoting health interventions that are not supported by evidence, or at the same time hiding or downplaying evidence, increases the risk of harm to women.”
In conclusion, she wrote: “We need to ensure that the goals of feminist health advocacy are not undermined by the commercial use of feminist discourse that promotes non-evidence-based care.”
In a linked editorial, Sarah Hawkes of University College London argues that women should harness the power of “collective action” to stand up to companies that are taking advantage.
She says such an approach “can be successful and replicable as a strategy to protect and improve all aspects of women’s health, promoting women’s rights to health as a matter of social justice rather than corporate profits.”
The BMJ study highlights content on the website of UK health and fertility clinic Hertility, which says: “You are not acting on the ovaries.” Understand your hormones and fertility, be the boss of your symptoms, and get the expert care you deserve, every step of the way.’
She adds, “Whether you’ve been trying for a while or are starting to think about your future family options, you deserve to know exactly what’s going on inside your body—ovaries and all.”
It also references the London Women’s Clinic website, which says: “We hope that by giving you a window into your fertility levels, 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 based on clinical and scientific evidence and to suggest otherwise would be extremely harmful.
‘Hertility meets the highest standards of regulatory approval in the UK and Europe, including approval by the government’s Care Quality Commission to diagnose, treat and prescribe.
‘At Hertility, we do not recommend checking AMH levels alone.
‘We test up to 10 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 narrow scope of a single hormone level.”