Women across Europe are less likely than men to be offered invasive or intensive treatments—such as surgery or strong painkillers—for the same medical conditions, according to a new review that highlights persistent gender gaps in healthcare.
The study, led by researchers at the University of St Andrews in Scotland, analysed 41 studies published between 2018 and 2023. It found a consistent pattern: women with heart failure, heart attack, or tachycardia were more often managed conservatively with medication, while men were more likely to receive invasive procedures like coronary artery bypass grafting or percutaneous coronary intervention.
Similar disparities appeared in other fields. Among patients with Parkinson's disease, men were more frequently referred for deep brain stimulation devices. Women were also less likely to receive a liver transplant or be referred for surgery.
“While the direction of the findings was not a surprise, the consistency was,” said Miriam Veenhuizen, honorary lecturer at St Andrews School of Medicine and co-author of the study.
Why does this happen?
The reasons behind these differences remain unclear. The researchers note that women have been under-represented in clinical trials until recent decades, meaning many treatment guidelines are based on data from men. This could lead to assumptions about how women respond to treatments or which procedures are appropriate for them.
“It’s not entirely clear why this is happening, but it is likely because women were under-represented in clinical trials until recent decades, so many guidelines rest on data from men,” Veenhuizen said.
The study’s co-lead, Andrew O’Malley, stressed the practical implications for clinicians: “For clinicians, the findings are a prompt to check whether treatment is being offered on clinical grounds rather than assumption.”
The researchers emphasise that it is not yet known whether these differences put women at a disadvantage. Some variations may reflect legitimate differences in disease presentation or patient preference. But the consistency across so many specialties suggests that systemic factors may be at play.
They call for further research to determine whether these patterns represent appropriate clinical variation or broader inequalities, and to ensure that all patients receive equitable care regardless of gender.
The findings echo other recent concerns about gender bias in European healthcare. For example, France recently alerted 1.6 million women about a potential tumour risk linked to a contraceptive, highlighting how medical guidance can have different implications for women. Meanwhile, new AI research suggests migraine may be multiple conditions, which could eventually lead to more tailored treatments for women, who are disproportionately affected.
As European health systems strive for precision medicine, this study serves as a reminder that the data underpinning clinical decisions must reflect the diversity of the population. Ensuring that women are adequately represented in research and that clinicians question their own assumptions will be key to closing the gap.
