Companies are jumping on the feminist health trend to sell unproven gadgets, tests and treatments, experts have warned.
Women risk being harmed if their health is allowed to be ‘hijacked’ by vested commercial interests, the researchers add.
Writing in The BMJ, Dr Tessa Copp says marketing that seeks to take advantage of the drive for equality and empowerment can lead to inappropriate medicalisation, over-diagnosis and over-treatment.
The University of Sydney academic calls for greater wariness of simplistic health messages that claim any knowledge is power.
And she urges health professionals and governments to ensure that easily understood, balanced information is available based on high quality scientific evidence.
The anti-müllerian hormone (AMH) test, which measures levels of AMH in the blood, linked to the number of eggs in a woman’s ovaries. However, experts warn there is clear evidence that the test cannot reliably predict a woman’s chances of conceiving
Dr Copp and her colleagues highlight that firms have historically abused messaging about female autonomy to encourage women to smoke and drink alcohol.
But they say this phenomenon has now expanded across women’s health to include the likes of breast cancer screening, hormone replacement therapy, menstrual tracking apps, drugs for sexual dysfunction and elective egg freezing.
The problem, they stress, is not with all uses of health technologies, tests, and treatments – but the way commercial interests push such interventions to a much larger group of women than is likely to benefit without being explicit about their limitations.
They discuss two current examples to argue how feminist discourse is being co-opted to promote non-evidence-based healthcare to healthy women.
The first is the anti-müllerian hormone (AMH) test, which measures 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 conceiving, fertility clinics and online companies market and sell the test to the general public, using phrases such as ‘Information is power and lets you take charge of your fertility’.
Dr Copp argues that misleading marketing using feminist rhetoric that encourages women with no signs or symptoms of infertility to seek AMH testing to check their fertility or to inform their reproductive planning ‘ultimately undermines empowerment and informed decision making as the evidence to date shows the test is invalid for these purposes’.
The second is the view that all women having screening should be notified about their breast density, one of several independent risk factors for breast cancer.
Arguments emphasise women’s ‘right to know’ but the authors note that breast density notification is currently being used to promote additional screening without robust evidence that it prevents breast cancer deaths.
Breast density notification can 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 individualised care can still advance women’s knowledge and health even when there is no clear evidence that the benefits outweigh the harms.
However, while the authors fully support stronger patient autonomy, they suggest that marketing and campaigning for interventions and provision of information without stating the limitations or unclear evidence of benefit ‘risk causing more harm than good and therefore may go against the empowerment being sought’.
The UK government’s 10-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 ‘women and girls feel listened to and have their concerns 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 not listened to when they seek help from the NHS for their health.
Dr Copp said: ‘Feminist narratives of increasing women’s autonomy and empowerment regarding their healthcare, which first arose through early women’s health movements, are now increasingly adopted by commercial entities to market new interventions that lack robust evidence or ignore the evidence that is available.
Some believe all women having screening should be notified about their breast density, one of several independent risk factors for breast cancer. But researchers say that breast density notification is currently being used to promote additional screening without robust evidence
‘Increased awareness and advocacy in women’s health are vital to overcome sex inequalities in healthcare, including the need for improved resources for under-researched conditions and to reverse historical biases that prevent optimal treatments for women.
‘However, promoting healthcare interventions that are not supported by evidence, or while concealing or downplaying evidence, increases the risk of harm to women.’
In conclusion, she wrote: ‘We need to ensure the goals of feminist health advocacy are not undermined through commercially driven use of feminist discourse pushing non-evidence based care.’
In a linked editorial, Sarah Hawkes, of University College London, argues that women should draw on the power of ‘collective action’ to stand up to the firms that are taking advantage.
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 an issue 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 ovary-acting. Understand your hormones and fertility, be the boss of 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 your future family options, you deserve to know exactly what’s going on inside your body—ovaries and all.’
It also references the website of the London Women’s Clinic, which says: ‘We hope that by giving you a window into your fertility levels, you are in a better position to make informed decisions about your future.’
The Women’s Health Clinic failed to respond to a request to comment but Hertility told the Mail: ‘Our testing is clinically and scientifically evidence based and to suggest otherwise would be extremely harmful.
‘Hertility adheres to the highest standard of regulatory approval across the UK and Europe, including having governmental Care Quality Commission approval to diagnose, treat and prescribe.
‘At Hertility, we do not recommend testing AMH levels alone.
‘We test up to 10 hormones and our testing is always based on an individual’s medical history, age, symptoms, past or current health conditions, medication and lifestyle.
‘This approach provides a more accurate and meaningful assessment of reproductive health, beyond the narrow scope of a single hormone level.’
