Women and men have different experiences of the same illnesses, especially cardiovascular disease, cancer, depression and dementia. Women are also more prone to
urinary tract infections than men. The onset occurs at a later age in women than in men. For instance the incidence of stroke in women under the age of 80 is less than that in men, but higher in those aged over 80. Overall the lifetime risk of stroke in women exceeds that in men.
Cancer Women and men have approximately equal risk of dying from
cancer, which accounts for about a quarter of all deaths, and is the second leading cause of death. However the relative incidence of different cancers varies between women and men. Globally the three most common types of cancer of women in 2020 were
breast,
lung and
colorectal cancers. These three account for 44.5% of all cancer cases in women. Other types of cancers specifically affecting women include
ovarian,
uterine (
endometrial and
cervical) cancers. While cancer death rates rose rapidly during the twentieth century, the increase was less and happened later in women due to differences in
smoking rates. More recently cancer death rates have started to decline as the use of tobacco becomes less common. Between 1991 and 2012, the death rate in women declined by 19% (less than in men). In the early twentieth century death from uterine (
uterine body and
cervix) cancers was the leading cause of cancer death in women, who had a higher cancer mortality than men. From the 1930s onwards, uterine cancer deaths declined, primarily due to lower death rates from cervical cancer following the availability of the
Papanicolaou (Pap) screening test. This resulted in an overall reduction of cancer deaths in women between the 1940s and 1970s, when rising rates of lung cancer led to an overall increase. By the 1950s the decline in uterine cancer left breast cancer as the leading cause of cancer death until it was overtaken by lung cancer in the 1980s. All three cancers (lung, breast, uterus) are now declining in cancer death rates, but more women die from lung cancer every year than from breast, ovarian, and uterine cancers combined. Overall about 20% of people found to have lung cancer are never smokers, yet amongst nonsmoking women the risk of developing lung cancer is three times greater than amongst men who never smoked. In addition to mortality, cancer is a cause of considerable morbidity in women. Women have a lower lifetime probability of being diagnosed with cancer (38% vs 45% for men), but are more likely to be diagnosed with cancer at an earlier age.
Breast cancer Breast cancer is most common type of cancer among women. Globally, it accounts for 25% of all cancers. The countries with the highest age-standardized prevalence rates per 100,000 females in the region were
Bahrain,
Qatar, and
Lebanon. Because it is largely asymptomatic in its earliest stages and lacks an effective screening programme, more than 50% of women have stage III or higher cancer (spread beyond the ovaries) by the time they are diagnosed, with a consequent poor prognosis.
Mental health Almost 25% of women will experience
mental health issues over their lifetime.
Women are at higher risk than men from
anxiety, depression, and
psychosomatic complaints. Globally, depression is the leading disease burden. In the United States, women have depression twice as often as men. The economic costs of depression in American women are estimated to be $20 billion every year. The risks of depression in women have been linked to changing hormonal environment that women experience, including puberty, menstruation, pregnancy, childbirth and the menopause. Women also metabolise drugs used to treat depression differently to men.
Suicide rates are less in women than men (<1% vs. 2.4%),
Dementia The prevalence of
Alzheimer's disease in the United States is estimated at 5.1 million, and of these two thirds are women. Furthermore, women are far more likely to be the primary caregivers of adult family members with dementia, so that they bear both the risks and burdens of this disease. The lifetime risk for a woman of developing Alzheimer's disease is twice that of men. Part of this difference may be due to life expectancy, but changing hormonal status over their lifetime may also play a part as may differences in gene expression. Deaths due to dementia are higher in women than men (4.5% of deaths vs. 2.0%).
Bone health Osteoporosis ranks sixth amongst chronic diseases of women in the United States, with an overall
prevalence of 18%, and a much higher rate involving the
femur,
neck or
lumbar spine amongst women (16%) than men (4%), over the age of 50. Osteoporosis is a risk factor for
bone fracture and about 20% of senior citizens who sustain a
hip fracture die within a year. The gender gap is largely the result of the reduction of
estrogen levels in women following the
menopause.
Hormone Replacement Therapy (HRT) has been shown to reduce this risk by 25–30%, and was a common reason for prescribing it during the 1980s and 1990s. However the
Women's Health Initiative (WHI) study that demonstrated that the risks of HRT outweighed the benefits has since led to a decline in HRT usage.
Anaemia Anaemia is a major global health problem for women. Women are affected more than men, in which up to 30% of women being found to be anaemic and 42% of pregnant women. Anaemia is linked to a number of adverse health outcomes including a poor pregnancy outcome and impaired
cognitive function (decreased concentration and attention). The main cause of anaemia is
iron deficiency. In United States women
iron deficiency anaemia (IDA) affects 37% of pregnant women, but globally the prevalence is as high as 80%. Anaemia affects over one-third of the population in the
Middle East and North Africa, caused by iron deficiencies or a combination of other factors, with women making up the bulk of those affected. In Saudi Arabia, 40% of women in the 15–49 age range suffer from anaemia. IDA starts in adolescence, from excess
menstrual blood loss, compounded by the increased demand for iron in growth and suboptimal dietary intake. In the adult woman, pregnancy leads to further iron depletion.
Violence Women experience
structural and
personal violence differently than men. The United Nations has defined violence against women as; Violence against women may take many forms, including physical,
sexual, emotional and
psychological and may occur throughout the
life-course. Structural violence may be embedded in legislation or policy, or be systematic
misogyny by organisations against groups of women. Perpetrators of personal violence include state actors, strangers, acquaintances, relatives and
intimate partners and manifests itself across a spectrum from
discrimination, through
harassment,
sexual assault and
rape, and physical harm to murder (
femicide). It may also include cultural practices such as female genital cutting. Violence was declared a global health priority by the WHO at its assembly in 1996, drawing on both the United Nations
Declaration on the elimination of violence against women (1993) and the recommendations of both the
International Conference on Population and Development (Cairo, 1994) and the
Fourth World Conference on Women (Beijing, 1995) This was followed by its 2002 World Report on Violence and Health, which focusses on intimate partner and sexual violence. Meanwhile, the UN embedded these in an action plan when its
General Assembly passed the
Millennium Declaration in September 2000, which resolved
inter alia "to combat all forms of violence against women and to implement the Convention on the Elimination of All Forms of Discrimination against Women". One of the
Millennium Goals (MDG 3) was the promotion of gender equality and the empowerment of women, which sought to eliminate all forms of violence against women as well as implementing
CEDAW. This recognised that eliminating violence, including discrimination was a prerequisite to achieving all other goals of improving women's health. However it was later criticised for not including violence as an explicit target, the "missing target". In the evaluation of MDG 3, violence remained a major barrier to achieving the goals. In the successor Sustainable Development Goals, which also explicitly list the related issues of discrimination, child marriage and genital cutting, one target is listed as "Eliminate all forms of violence against all women and girls in the public and private spheres" by 2030.
UN Women believe that violence against women "is rooted in gender-based discrimination and social norms and gender stereotypes that perpetuate such violence", and advocate moving from supporting victims to prevention, through addressing root and structural causes. They recommend programmes that start early in life and are directed towards both genders to promote respect and equality, an area often overlooked in
public policy. This strategy, which involves broad educational and cultural change, also involves implementing the recommendations of the 57th session of the UN
Commission on the Status of Women (2013). To that end the 2014 UN International Day of the Girl Child was dedicated to ending the cycle of violence. In 2016, the World Health Assembly also adopted a plan of action to combat violence against women, globally. == Women in health research ==