STATEMENTS ON SIGNIFICANT MATTERS
Dr RYAN (Kooyong) (12:25): Last week was Women's Health Week. Its theme was 'Do it anyway'. It was an encouragement to women to take steps to look after their own health, even when life gets in the way.
That's a good theme. But, too often, when women do take that step—when they go to the doctor, describe their symptoms and ask for help—the system fails. Women in this country are diagnosed later, treated less and believed less than men at almost every stage of life.
That is the product of a health system and a medical culture built around the male body, which still, in 2026, regard women as a variant. I know, as a doctor who has worked in the public health system in Australia for three decades, that the bias I'm describing isn't malicious; it's structural. It's in what we were taught, what we weren't taught, which bodies the research was done on and the norms established, and whose pain we were trained to take seriously.
In 2024, nearly 3,000 Australian women and health professionals responded to the National Women's Health Advisory Council's #EndGenderBias survey. Two-thirds had experienced gender bias or discrimination in health care. They described being dismissed, disbelieved and labelled 'hysterical' or 'a drama queen'.
They described being sent home when they needed surgery, with paracetamol and a hot water bottle. That survey is not an outlier. A separate national survey of 2,000 Australians in 2024 found that 55 per cent of women felt their pain had been ignored or dismissed.
Nearly half of them said that women aren't taken seriously because they're seen as being too 'emotional'. Let's consider what that dismissal costs. Endometriosis affects about one in seven women in Australia.
The average time from first symptoms to diagnosis is about seven years: seven years of being told that your period pain is normal, that it's in your head and that you should try a heat pack. The Institute of Health and Welfare estimates that endometriosis costs this country more than $7 billion every year, most of it in lost quality of life and lost productivity.
We're talking about teenage girls who are missing school and women in their 20s and 30s losing jobs because no-one asked the right questions. Heart disease is where the bias is most lethal. About 20 Australian women die from coronary heart disease every day—nearly three times the number who die from breast cancer.
In 2024, more than 2,300 Australian women died from a heart attack. Last October, Professor Clara Chow and her colleagues published in the Medical Journal of Australia the largest Australian study of its kind. They looked at nearly 30,000 people in New South Wales who'd had their first major heart attack over the preceding decade.
Women were as much as 16 per cent less likely than men to get an angiogram or a stent within the recommended window. They were much more likely to be dead a year later. The researchers concluded that, at the current rate of improvement, the health gap won't close for at least another decade, and that as many as one in five heart-attack deaths in women could be prevented if they just received the same care as men.
Why does that happen? Because women's heart attacks don't look like the Hollywood heart attack: a man clutching his chest. Women more often present with atypical symptoms: nausea, jaw pain, breathlessness or fatigue.
But those symptoms get read as anxiety, as stress or as menopause, so a woman having a heart attack is much more likely to be sent home. Which does bring me to menopause—every woman who lives long enough will go through it. About a quarter of Australian women aged between 45 and 64 say that it makes their daily life difficult.
But the Senate inquiry that reported in 2024 heard from the Australasian Menopause Society that medical students receive as little as one hour—one hour!—of menopause education across their whole degree. Women told the inquiry that their doctors didn't recognise perimenopause until they started to have hot flushes, a clue that's too late. Many were treated for anxiety or depression for years before their doctors joined the dots.
Part of the reason for that is a piece of science which went badly wrong. In 2002, a long-term follow-up study in the states, the Women's Health Initiative, suggested that combined hormone therapy increased health risks like breast cancer and heart disease. It was reported in a way that terrified a generation of women.
Prescribing collapsed. It's taken more than 20 years for that evidence to be properly reread and for the profession to accept that, for women under 60, the benefits of hormone replacement therapy clearly outweigh the risks. That's 20 years in which millions of women went unnecessarily untreated.
It's only in the last 18 months that things have really started to shift in this country. In March 2025, new hormone therapies were listed on the PBS for the first time in more than 20 years. There's now a Medicare item for a menopause health assessment.
These changes are welcome, and we thank the government for them. I supported them, but they are a beginning, not an end. The workplace-related recommendations of that Senate inquiry for flexible work, proper data, reproductive health leave have thus far been largely left on the shelf.
What happens after menopause matters just as much and gets even less attention. When oestrogen falls, a woman's risk of heart disease rises sharply. Our bones weaken.
Osteoporosis affects about one in four women over 50, compared with one in 10 men. Two in five women over 50 will suffer a fracture from a minor fall. Nearly three-quarters of hospital admissions with a hip fracture in this country are women.
We know how to prevent that but we don't because we treat bone health in older women as an inevitability rather than a medical condition. Only about half of the older women with high blood pressure in this country have it controlled. Women with high cholesterol are prescribed statins at lower rates than men.
And then dementia—now the leading cause of death in Australia. It's been the leading cause of death for women since 2016. Nearly two-thirds of the 17,500 Australians who died of dementia in Australia in 2024 were women.
Older women are also more likely to be living alone on lower superannuation or to be providing unpaid care for someone else, while their own early symptoms of dementia go unreported. So how did we get here? Partly it's the science.
For most of the 20th century, women were routinely excluded from clinical trials. In the United States, women of childbearing age were formally shut out of early stage drug trials until 1993. Drug doses, normal values, diagnostic thresholds, the typical symptoms in the textbooks, are mostly established in men and retrofitted to women.
A 2025 analysis in the Medical Journal of Australia found that most Australian clinical guidelines still don't properly account for sex and gender differences. Partly it is culture. Medicine inherited the idea of the hysterical woman, and it's never fully shaken it.
We expect women to have pain. We attribute their symptoms to emotion. Menopause is often just a punchline.
When a 50-year-old woman says she can't think straight, she can't sleep and her heart is racing, our system's first instinct is still to reassure her, not to investigate her. But partly it's money as well. Our Medicare system rewards short consultations.
A woman with complex, overlapping symptoms, those which are most likely to be missed, needs a long appointment with a good GP, but our funding model discourages exactly that. None of this is inevitable. We can teach menopause and we can teach women's cardiac presentations properly in every medical school.
We can require that publicly funded research collects and reports data by sex. We can fund longer consultation. We can implement the Senate inquiry's recommendations rather than just filing them.
And we can stop treating half of our population as a special interest group. Women's Health Week asks women to 'do it anyway'—clue: they will—but this parliament's job is to make sure that, when they do, the system does its part