If you have been following health policy in recent months, you may well have noticed that women’s health issues have grown in prominence. Whereas the focus in the past was on reproduction and related issues, policy today increasingly considers women’s health at all stages of life. 

The National Council’s adoption in 2020 of the postulate “Women’s Health. Better Consideration of Their Specific Characteristics” marked a breakthrough for women’s health at the federal level. The Federal Council was tasked with establishing how women’s needs can be better taken into account in research, prevention and care. The resulting comprehensive Federal Council Report on Women’s Health led to various measures, including the National Research Programme on Gender Medicine and Health. 

To understand why medicine still does not take sufficient account of the specific needs of women, we need to look back into history.

The upshot was that little consideration was given to biological differences between men and women unless they were directly related to the sexual organs. Although there is an increasing trend towards differentiation according to biological sex, there are still only a handful of studies that analyse safety and efficacy of treatments by sex. As the Federal Council report explains, this has implications for healthcare and, in particular, for the quality of treatment that women receive. 

A clear difference is evident between industrial and academic research. Industry-funded clinical trials tend to have a more balanced female/male mix in their sample groups than academic studies do. This is in part down to the international ICH guidelines, which set requirements for the development and approval of medicinal products. 

To counteract this problem, the Federal Council proposed a new statutory provision to boost the inclusion of relevant groups of people in clinical trials and other research projects involving humans. The newly created Article 2(c) of the Human Research Ordinance was implemented shortly after the publication of the report in 2024. It will probably take a few years before its impact can be assessed. History also shows, however, that medical progress goes hand in hand with social change.

How medicine, society and politics interact

In its article “The Influence of Social Change on Women’s Medicine”, the University of Basel notes that progress in women’s medicine and society have influenced each other in recent decades. Research on women’s health was for a long time focused on reproductive issues, but societal change has now brought other aspects of women’s health to the fore. It argues that gynaecology has evolved from a narrow focus on the reproductive organs to an interdisciplinary field that supports women at all stages in life.

Where research and society interact like this, public policy often acts as an enabler. It promotes research, puts the framework in place enabling implementation in practice, and addresses societal concerns. It is therefore thanks not least to political progress that new scientific breakthroughs have been made financially possible in the first place. 

Conversely, public debate often provides vital impetus for politicians. Patients, associations and the media breaking taboos on topics such as the menopause, menstrual problems and increased adoption of gender-sensitive medicine generates visibility and political pressure. One example of this is the petition Endometriosis. Give sufferers a voice! submitted by the Swiss Endometriosis Association, which led to a committee postulate and, following adoption in parliament, to the report “Strategy for the early detection of endometriosis”. 

Increasing the proportion of women does not necessarily lead to more procedural requests, but it does make them more specific

International studies have shown a positive correlation between the number of members in an affected group and the scale of their influence over political discourse. Switzerland is no exception. The postulate that led to a comprehensive report on women’s health was submitted in 2019 – a record-breaking year for women at the polls – and adopted the following year. There is not a direct correlation between the number of procedural requests and female representation, as the graph below shows:

Please note: The filter “health, women” is very broad, meaning that all topics with these keywords are captured. As such, the overview includes political matters that only tangentially affect women’s health.

Nevertheless, a quick glance at the procedural requests shows that over the years the initiatives on women’s health have become more and more specific and have increasingly focused on all stages of life.

However, the impact of a group of people cannot be assessed solely on the basis of the number of procedural requests submitted. What matters more is which of these have been adopted by parliament and what progress has been made. 

That is not to say that men now have no role to play. Important proposals adopted by parliament were tabled by a committee, such as the motion to promote research and treatment for specific women’s diseases or the postulate strategy for the early detection of endometriosis. On the subject of endometriosis, however, a male National Councillor submitted a motion that sought to strengthen research into the disease. This was adopted by the National Council, but then rejected by the Council of States, meaning that it did not result in any measures.

Women’s health is moving up the political agenda

Only eight proposals actually contain the words “women’s health” in their titles, and all of these were submitted by women. The first procedural request was a motion entitled “Creation of a central office for women’s health at the federal level”, dating back to 1998. At that time, only 52 of the 246 seats in parliament were occupied by women. The motion was later withdrawn by the motioner. 

From today’s standpoint, this initiative is exciting and noteworthy, as many of the issues it addressed, such as gender-specific research, gaps in care and taking into account the realities of women’s lives, did not return prominently to the health policy agenda until some 25 years later with the Federal Council Report on Women’s Health.

The next big step is now imminent. Two identical postulates entitled “Women’s health in midlife. The need for action during menopause and perimenopause to improve health and reduce absence rates at work” were partly recommended by the Federal Council for adoption.