To negate this, the campaign \u2018Beyond Bikini Medicine\u2019<\/a> has been hailed as a powerful and growing movement for change. Its use across both the medical literature and the lay media<\/a> has since broadened into a much-needed campaign for equitable sex and gender responsive approaches, not just for research<\/a> but for health policy<\/a>, innovation<\/a>, service provision<\/a> and education<\/a>.<\/p>\n Beyond reproductive organs<\/p>\n Outside the reproductive organs, it is now well established that women have different presentations<\/a>, predispositions<\/a> and trajectories<\/a> across hundreds of diseases. They are not just smaller versions of men, yet clinical guidelines<\/a>, drugs, research and development, provider attitudes, and even cell lines and animal studies, are still predominantly based on the male, with consequent underfunding of sex- and gender-tailored research<\/a>, technology, and in particular health services<\/a>. Australian researchers<\/a>, most notably from the George Institute for Global Health, have been influential in highlighting the need to address this unmet gender gap across the board<\/a>. Redressing the 25% more time women spend in poor health, in contrast to men, would, according to recent World Economic Forum<\/a> (WEF) reports, boost the global economy by one trillion dollars<\/a> (United States) annually by 2040.<\/p>\n \u201c\u2018Bikini medicine\u2019 has marginalised women in every area of health<\/a>\u201d headlined a recent MJA Insight+ article. While a media-savvy catch cry, the term itself can be criticised for being patronising, outdated, and indeed pejorative, implying an entrenched Western sexist stereotype that has not changed since Wenger introduced it. Paradoxically, continued use of this term even as \u2018Beyond Bikini Medicine\u2019 may diminish rather than augment the overall push for better women\u2019s health.<\/p>\n Firstly, many female reproductive conditions are systemic not local, with manifestations well outside the so-called \u2018bikini\u2019 organs. Polycystic ovary syndrome (PCOS) has substantial metabolic and endocrinological sequelae, endometriosis is increasingly recognised as an inflammatory disorder that may appear at many sites, just about every body system is deranged in pre-eclampsia, hyperemesis gravidarum can be lethal, and peri-menopause affects all major organ systems, while premenstrual syndrome\/dysphoric disorder has debilitating neuropsychological as well as physical manifestations. Next, reproductive disorders such as gestational diabetes, preterm delivery, stillbirth, PCOS and endometriosis, and hypertensive disorders of pregnancy carry significant long-term cardiometabolic risks including mortality, likely through genetic predisposition across the life course. Indeed, even within its organ remit, \u2018bikini medicine\u2019 implies a focus centred on the reproductive years while the disease burden of the equally numerous decades women spend in later life is underestimated<\/a>.<\/p>\n The ongoing gender health gap<\/p>\n The gender health gap spans three groups: disorders that affect women disproportionately, differently, or uniquely. Of these, the first (among others, autoimmune diseases, migraine, depression and osteoporosis) is by far the largest, with unique reproductive conditions next estimated at around 10%, according to the WEF\u2019s 2024 report. Another report from the WEF<\/a> finds that about a third of the gap is made up of just nine conditions, seven of which are reproductive (breast cancer, cervical cancer, maternal hypertensive disorders, post-partum haemorrhage, menopause\/perimenopause, premenstrual syndrome and endometriosis); closing this could prevent almost 27 million disability-adjusted life years annually. Yet it is across the whole spectrum that research into female dominant compared to male dominant conditions is underfunded, and there are cogent macroeconomic and social arguments for investing in pan-women\u2019s health across the life course. Rather than balkanise the components, an equitable whole-of-woman approach is needed. This would assist both obstetricians and gynaecologists<\/a> in embracing a whole-of-patient approach, and other specialists in appreciating gendered health perspectives inclusive of their reproductive context. In this light, it is instructive to see a recent $15M international grant<\/a> on cardiovascular disease in postmenopausal women co-led by an Australian gynaecologist.<\/p>\n Nanette Wenger has spent seven decades convincing her colleagues to look \u2018beyond bikini medicine.\u2019 Hers was the first and the strongest voice to call for equitable inclusion of women in research in medicine, particularly but not only in cardiovascular medicine including CHD. But \u2018bikini medicine\u2019 as a medical term has outlived its use-by date. In the 21st century, it is better to unite around sex- and gender- specific precision medicine for the whole woman, than dwell on an oversimplistic and trivialising catchphrase.<\/p>\n Nicholas M Fisk AM is an emeritus professor in the faculty of medicine and health at UNSW. He was professor of obstetrics and gynaecology at Imperial College London, 1992-2007, executive dean of medicine and health sciences at University of Qld, 2010-2016, and then DVC Research & Enterprise at UNSW Sydney until 2024.<\/p>\n Caroline de Costa was professor of obstetrics and gynaecology at James Cook University, Cairns, 2004-2021, and is now an adjunct research professor at The Cairns Institute of JCU.<\/p>\n The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the\u00a0MJA\u00a0or\u00a0InSight+\u00a0unless so stated.\u00a0<\/p>\n Subscribe to the free\u00a0InSight+\u00a0weekly newsletter\u00a0here<\/a>. It is available to all readers, not just registered medical practitioners.\u00a0<\/p>\n![\"\u2018Bikini](\"https:\/\/www.newsbeep.com\/nz\/wp-content\/uploads\/2026\/03\/shutterstock_2269474065.jpg\")
Women have different presentations, predispositions and trajectories across hundreds of disease (PeopleImages \/ Shutterstock).<\/p>\n