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Thursday, October 15, 2026

 

Rise in private testosterone prescribing risks overtreatment and more strain on the NHS



Experts call for national data on private prescriptions to close the evidence gap



BMJ Group






The rapid expansion of private testosterone prescribing risks extending treatment beyond men with clearly defined need to people with non-specific symptoms and borderline test results, for whom the balance of benefit and long term risk are less certain, warn experts in The BMJ today.


Stephen Atkin and Eric Kilpatrick argue that the complexity of care is seldom covered in commercial testing, so managing the longer term risks of testosterone therapy will likely fall to the NHS. 


In 2024, the UK testosterone replacement market was valued at around $205 million and is projected to reach $365 million by 2032. NHS figures show community dispensing increased by 52% from 2020/21 to 2024/25 alongside a ten-fold rise in testosterone gel prescriptions for women aged 50 and older in England between 2015 and 2022. 


Private prescriptions are not recorded nationally, so the scale of private testosterone provision is unknown, explain the authors. However, several indicators suggest rapid growth: a proliferation of private and online clinics, subscription pricing of £100-375 a month (to cover ongoing monitoring, remote consultations, and home-delivered medication), and heavy marketing via social media, influencers and outdoor advertising.
The market is potentially large, they add. Declining testosterone and libido are natural aspects of ageing, and up to a fifth of men over 50 may report deficiency symptoms, although under 1% receive treatment in the NHS.


Diagnosis takes time and repeated testing. It is not established how consistently private providers do this, but they warn that rapid access subscription models built around marketing non-specific symptoms “are unsuitable to handle the complexity of the diagnostic process and risk unnecessary lifelong treatment and a resulting NHS monitoring burden.”
For testosterone therapy in men, clinicians rely on professional society guidance with differing thresholds, they write, meaning NHS clinicians may see patients who have already started taking testosterone against a more permissive private threshold.
They point to the longer term risks of testosterone therapy, such as heart and kidney problems that need ongoing monitoring which they say will likely fall to the NHS. There are also concerns about private off-label testosterone prescribing for women, mainly for low libido associated with menopause.
As stated in official guidance, the responsibility of care rests exclusively with any private sector clinician who initiates treatment unless an NHS GP formally agrees to shared care, they explain. In practice, however, patients who started treatment privately may return to their GP informally for tests or managing side effects, leading to the NHS absorbing the workload without any formal agreement.
The authors stress that testosterone replacement remains a valuable treatment for carefully selected patients, but say national data are needed to close the evidence gap on private prescribing of testosterone. 


“A reporting framework for private prescribers and dispensing pharmacies could capture indications, patient numbers, monitoring, and transfers of care,” they write. “This would lead to transparent prescribing and demonstrable adherence to evidence based care, protecting patients while preserving access to effective treatment.”
 

Wednesday, October 14, 2026

 

Menopause: more than a slow change, it’s a sudden shift across the body


Using a new method inspired by astronomy, Weizmann Institute researchers analyzed 300 million lab tests and uncovered a sharp physiological turning point at menopause




Weizmann Institute of Science





Menopause is commonly viewed as a gradual process that takes years, but a new study by Weizmann Institute of Science researchers, published today in Nature Medicine, reveals that the female body also undergoes a sharp transition around the time of the last menstrual period. Analyzing more than 300 million laboratory test results from over 1 million women in the United States and Israel, Prof. Uri Alon and his team identified abrupt changes in dozens of measures of bodily health and function, far beyond the familiar shifts in sex hormone levels and the loss of fertility.

The changes appeared in 52 of the 90 types of laboratory tests examined, covering nearly all body systems, including tests of bone health, liver and kidney function, and cholesterol levels. No such abrupt changes were observed in men of similar ages, and the changes were less pronounced in women receiving menopausal hormone therapy. The study also revealed that the sudden shifts were preceded by accelerating changes in sex hormone levels that began more than a decade before menopause – several years earlier than previously thought.

The research team, led by Dr. Glen Pridham and Yoav Hayut from Alon’s lab in Weizmann’s Molecular Cell Biology Department, analyzed two large sets of data: results from the US National Health and Nutrition Examination Survey, conducted over more than two decades, and medical records collected over some 20 years by Israel’s health insurer Clalit.

Such large datasets are rarely used in menopause research because they generally lack information about the age at which women had their last period. To overcome this limitation, the researchers developed a computational method inspired by astronomy. Just as astronomers can sharpen an image by mathematically correcting distortions caused by a telescope, the new method removed the “blur” in medical data caused by differences in the age at which women reach menopause.

Because most of the abrupt changes identified in the study are associated with increased disease risk, the findings could help women take preventive steps, such as exercising and improving their diet, years before menopause. “Our study extends the window for potential preventive care to almost a decade before menopause,” Alon says. “More broadly, the method we developed may help study other major changes in life, such as puberty, pregnancy or the onset of disease.”

Also taking part in the study were Dr. Noa Lavi-Shoseyov and Prof. Michal Neeman of Weizmann’s Immunology and Regenerative Biology Department; Dr. Noa Hovav of the Menopause Community Center, Clalit Health Care; and Dr. Yoel Toledano of the Helen Schneider Women’s Hospital, Rabin Medical Center. Dr. Lavi-Shoseyov is also affiliated with the IVF Unit, Department of Obstetrics and Gynecology, Kaplan Medical Center.

Monday, October 12, 2026

How Egyptian femtech is tackling taboos around women's health

Cairo – Cultural taboos and a lack of understanding can be a barrier for women to access healthcare in Egypt, alongside the cost of treatment. But the country's budding femtech sector is creating new pathways to help and information.

Issued on: 11/10/2026 - RFI

Femtech is a growing sector in Egypt, where cultural taboos as well as costs can make accessing information on women's health difficult. ASSOCIATED PRESS - Amr Nabil


By: Lara Reffat in Egypt


A 2019 study by the independent Egyptian Center for Public Opinion Research (Baseera) found that only 20 percent of Egyptian women are covered by medical insurance.

Aside from emergency services and some essential medicines, including childhood vaccines, health services in Egypt are paid for out of pocket. While private medical insurance is an option, it is out of reach for the average Egyptian household.

With healthcare costs often prohibitive, forgoing seeking advice and treatment is not uncommon.

Technology, including artificial intelligence (AI), can plug the gaps – and in the case of women's health concerns such as those around menstruation, reproductive health and menopause, answer questions women may have been keeping buried for years.

Cultural context

However, users can spot when a bot lacks cultural context – something Nesma Amin wanted to address with her app, Aziza, which she founded in 2023. It focuses on menstruation, a topic still mired in misinformation and taboos in Egypt.

"I noticed that most foreign apps only reach a certain group of people who can be comfortable speaking English or speaking on this topic in a certain way – different from what we're used to in our culture," she said.

Spoken Arabic varies greatly across regions, reflecting the individual culture of a country, so while medical information is often delivered in fusha (formal Arabic), this is a far cry from the Egyptian dialect used in daily life.

Sohayla El Fakahany, an Egyptian medical anthropologist whose works focuses on sexual and reproductive health and rights, explains how the use of language is pivotal to delivering information.

"Language and cultural nuance are not simply added features, they are central to whether women and girls feel comfortable engaging with a digital health platform," she said.

"In many contexts, including Egypt, topics such as menstruation, infertility, vaginismus, menopause and sexual pain remain highly stigmatised. If an app uses judgemental, overly clinical or culturally insensitive language, users may disengage – regardless of the quality of the medical information."

Femtech gains traction

Femtech – a sector which covers a range of women’s health services as well as physical products, from menstrual and fertility trackers to wearable devices to help with chronic conditions – is growing in the country.

For Amin, accessibility was a priority.

"With an Egyptian woman, you will always find that she prioritises her children, education and household needs. All these things come before her health, so it did not feel right at all to have a [paid] subscription [model] or any barriers to our features," she explained.

Her app's features include menstrual and pregnancy trackers as well as the ability to directly answering the user’s questions – and all are attuned to cultural sensitivities.

"A foreign app assumes certain things – that a user is sexually active, and so on. For instance, I've received feedback from our users who say they are glad that notifications are discreet and Aziza doesn’t send notifications or messages that may seem inappropriate."

She says that feedback from users has been mostly positive, partly because social media had already opened the conversation around reproductive health.

However, she added: "On the ground we faced a lot of pushback, but because I worked in the field before, I know how to deal with these topics on the ground. And I train my team. We take a lot of training on how to handle tough conversations around menstruation, around sexual health, how to talk with young boys and how to talk with men."

Amin works with doctors in designing and developing features in the app, but insists that working with women and girls directly is just as important.

"We have more than 75 student ambassadors. They're also medical students. We focus on training people on the basics of menstruation, basics of self-care and women's health. Every workshop is tailored around a specific need."

Beyond software

The sector goes beyond software, with new physical products on the market too. While pads are more or less the only menstrual product used by the average Egyptian woman, period underwear has begun to appear.

Hatem Elkady, CEO of Shemsi, a Cairo-based period products maker, said: "In Egypt and the wider region, the menstrual care market has been stagnant for decades, dominated by disposable pads.

"While internal products like menstrual cups and tampons face strong cultural resistance and taboos, traditional pads bring their own set of challenges, like skin irritation and constant anxiety over leaks."

The data on tampon use in Egypt is limited, as large-scale reproductive health studies in the country chiefly focus on pad and pantyliner use. Small, local pharmacies seldom sell tampons and even larger chain pharmacies tend to display them less prominently.

The driving force behind the continued market domination of sanitary towels is the stigma around loss of virginity. Unmarried women are warned that inserting any objects could compromise the hymen. Even after marriage, disdain for tampons persists.

According to Elkady, wearable period care assuages some of these fears – but not all.

"In a society conditioned for generations to believe that menstrual hygiene must be disposable, introducing reusable period underwear was met with a lot of initial scepticism. Women wondered, will it truly absorb? Is it hygienic? Will it leak? We overcame this by focusing heavily on transparency, open conversations and community education."


'Lived experience'

Shemsi presents the fact that its products are environmentally friendly as a benefit, along with, crucially, their value for money – due to the fact that they are reused.

"They are designed to be washed easily alongside regular laundry and can be reused for up to 300 washes per garment," said Elkady.

However, while a large pack of pads costs roughly $2 (USD) in Egypt, a pair of Shemsi underwear is closer to $14 – a difference in initial outlay that could deter women on a tight budget.

"We understand that this initial upfront investment can be a shift for families during current economic times. To ensure our sustainable solutions are accessible to everyone and to ease the immediate financial burden, we offer flexible payment options, including instalment plans. This allows families to make a one-time investment in their health and budget without financial stress," says Elkady.

For El Fakahany, this recognition of the reality of women's lives is essential to success for companies in the sector.

"When women feel that a platform reflects their lived experience and communicates with empathy and respect, they are more likely to trust it, continue using it and act on the health information it provides."

Saturday, October 03, 2026

 

The risk of looking back at former versions of ourselves



New study examines effects of self-oriented comparison





Ohio State University




COLUMBUS, Ohio — For decades, body image researchers have focused almost exclusively on how we compare ourselves to others, and the toll it takes on our well-being. But a new study from The Ohio State University shows that we are often our own worst critics, especially when comparing who we are today with past versions of ourselves.

It is well-established that comparing your body to someone else’s can lead to a negative body image and disordered eating. Popular theories in the field suggest that across the lifespan, our peers, parents and the media we consume all reinforce societal beauty standards, driving people to measure their own value against unrealistic ideals. However, according to the study published recently in Body Image, people are just as likely to compare their current bodies to their former appearance, with equally harmful results. And few scholars have studied this phenomenon in-depth.

“There’s so much literature on social comparison, especially in body image and eating disorder literatures, and there’s virtually nothing on self-oriented comparison,” said lead author Tracy Tylka, a professor of clinical psychology at Ohio State’s Marion campus.

Findings in Tylka’s new work, and a measurement scale she and colleagues created and validated, may have potential to alter psychological treatment for people seeking help with adjusting to appearance-related changes – including aging.

“Self-oriented comparison matters. It is uniquely associated with body image and eating behavior,” she said. “In clinical treatment, we shouldn’t just focus on how clients are comparing themselves to others, but also how they are comparing themselves to previous versions of themselves.”

For Tylka, the gap became clear during conversations with her former Ohio State graduate student and the study’s co-author, Nichole Wood-Barcalow, who now works in private practice in Westerville, Ohio. Wood-Barcalow had noticed a pattern among her clients, who frequently compared their current appearance with how they looked in old photos, videos and memories of their younger selves. 

They would tell Wood-Barcalow, “Oh my gosh, I can’t believe how much I’ve changed.”

These reflections were often triggered by major life milestones and physical changes, including puberty, pregnancy, menopause, andropause, illness, aging and weight fluctuations. While some people felt they had changed for the better, most perceived these appearance-related shifts negatively.

Tylka has a deep background in psychometrics and analysis and has created scales that measure everything from intuitive eating and body appreciation to body acceptance by others. Established scales measuring social comparison are used regularly in research and clinical practice, so when Tylka searched for a trait-based scale to measure self-oriented comparison, she was surprised to learn it didn’t exist yet.

“Once we found out this was such an untouched construct with no scale developed to measure it, I knew we had to assess it,” she said.

Historically, she explained, body image and eating disorder research have focused on young white women or adolescents, who are comparing themselves more to others than to previous versions of the self.

“The body image field has been late to notice ageism and the lack of research on the aging process as it relates to body image. As we age, we move further away from what society tells us we should look like, and we compare ourselves to previous versions, photos or videos from decades ago,” Tylka said.

Tylka worked with Wood-Barcalow and other experts to design an 11-item measure of self-oriented appearance comparison, named the Self-Oriented Comparison Scale for Appearance (SOCS-A). They tested the scale across two separate community samples of U.S. adults to confirm its accuracy.

Through statistical analysis, the study confirmed support for two distinct subscales: upward and downward self-oriented comparison. Upward comparison involves measuring your current reflection against a past vision of yourself where you felt more attractive, while downward comparison means looking back at a photo, memory or time when you felt less attractive. Among study participants, researchers found that upward comparison was strongly linked to negative body image, body shame, rumination and disordered eating. Downward comparison, by contrast, was associated with lower levels of shame and higher appearance pride and body appreciation.

“What surprised us was that downward comparison was viewed more favorably. We were expecting a pattern more similar to social comparison, where downward comparison is also maladaptive,” Tylka said. “People think comparing themselves to others they view as less attractive would make them feel good, but downward social comparison is linked to body-focused shame, guilt and less body image flexibility.”

In other words, when we use others as a gauge to evaluate ourselves, we might feel bad for those other people or guilty for making comparisons. Downward self-oriented comparison, however, often means you worked to change or overcome something you didn’t like about your appearance, so you’re more likely to report feeling a sense of pride and accomplishment.

The study results also revealed gender differences. While the scale worked the same way structurally across the gender spectrum, women scored considerably higher than men on upward self-oriented comparison, while men scored higher on downward self-oriented comparison.

Tylka said this finding aligns with societal pressures: Women are expected to maintain a certain appearance, and if they deviate from that in any way, it tends to bother them more because their worth in society is often tied to appearance.

She hopes that the SOCS-A will be translated and used by research teams around the world – and in prevention programs, clinical interventions and therapy settings — to explore the experiences of diverse groups of people going through appearance-related changes and evaluate whether upward self-oriented comparison decreases as a result of treatment.

“Beyond age, I think (the SOCS-A) has relevance to be explored in the context of GLP-1 use,” Tylka added. “I am starting to do research with colleagues on GLP-1s, body image and eating behavior. We haven’t analyzed the data yet, but I think the intersection with self-oriented comparison will be really interesting.”

This work was funded by an Ohio State Joan Huber Fellowship Grant.


Written by Elizabeth Weinstein

Friday, September 18, 2026

 

Women’s kidney health may be overlooked, delaying critical prevention and treatment opportunities



A new American Heart Association scientific statement encourages equitable access to kidney care, sex-specific research analyses and more to improve women’s kidney health



American Heart Association








Statement Highlights:

  • Diagnosis of women’s chronic kidney disease (CKD) is often delayed, and they are less likely to begin dialysis or receive a kidney transplant.
  • Several female-specific factors impact women’s kidney and cardiovascular health throughout their lifespan, including menstrual health, pregnancy/postpartum and autoimmune disease along with social and cultural factors.
  • Women remain underrepresented in clinical trials for CKD.
  • The statement suggests advancing kidney health for women by including reproductive health assessment in CKD care, increasing women’s enrollment in clinical trials, sex-specific analysis of study findings and further study of how female biology and life stages affect kidney function and the effect of CKD treatments.

Embargoed until 4 a.m. CT / 5 a.m. ET Thursday, Sept. 17, 2026

DALLAS, Sept. 17, 2026 — Chronic kidney disease (CKD) affects about 1 in 10 women worldwide, yet diagnosis is often delayed and women are less likely to receive critical treatments like dialysis or a kidney transplant compared to men, according to a new American Heart Association scientific statement published today in the Association’s flagship journal Circulation.

The statement suggests improving women’s kidney care by recognizing how women’s unique biology and social factors affect kidney health and designing research that includes sex-specific analyses of kidney function and CKD medications.

“Many cases go undiagnosed in women because common tests and research do not always reflect women’s biology and life stages,” said Eman Y. Gohar, Ph.D., M.S., FAHA, the volunteer chair of the scientific statement writing group.

“Biological differences include genetics, sex chromosomes, hormones, immune-system responses and differences in how the body processes and responds to medication,” Gohar said. “We also need to acknowledge female-specific factors that do not apply in the same way to male patients. These include menstrual health, pregnancy, postpartum changes and menopause as well as socioeconomic factors like financial barriers or cultural expectations. Each of these creates considerations that are unique to women and may require tailored care.”

The scientific statement, “Women’s Kidney Health in Focus,” lists seven challenges women face in kidney care:

  • Underrepresentation in clinical trials
  • Less treatment access
  • Delayed referrals
  • Adverse pregnancy outcomes
  • Menopause
  • More adverse effects of kidney treatment medication
  • Lower rates of kidney transplant

Medication effects and underrepresentation in clinical trials

According to the statement, women may have different responses to kidney treatment medication compared to men but continue to remain underrepresented in clinical trials.

“Women are not simply smaller versions of men,” said Gohar, an assistant professor of medicine at Vanderbilt University Medical Center in Nashville, Tennessee. “Their biology, reproductive life stages and responses to medication may differ, and those differences need to be reflected in clinical care and research.”

Women and men may respond differently to medications because of differences in how they are absorbed, distributed, broken down and removed from the body. In fact, laboratory research points to estrogen receptors as having a potential role in women’s kidney function.

Kidney disease may be underrecognized in women, causing delayed referrals for care

Kidney function is commonly estimated using creatinine, a waste product generated by muscle. Because women typically have less muscle mass and may produce less creatinine, these estimates may not always accurately reflect kidney function, thus causing kidney disease in some women to be misclassified or recognized later.

Understanding aspects of kidney health that are unique to women’s life stages is critical for advancing precision medicine.

Kidney and reproductive health are closely connected

“Kidney health and reproductive health are intertwined,” Gohar said. “Pregnancy, menstrual health and menopause may provide important information about a woman’s current and future kidney health.”

Pregnancy in women with CKD may increase the risk of kidney disease progression and pregnancy complications. Taking steps to manage blood pressure, blood sugar and body weight is suggested for women with CKD who plan to become pregnant.

In women without CKD, pregnancy complications such as preeclampsia may signal an increased risk of future kidney disease, heart disease and stroke.

Natural menopause before age 45 and surgical removal of the ovaries before age 50 are each linked with a higher risk of CKD. Other factors contributing to CKD after menopause include increases in obesity, type 2 diabetes and high cholesterol.

The statement suggests that embedding reproductive health assessment in CKD care is one step towards advancing precision kidney medicine.

In addition to pregnancy and menopause, other women-specific conditions affect CKD risk. Polycystic ovary syndrome, a common hormone disorder among women, and the autoimmune disease lupus, which is more common in women than men, are linked with a higher risk of CKD.

Women face gaps in access to timely kidney care and kidney transplants

Women tend to begin dialysis at a lower level of kidney function compared to men, indicating a delay in treatment initiation. They are also less likely to receive a kidney transplant. Globally, men receive kidney transplants about 30% more often than women. In some low- and middle-income countries, the gap is more than 10-to-1.

Poverty, limited health literacy, caregiving responsibilities, cultural expectations, limited support and treatment costs may delay diagnosis or make specialist care harder to reach. These barriers may be especially serious in low-resource environments where access to kidney specialists, dialysis or transplant care is limited.

Kidney disease is part of the cardiovascular-kidney-metabolic syndrome

CKD is a major contributor to heart disease and stroke risk, which is why it is part of cardiovascular-kidney-metabolic (CKM) syndrome.

Diabetes, another part of CKM syndrome, is the leading cause of CKD worldwide. Among people with diabetes, some evidence suggests women may progress to kidney failure at higher rates than men.

Opportunities to improve kidney care for women

The statement identifies research priorities that include enrolling enough women in clinical trials to determine whether treatments affect women and men differently, reporting results by sex and reproductive health-specific factors. Future research may help health care professionals detect kidney disease earlier and choose safer, more effective treatments.

This scientific statement was prepared by the volunteer writing group on behalf of the American Heart Association’s Kidney in Cardiovascular Disease Committee of the Council on the Kidney in Cardiovascular Disease; Council on Clinical Cardiology; and Council on Lifestyle and Cardiometabolic Health. American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.

Co-authors are Vice-Chair Silvi Shah, M.D., M.S.; Ester S. Oh, Ph.D., M.S.; Sofia B. Ahmed, M.D., MMSc; S. Ananth Karumanchi, M.D.; Roy Mathew, M.D.; Sayna Norouzi, M.D.; Giorgina Piccoli, M.D.; Jane Reckelhoff, Ph.D., FAHA; Amanda Vinson, M.D.; Licy L. Yanes Cardozo, M.D. Authors’ disclosures are listed in the manuscript.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources from the American Heart Association:

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About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.