Contributors: Stefani Hayes, ND, L.Ac.; LaDeana Jeane, ND, FABNO; Silmacoral López Jiménez, ND; Danielle Melvin, ND  

Since I was asked to write this article, I have been pondering the question: What are some advancements in women’s health in the last 1-2 years? On a day-to-day basis of clinical practice, areas of advancement affect diagnosis, screening, and treatment options. There’s a lot to stay up to date on: Current guidelines on testing, prevention and risk reduction; new and evolving functional medicine testing; STI screening; cervical cancer screening; lipid evaluation; determining 10-year risk of atherosclerotic cardiovascular disease; screening for diabetes; colon cancer and breast cancer screening; and many more. Then there’s the continuing stream of botanical and nutraceutical research on oh-so-many things that I need to stay up to date on. Finally, the years of research on menopausal hormone therapy, and the last 25 years in particular. There are many other areas of primary care and gynecological issues in regard to treatment options, from natural to pharmaceutical to surgical. These issues are not necessarily the same as the latest fad issue or fad test or fad elixir of health and wellness.  

Rather than focus on an individual ingredient, test, or treatment option, let’s look at some big themes. After that, I have invited several colleagues to pick an area of import and advancement that is meaningful today in the clinical practice of providing good health care to women. 

It’s always important to keep in mind that whatever the trend is today, it often continues to impact the health care industry at large and the health and wellness outcomes for women for many years into the future. 

The health of women in the United States is in a worrisome place and has had some recent body blows. Women’s life expectancy is at its lowest since 2006. Women are experiencing the consequences of state and federal legal decisions that limit their access to health services and reproductive care. Millions of women are either newly uninsured or with significant gaps in their coverage. Not only do the policies and restrictions and lack of coverage affect women’s access to care, but healthcare providers that have long served low-income women are leaving those regions or at risk of clinic closures. In 2022, residents of more than one-third of U.S. counties had very little or no access to maternity care.  

Access to contraception and infertility treatments is also at risk, not only for women patients, but legal and personal threats to clinicians providing these services also leads to providers leaving that region, further putting more women at risk.   

If one measures all-cause mortality, maternal and infant mortality, preterm birth rates, syphilis among women of reproductive age, infants born with congenital syphilis, self-reported health status, postpartum depression, breast and cervical cancer deaths, poor mental health, and intimate partner violence, the states where women have the best outcomes are Massachusetts, New Jersey, and Connecticut, while Mississippi, Arkansas, and West Virginia rank lowest. 

The best performing health system for women overall in the U.S. is Massachusetts, and Vermont, Rhode Island, Connecticut, and New Hampshire complete the top five with the highest ranked states being concentrated in New England, the Mid-Atlantic and the northern Midwest. The lowest-ranked states overall are  Mississippi,  Texas,  Nevada,  Oklahoma, and  Arkansas with others across the Southeast and Southwest. The three west coast states rank better than average but not in the top tier. 

The Gender Gap 

All experts in women’s health agree that there is a lack of extensive data related specifically to women’s health issues. Underfunded research on female health issues has led to a gender health gap that is adversely affecting the quality of life for women around the world. “Women are likely to spend more than 25 percent more of their lives suffering from disease and chronic health conditions than men, and women are less likely to be diagnosed with a disease or chronic condition than men.”¹ 

The Racial and Economic Gap 

Deaths from preventable causes are on the rise and deep inequities persist, leading to stark racial differences in maternal mortality and deaths from breast and cervical cancers. 

Most of the southern states have few maternity care providers, higher rates of maternal mortality, especially for women of color, with wide health care system disparities for non-white or ethnic women. 

Advances in Testing for Women’s Health 

We’ve known for decades that screening and diagnostic tests are essential to early detection, with early and appropriate treatment leading to the best outcomes. There is a current effort to improve screening methods for women and to update diagnostic procedures that can then provide more accurate results and thus appropriate interventions. Screening and diagnostic methods for cardiovascular disease in women is  a weak spot in that women have been underrepresented in the establishment of screening methods and testing, thus leading to delay in diagnosis of cardiovascular events.  

Recent advances in non-invasive prenatal testing (NIPT) and genetic screening procedures allow parents to have a better understanding of the likelihood that genetic conditions could occur in their offspring.  

Hormonal and reproductive health testing has made great strides in determining a woman’s fertility, if she is entering perimenopause or menopause, and in diagnosing women with polycystic ovarian syndrome or other types of gynecological and endocrinological health conditions. 

Telehealth in Women’s Health Management  

The necessity for this during the early days of the Covid-19 pandemic really opened the door to advances in technology for telemedicine, which makes health care more accessible for women not only in the U.S., but around the world. For some women, telehealth offers a safe and secure setting, not just one of convenience.  

Wearable  Health and Monitoring Devices  

Wearable health tech improvements let providers collect accurate, gender-specific data. Research may not have included many women, and this individual testing can fill in that gap. Areas where I’ve seen a particularly high use are in continuous glucose monitoring and heart rhythm monitoring.  

Digital Reproductive Health Platforms  

Access to information, resources, and health care can be found on mobile apps, websites, chatbots, and in virtual consultations with health care professionals. Sexual and reproductive health, weight loss, menopause care, and mental health are strong in this space.  

Minimally Invasive Surgical Techniques  

Women are benefitting from minimally invasive surgical techniques to diagnose and treat. Most pronounced in my practice includes uterine artery embolization for uterine fibroids, laparoscopic pelvic surgery for endometriosis, and the LEEP (Loop Electrosurgical Excision Procedure), a procedure used to remove abnormal cells from the cervix. These minimally invasive surgical techniques improve results, reduce recovery time, and minimize the risks associated with more invasive surgeries.  

Femtech  

The extreme demand for Femtech, or female technology, has given rise to the Femtech industry, which, according to the  Medical Device and Diagnostic Industry online publication, is worth more than $50 billion worldwide. Femtech products have the ability to revolutionize women’s healthcare and improve healthcare outcomes for women of all ages.  

Personalized health apps are a common example of Femtech. Tracking the menstrual cycle, fertility apps, weight apps and more come to mind. Femtech innovations are driving many women’s health research efforts.  

Artificial Intelligence (AI)  

AI is impacting women’s health consumers and health providers. It is evolving quickly but is likely to play a key role in best practices and future medical technology. AI is being used to interpret and analyze data, forecast outcomes for women based on personalized data, and offer personalized advice. AI tools are also enhancing accuracy of diagnostic evaluations, reducing human errors, and allowing providers to offer better care and better health outcomes. 

AI also offers virtual health assistants so that a woman can receive immediate guidance and advice. With the current nursing shortage, this is likely going to become more common.   

Preventive Health Strategies, Lifestyle Interventions and Natural Medicine 

Research in nutrition, exercise, and botanical and nutraceutical agents continues to play a pivotal role for many women in their physical and mental health. Health care providers who are well informed about these lifestyle and natural therapies are increasing in demand and will continue to do so.  

Areas of expanded research in botanical and nutraceutical supplements for women have included some key areas that I use every day in clinical practice: lavender extract for anxiety disorders; NAC (N-acetyl cysteine) for polycystic ovary syndrome; the effect of curcumin on Alzheimer’s disease; and vaginal-specific species and strains of lactobacillus in bacterial vaginosis, to name just a very few.  

Functional Medicine Tests 

We see more and more tracking and testing methodologies and technologies for insomnia, mental health, hormone evaluation, stool evaluation, vaginal evaluation, nutrient analysis, and more. These have continued to expand in options, companies and platforms. While functional medicine testing can lend insight and lead to helpful strategies for treatment options, be mindful of scientific validation, if overmedicalizing and over testing is involved, and if the results reveal a useful action plan that can alter her health outcome.  

Vaccination and Screening Recommendations for Women  

Vaccination and screening recommendations will continue to evolve with the main emphasis being on prevention and early detection. Breast cancer screening guidelines from the U.S. Preventative Services Task Force was recently updated with a recommendation of a screening mammogram every other year for women between the ages of 40 and 74.  

More Advancements 

Several advancements in women’s health in the last 1-2 years have included new treatments for fertility, advances in cancer therapies, increased focus on preventative care, mental health, and the impact of climate change and environmental exposures. Key areas in reproductive health have included ovarian rejuvenation, AI in fertility, hormone free contraception, TMS (transcranial magnetic stimulation), treatment for depression, the one-time HPV vaccine, gut microbiome health, vaginal microbiome health, weight loss medications, and continuing nuanced research on menopausal hormone therapy benefits and risks. 

Initiatives like the Women's Health Impact Tracking (WHIT) platform, the Society for Women's Health Research (SWHR) agenda, and the World Economic Forum's Global Alliance for Women's Health are all working to address disparities and improve outcomes. There is a new wave of increased funding and attention for women’s health research and innovation.  

Areas of Need in Advancement

There are clear areas of need in women’s health where we have a long way to go in terms of better understanding, better outcomes, or less invasive treatment options: 

• Endometriosis  
• Uterine fibroids 
• Breast cancer etiology and risks 
• Cardiovascular disease 
• Alzheimer’s disease 
• Fibromyalgia 
• Chronic fatigue syndrome 
• Infertility 

Funding of research – not only in women-only health care issues, but primary care for women – needs a new focus and funding. There are numerous initiatives, efforts, committed organizations, and institutions that are well-informed on the health and research dollars statistics that are leading these efforts.  

References

World Economic Forum Report, January 20 2025. https://www.weforum.org/publications/blueprint-to-close-the-women-s-health-gap-how-to-improve-lives-and-economies-for-all/ 

Updates in Women’s Health 

Lastly, I’ve invited a few colleagues to highlight something relevant in their women’s health practice, considered an advancement or update in women’s health.

Microbiome and Fertility 

Contributor: Stefani Hayes, ND, L.Ac. 

Allopathic research is showing what naturopaths have always known – that the microbiome matters for fertility. IVF clinics are increasingly utilizing the EMMA and ALICE tests, which evaluate the microbial balance of the uterus, largely on patients with unexplained embryo transfer failures and recurrent pregnancy loss. While the allopathic treatment is often to give antibiotics, potentially further aggravating the imbalance and increasing risk of antibiotic resistance, naturopaths are incredibly equipped to address these concerns – with specific probiotic species, strains of lactobacillus that are indicated, or even VMT (vaginal microbiome transplant) if needed.  

References 

Endometrial microbiota composition is associated with reproductive outcome in infertile patients, January 2022. https://pubmed.ncbi.nlm.nih.gov/34980280/ 

The microbiome in recurrent pregnancy loss – A scoping review, June 2024. https://www.sciencedirect.com/science/article/pii/S0165037824000603  

Breast Cancer Screening Updates 

Contributor: LaDeana Jeane, ND, FABNO 

According to the American Cancer Society (2025), over the past 31 years, cancer mortality rates have declined by 34%. However, recent data indicate a significant increase in cancer incidence among young adults under 50, with pronounced racial disparities underscoring the urgent need for earlier and equitable screening programs. This trend is especially concerning for women: cancer rates in those under 50 are now 82% higher than their male counterparts, up from 51% in 2002. Unfortunately, cancers in younger populations tend to be more aggressive and are often diagnosed at later stages, negatively impacting treatment outcomes.  

Breast cancer is among the most common malignancies rising in prevalence among younger women. In response to increasing incidence and to address disparities, screening guidelines are adapting to support earlier detection. Major organizations now agree and recommend initiating breast cancer screening at an earlier age to improve outcomes and promote health equity. In 2024, the US Preventative Services Task Force (USPSTF) and others updated their guidelines to recommend starting breast cancer screening in average-risk patients by age 40, rather than 50. To identify women at high risk, guidelines recommend that all women undergo a breast cancer risk assessment by age 25, which allows for individualized screening recommendations; breast and chest cancer screening for transgender and non-binary individuals also presents unique clinical considerations requiring personalized assessments and tailored screening recommendations; some are outlined by the American College of Radiology.  

Breast Cancer Screening Guidelines by Organization

• USPSTF recommends bi-annual screenings starting at age 40; they also recommend discontinuing screenings at age 75
• NCCN recommends annual screenings starting at age 40; they also recommend an annual screening mammogram with tomosynthesis, supplemental screening for dense breasts should be considered, and there is no specified age to discontinue screening
• ACOG recommends annual or bi-annual screenings starting at age 40; they also emphasize shared decision-making and do not specify an age to discontinue screening
• ACS screening frequency guidelines vary by age, but they recommend screenings to start at age 40; screening should continue if life expectancy is greater than or equal to 10 years

References 

Siegel RL, Kratzer TB, Giaquinto AN, Sung H, Jemal A. Cancer statistics, 2025. CA Cancer J Clin. 2025;75(1):10-45. doi:10.3322/caac.21871. Published online January 16, 2025. 

Advances in Cervical Cancer Screening: New Self-Collection Alternatives for HPV Detection  

Contributor: Silmacoral López Jiménez, ND

Over the years, various strategies have been implemented to empower women in managing their gynecological health, particularly regarding participation in cervical cancer screening. The Pap smear has long been a cornerstone in these efforts. It is now well established that the Human Papillomavirus (HPV) is the primary etiological agent responsible for precancerous cervical changes and cervical cancer. As a result, current screening guidelines often include HPV co-testing alongside cytology. 

However, the traditional screening method, which requires the use of a vaginal speculum for sample collection, presents a significant barrier for many women. Feelings of discomfort, pain, and invasiveness are frequently cited as reasons for non-participation in routine screening. In the United States, approximately 30% of women do not undergo cervical cancer screening at the recommended intervals, contributing to a persistent annual incidence of around 11,500 new cases of cervical cancer. 

To address this gap, in 2024 the U.S. Food and Drug Administration (FDA) approved two self-collection HPV tests designed to detect high-risk genotypes of the virus. These tests, Onclarity HPV (developed by Becton, Dickinson and Company) and cobas HPV (manufactured by Roche Molecular Systems), allow patients to collect their own cervical sample using a swab or brush in a primary care setting. 

Both the Onclarity and cobas HPV tests are based on real-time polymerase chain reaction platforms designed to detect the presence of 14 high-risk human papillomavirus genotypes. Some genotypes, such as HPV 16 and 18, are reported individually, while others are analyzed and reported in grouped categories. Although these self-collected samples must currently be processed in a primary care facility, the long-term goal is to make these tests accessible for at-home use. This approach not only enhances convenience and privacy for individuals who may feel uncomfortable with in-office procedures, but it also holds great promise for expanding access to cervical cancer screening in underserved and remote areas, where regular access to primary care centers is limited. By overcoming logistical and geographic barriers, at-home self-collection could significantly improve screening rates and contribute to early detection and prevention of cervical cancer in vulnerable populations. 

References

Giorgi Rossi, P., Ronco, G., Mancuso, P., Carozzi, F., Allia, E., Bisanzi, S., Gillio-Tos, A., De Marco, L., Rizzolo, R., Gustinucci, D., Del Mistro, A., Frayle, H., Confortini, M., Iossa, A., Cesarini, E., Bulletti, S., Passamonti, B., Gori, S., Toniolo, L., Barca, A., Bonvicini, L., Venturelli, F., Benevolo, M., & NTCC2 Working Group. (2024). Extended HPV genotyping by the BD Onclarity assay: Concordance with screening HPV-DNA assays, triage biomarkers, and histopathology in women from the NTCC2 study. Microbiology Spectrum, 12(1), e00897-24. https://doi.org/10.1128/spectrum.00897-24 

Reynolds, S. (2024, July 24). FDA approves HPV tests that allow for self-collection in a health care setting. National Cancer Institute. https://www.cancer.gov/news-events/cancer-currents-blog/2024/fda-hpv-test-self-collection-health-care-setting  

Wheeler, C. M., Torrez-Martinez, N. E., Torres-Chavolla, E., Parvu, V., Andrews, J. C., Du, R., Robertson, M., Joste, N. E., Cuzick, J., & New Mexico HPV Pap Registry Steering Committee. (2024). Comparing the performance of 2 human papillomavirus assays for a new use indication: A real-world evidence-based evaluation in the United States. American Journal of Obstetrics and Gynecology, 230(2), 243.e1–243.e11.  

An Update on Bacterial Vaginosis 

Contributor: Danielle Melvin, ND

Bacterial vaginosis (BV) is one of the most common vaginal infections among women of reproductive age, caused by an imbalance in the vaginal microbiota—specifically, a reduction in protective lactobacilli and an overgrowth of anaerobic bacteria such as Gardnerella vaginalis. Symptoms may include thin white or grey discharge, a fishy malodorous smell, itching, and irritation, though many cases are asymptomatic. Diagnosis is typically made using the Amsel’s criteria, which evaluates for a vaginal pH greater than 4.5, the presence of clue cells, a homogeneous, thin, white, or gray discharge, and a fishy odor via the “whiff test”. Standard treatment involves oral or topical antibiotics, most commonly metronidazole or clindamycin. Despite treatment, recurrence is common, affecting up to 70% of women within a year. Emerging research now suggests that BV may have a sexually transmitted component. A 2025 study published in the New England Journal of Medicine, titled “Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis,” provides compelling evidence that treating male partners may significantly reduce the recurrence of BV in women. In the randomized trial, women whose male partners were also treated with oral metronidazole and topical clindamycin had a 35% recurrence rate, compared to 63% in the control group where only the women were treated. These findings challenge the long-standing belief that BV is not sexually transmitted and point to the male genital microbiome as a possible reservoir for reinfection. This research may shift clinical guidelines toward partner treatment as a new strategy for managing persistent or recurrent BV. 

References 

Vodstrcil, L. A., Plummer, E. L., Fairley, C. K., Hocking, J. S., Law, M. G., Petoumenos, K., ... & Bradshaw, C. S. (2025). Male-partner treatment to prevent recurrence of bacterial vaginosis. New England Journal of Medicine, 392(10), 947-957. 

Bacterial vaginosis treatment guidelines. https://www.mshc.org.au/health-professionals/treatment-guidelines/bacterial-vaginosis-treatment-guidelines#references