There is a growing crisis among women regarding their brain health. Women are significantly more affected by neurological conditions such as migraines, Alzheimer’s disease, and multiple sclerosis (MS). Yet, despite the higher prevalence, they remain underrepresented in brain research, clinical trials, and treatment guidelines. This gender gap in neurology is not just a medical oversight — it’s a deeply rooted, systemic problem that has led to under-diagnosis, misdiagnosis, and inadequate care for millions of women.
“There is a clear mismatch between disease prevalence and research priority,” says Dr. Pankaj Agarwal, Head of the Department of Neurology at Gleneagles Hospital, Parel, Mumbai.
“Women’s neurological health needs to be placed at the centre of our clinical and scientific focus — not treated as a side issue.”
Male-Centric Research
One of the fundamental barriers to equitable neurological care is the historic male bias in clinical research. For decades, men were used as the default subjects in medical studies, with women excluded due to concerns about hormonal fluctuations and reproductive variables.
“Medical research traditionally treated men as the standard model,” explains Dr. Pradeep Mahajan, Regenerative Medicine Researcher and Founder of StemRx Hospital & Research Centre. “Women were excluded from trials because their hormonal cycles were considered too complex. This led to a lack of data, misdiagnoses, and suboptimal treatments for women.”
Even today, many clinical trials fail to recruit adequate numbers of female participants, and fewer still analyze results by sex. This lack of disaggregated data means that treatments may not work the same — or as well — for women, but these differences are rarely studied in depth.
Diagnosis & Treatment Bias
In clinical practice, women’s neurological symptoms are often dismissed or misattributed. Symptoms like fatigue, headaches, or cognitive decline are sometimes labelled as emotional, hormonal, or stress-related — leading to serious delays in diagnosis. “This is particularly true in conditions like migraines or autoimmune neurological disorders, where symptoms can be subjective and intermittent,” says Dr. Mahajan.
“Many women are left without answers for years, which significantly affects their quality of life and long-term outcomes.”
Alzheimer’s is a prime example. Women account for nearly two-thirds of all cases globally, yet are frequently diagnosed later than men, when cognitive decline is already severe and less responsive to treatment.
Hormones and Epigenetics
Hormonal fluctuations and stress have a profound impact on brain health, yet they are seldom factored into care models. Chronic stress, especially during pregnancy or menopause, has been linked to worsening neurological outcomes. Epigenetic research now shows that such stressors not only affect women but can also influence neurological development in their children.
“Women’s health can’t be separated from their environment and emotional experiences,” notes Dr. Mahajan. “These are not secondary factors — they are central to understanding and treating neurological disorders in women.”
What Needs to Change
To close the gender gap in neurology, a multi-faceted approach is required — starting from research institutions and extending to clinical practice and public policy. Both Dr. Agarwal and Dr. Mahajan offer clear solutions:
Ensure Female Representation in Research: “We must include women of all ages in clinical trials and analyze results by sex,” says Dr. Agarwal. “Without this data, we cannot create effective treatment strategies.”
Educate Healthcare Professionals: Doctors should be trained to recognize gender-specific symptoms in disorders like stroke, MS, and dementia. “Too often, subtle signs in women are overlooked,” Dr. Mahajan adds.
Experts suggest that funding for women-centric conditions should be increased. Diseases that disproportionately affect women must receive more targeted research and resources. There also needs to be integration of Mental Health and Lifestyle into Neurological Care –
stress, caregiving burdens, hormonal transitions — all must be considered. “We need to develop care models that reflect the reality of women’s lives,” says Dr. Mahajan. Importantly, women must be empowered to advocate for themselves. Women should be informed about what symptoms to look out for and feel confident demanding thorough evaluation.
Policy & Awareness
Systemic change won’t happen in the clinic alone. It must be driven by health policy and supported by public awareness. Regulatory bodies should mandate gender inclusivity in research protocols, and governments must prioritize neurological health in women through public education campaigns and dedicated funding. “We’re at a point where awareness must translate into action,” says Dr. Agarwal. “The tools and knowledge are there. What’s needed now is the commitment to apply them, across the healthcare system.”
The Way Forward
The underrepresentation of women in neurological care is more than a research gap — it’s a public health failure. As science begins to catch up with reality, the opportunity to correct this imbalance is finally within reach.
“Women deserve brain health care that is based on evidence, not outdated assumptions,” concludes Dr. Mahajan. “When we start seeing women’s health as foundational rather than exceptional, we’ll finally begin to make progress.
Matter Of Concern
l Men were used as the default subjects in medical studies. Women were excluded due to concerns about hormonal fluctuations and reproductive variables.
l Women’s neurological symptoms are often dismissed or misattributed.
l Symptoms like fatigue, headaches, or cognitive decline are sometimes labelled as emotional, hormonal, or stress-related—leading to serious delays in diagnosis.