Did you know that studies in medical science are heavily biassed towards outcomes seen in biological men (Criado-Perez, 2020)? Many animal studies that explore diseases and their treatments have been found to use only male animals. As well as this, randomised control trials that study the effects of new medicines for different diseases and mental health disorders often use sample groups predominantly made up of biological men (Criado-Perez, 2020). It is only in the last decade or so that we are realising that not enough is known about the differences between biological gender and disease progression and outcomes. For instance, we are only now realising that heart attack symptoms are very different between men and women. These facts are staggering considering the significant biological and hormonal differences between men and women. If we are different biologically and physiologically, why are we treated with the same medication and approaches? Sadly these factors are also apparent in mental health and there is still a huge shortfall in studies that look at mental health and neuropsychiatric conditions from a uniquely female perspective, or explore the difference between male and female causes, progression and outcomes.  

Some Facts and Stats regarding women’s mental health and neuropsychiatric difficulties

  • Women are 70% more likely to suffer from depression and anxiety during their lifetime. 
  • Up to three quarters of girls and women with ADHD are underdiagnosed.
  • Autism has been understood for years as a male diagnosis and it has been commonly diagnosed 4 times as much in biological boys than in biological girls. However, more recent and less male centric research reveals that autism simply looks different in females and males and that females have autism in equal numbers. There is also emerging evidence that suggests that some girls suffering with anorexia may in fact be suffering from autism.

The role of hormones in mental health

Hormones are chemical messengers secreted by our endocrine glands and influence things like metabolism, growth, sexual health and reproductive system functioning. Biological women have a completely different and more complex hormonal make-up to biological men. Hormones and hormonal imbalances also play a major role in the regulation of moods and emotions. It is no wonder then that women might be more predisposed to difficulties with mental health and wellbeing throughout their reproductive and post reproductive lifetimes (Wisner, 2023). However, it is only in the last 10 years or so that this is finally being discussed and the research is finally starting.

Hormonal changes and imbalances in biological women

A woman’s monthly hormonal changes in oestrogen, progesterone and testosterone can have a big impact on mental health (Vasan, 2023). As well as this, during menopause, oestrogen and progesterone levels decrease which can lead to anxiety and depression (Vasan, 2023)

During their lifetime many biological women endure a lot more hormonal imbalance than men. For instance PMS or Premenstrual Syndrome which affects a large proportion women in their lifetime is caused by hormonal fluctuations which are linked to significant mood swings  and emotional upheaval (Vasan, 2023). As well as this, if a woman decides to reproduce she must go through a whole set of hormonal changes and imbalances both in the pre- and postpartum period. Such hormonal upheaval can lead to pre- and postpartum anxiety, postpartum depression and anxiety and even postpartum psychosis. 

Lastly, hormonal changes and imbalance in the perimenopause and menopause period can cause depression, anxiety, insomnia, migraine, cognitive confusion and a whole host of other symptoms that are only more recently being recognised.

A lifetime of physical issues

Aside from these hormonal issues, many healthy biological women also experience more consistent and regular pain than healthy biological  men in the form of menstruation cramps, ovarian pain, and for some acute and chronic pain caused by endometriosis. (Wisner, 2023). As well as this, women can be more susceptible to pain at different times of their monthly cycle, due to fluctuating hormones. Women also experience more extreme physical and bodily changes throughout their lifetime compared to men because of hormonal changes and childbearing e.g. more weight gain and weight loss, sore breasts, stretch marks and painful changes to their vulva and vagina, including injuries suffered in childbirth and dryness during menopause, to name but a few. Women are also more likely to experience urinary incontinence and urinary tract infections (Criado-Perez, Wisnerm 2023). In light of all these findings, it goes without saying that such huge physical changes will also have an impact on wellbeing and mental health.

More public awareness and research regarding women’s health is emerging all the time, but it is important for all health workers to be aware of these difficulties and tailor their treatments according to the unique needs of biological women. 

If you are affected by any of the content in this blog, here are some resources and reading. You can also make an appointment with any of our psychologists if you are struggling with any of these issues. Many of the therapeutic approaches that we use at Compass Psychology can be of help with the issues raised in this article and our clinicians are all well versed in issues around women’s health throughout the lifespan. 



  • Invisible Women. Caroline Criado-Perez (2020)
  • The Link Between Hormones and Mental Health, Wendy Wisner, (2023)