Most striking was that, based on PET imaging, the brains of post-menopausal women far past the menopause transition were still “hungry” for oestrogen.175 Basic science research on hormones, such as this study of oestrogen receptors in the brain, has implications for care delivery and healthcare payment. For example, most CPGs recommend the initiation of HRT around the menopause transition, and oestrogen therapy is often reimbursed by health insurance companies only when started in this time frame. Yet this research suggests that older women may also benefit from initiation of oestrogen replacement therapy. In other words, near-term research results may highlight opportunities for near-term impact in the lives of women. CPGs offer standardized recommendations for healthcare professionals and could be enhanced to reflect women-specific evidence, particularly for women-specific conditions that affect health span. Having CPGs for women-specific conditions such as endometriosis and menopause and accounting for sex-specific differences in the CPGs for conditions that affect both men and women, such as ischaemic heart disease, are essential actions and not currently achieved across all of the studied countries or selected conditions. The time is now for healthcare providers to have access to comprehensive, evidence-based guidelines and the education, training and necessary infrastructure to implement them in practice. CPGs based on research conducted in HICs sometimes clash with the reality of care delivery in LICs and LMICs. Even within UMICs and HICs, the actuality of care delivery – including resources, access and health-related social needs – may impair delivery of evidence-based clinical care. CPGs could help to account for local realities while also ensuring the best evidence-based care available in a geographical area. More research is needed to understand how to ensure the highest-quality care is delivered within and between countries, particularly those with fewer care delivery resources, and then incorporated into country-level CPGs when appropriate. The studied countries may have locally relevant clinical approaches that are effective within the reality of their communities and care systems, such as India’s emphasis on education and clinical breast exams as a breast cancer screening tool, that could benefit from structured research. Overall, though, lower incomes, race and ethnicity, geography or other factors should not determine a woman’s fate when it comes to her health – including and perhaps especially in countries with the resources to prevent disparities and inequities. As the use of AI/machine learning continues to evolve, countries may also consider AI-enabled functions to ensure timely updates to CPGs. A challenge could be to make sure inputs into the language learning model reflect sex-specific differences and data and considerations specific to a country and its delivery system. Without this, AI could further perpetuate inequities and disparities in care delivery for women.3.3 Care for women: Implement CPGs for women-specific conditions and account for sex-specific differences within CPGs Blueprint to Close the Women’s Health Gap: How to Improve Lives and Economies for All 30

Blueprint to Close the Women%E2%80%99s Health Gap 2025