Invisible pain, visible impact: the urgent need to prioritise women's health in rheumatic and musculoskeletal diseases.

Abstract

Rheumatic and musculoskeletal diseases (RMDs) present a substantial yet often underrecognised public health challenge. This viewpoint article highlights significant sex- and gender-based disparities, where women are disproportionately affected by prevalence, diagnosis, treatment, and occupational risk factors. Many prevalent RMDs, including osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, and fibromyalgia, exhibit a higher prevalence and greater burden in women. Women frequently experience prolonged diagnostic delays, receive incorrect initial diagnoses, and face unequal access to effective treatments, often leading to worse outcomes. Occupational factors, such as organisational strain and repetitive tasks, also render women more susceptible to RMDs. These inequities are compounded by biases in medical education, research, and clinical practice, where women's symptoms are often dismissed or normalised. The impact extends to reproductive health, mental well-being, and socio-economic stability for women with RMDs. Addressing these pervasive disparities is paramount for achieving health equity and improving overall public health. We advocate for the urgent inclusion of RMDs within the growing Women's Health agenda, particularly at the European Union level, to drive targeted research, implement gender-sensitive diagnostic and treatment strategies, and revise medical education. Collective action is essential to ensure RMDs and their disproportionate impact on women gain the visibility and policy prioritisation they demand.