The first Women's Health: Genes, Data and Advancing Approaches 2025 conference (27-29 January 2025) from Wellcome Connecting Science was an amazing combination of interdisciplinary science focused on the determinants of important aspects of women’s health. I was lucky enough to attend through funding from the Women in CMMID (WinC) grant, giving a presentation on my work on antimicrobial resistance and sex.

Much of the conference focused on female-only diseases such as ovarian cancer, polycystic ovary syndrome (PCOS), and endometriosis. There were an alarming number of stories of delayed diagnosis, underfunding, and variable or unclear symptom profiles leading to a poor diagnosis ability. Perhaps due to the title (“genes” was included) and the location of the conference (Sanger Institute), much of the focus was on uncovering genetic determinants. I think that was why I saw far more Manhattan plots (used in genome wide association studies) than I’m used to! Something else that fell outside of my comfort zone was a lot of discussion on the use of organoids and building in vitro models to mimic several of these systems.

There were several talks presenting research on the drivers and impact of variation in timings and life course effects of menarche through to menopause. This covered understanding the genetic determinants of reproductive health through to the impact on long COVID symptoms and mental health. For example, it seems that females live longer than males in most mammals even in times of stress, which may be linked to epigenetics: men are epigenetically older than women who have increased “epigenetic ageing” only after menopause.

Pregnancy seems to interact with many of these syndromes, with several presentations on the importance of oestrogen levels and the suggestion that fertility decline will lead to women living longer. Though we have to be careful not to just study the maternal pregnancy exposures assuming they contribute all the developmental origins of health and disease. We also heard about the history of hormone replacement therapy (HRT), including the “Davina effect” (a jump in use after Davina McCall’s documentaries on the topic), the complex links between menopause symptoms and other comorbidities, and the inverse correlation between deprivation and HRT use.

The differences in immunity by sex seem to be well established, with women having lower infection severity and higher vaccine responses but more autoimmune diseases. A lot of active research into the pathways of this phenomenon was presented, exploring an array of issues such as the importance of sex hormones – one example used gender-affirming treatment to unpick the impact of genetics vs hormones. Another pathway on the need to understand differences in immune ageing was considered by several groups, who were exploring differences in both the composition of immune cells and their expression profiles to untangle effects.

The focus of the conference was different to those that I usually attend in that it was very much focused on the biological underpinnings of health, as well as being attended by 95% women. In terms of policy and the wider context, we heard a moving story about the stigma around cervical cancer in Zambia and worrying evidence from the MESSAGE project about the lack of inclusion of sex and gender in NICE guidelines.

It was also interesting to hear about the multi-faceted reasons why women may be underrepresented in randomised clinical trial recruitment (only about 20% are women) even when there are technically no protocol barriers to inclusion. In a coincidental LSHTM double-act, talks on Enny Da Paixao Cruz’s research on the impact of infection during pregnancy followed by my own presentation on how antibiotic use and resistance varies by sex were the only talks focused on infection.

From a modelling perspective, it was interesting to see how many studies used UK biobank data and, in particular, the wealth of genomic sequences. There were multiple talks generating prediction models for disease risk, but many relied only on genomic information when other environmental or societal factors were often mentioned as important. There was also a lack of representation from the Global South in terms of conference attendees and the data they used – as is so often the case, more data is needed!

For my research, I made some interesting connections and met some lovely, enthusiastic people. I learnt some interesting facts, such as the unexplained fact that 2/3 of dementia cases are women and that PCOS is linked to type two diabetes risk, but I would have liked to see more on infection and how women’s health varies globally in balance with all the work on female-specific diseases.