Evvy’s Equal Research Day – And New Book – Exposes Gender Health Gaps

In 2022, Jimmy Kimmel Live took to the streets. There, the show’s interviewer stopped random men and asked them questions about basic female anatomy and health, including “Do most women have one uterus or two?”, “What does PMS stand for and how often does it happen?” and “What part of the body does a mammogram examine?”. None of the men knew the correct answers. In 2023, the same interviewer asked different men similar questions. Again, none of the men knew.

These two segments, titled “What Do You Know About the Female Body?”, showed that many people don’t actually know that much. And while the Jimmy Kimmel Live segments are recent, that knowledge gap has existed for hundreds of years. The first known clinical trial took place in 1747, and, in the centuries that followed, scientists developed the first vaccines, discovered penicillin, invented the first EKG machine, performed the first human heart transplant, and more. But all these innovations – as well as the foundational research, data, and development behind them – were done without women.

“Everything starts with research and data,” says Priyanka Jain, Chief Executive Officer and co-founder of Evvy. Evvy, a New York-based women’s health startup, was founded in 2021 after its three co-founders – Ms. Jain, Chief Scientific Officer Pita Navarro, and Chief Marketing Officer Laine Bruzek – learned that women weren’t required in clinical research in the United States until 1993. That year – 246 years after the first clinical trial had taken place – Congress passed the NIH Revitalization Act to require the inclusion of “women and minorities” in clinical trials for the very first time. All the scientific and medical advancements that had transpired prior were based solely on men, leaving women – and, subsequently, women’s health – understudied, under-researched, and, overall, unequal.

Evvy is working to help close the resulting gender health gaps: the inequities in healthcare, including access and outcomes, between men and women. The company’s first focus is the vaginal microbiome. Vaginal discomfort is one of the leading reasons women seek healthcare advice, and over 90% of those cases can be attributed to imbalances in the vaginal microbiome. An unbalanced, or disrupted, vaginal microbiome can manifest in conditions such as aerobic vaginitis (AV), bacterial vaginosis (BV), recurrent UTIs, and yeast infections, can affect the outcomes of cervicitis (inflammation of the cervix), pelvic inflammatory disease (PID), and toxic shock syndrome (TSS), and can be associated with infertility, pregnancy complications, STI acquisition, and possibly even cancer, among others. And yet, despite these wide-reaching effects – and despite the fact that about half of the population have a vagina, and, therefore, have a vaginal microbiome – a 2021 review called the vaginal microbiome “poorly known”: a representation of how women’s health conditions in general are incredibly important but have been insignificantly researched and understood.

A year after the company’s founding, in 2022, the team launched Equal Research Day to honor the company’s roots, to commemorate June 10 as the anniversary of the NIH Revitalization Act, and to highlight how knowledge about women’s health and bodies is still lacking. The Equal Research Day campaign is an opportunity to “take a step back from vaginal health and look at women’s health more broadly,” Ms. Bruzek explains. Or, as Ms. Jain puts it, “Equal Research Day is a time where we can all convene and scream from the rooftops, ‘The gender health gap still exists in 2024!’”

Examples of the gender health gap exist across all fields of healthcare, including cardiovascular health, autoimmune diseases, and prescription drugs. Women are 50% more likely to be misdiagnosed following a heart attack, even though cardiovascular disease – which includes heart attacks – is the leading cause of death in women, killing about one in three every year. For another example, as many as 80% of Americans with an autoimmune disease are women but no more than 40% of participants in autoimmune disease-focused clinical trials are women. And between 1997 and 2000, just a few years after the 1993 NIH Revitalization Act was passed, the Food and Drug Administration (FDA) pulled 10 prescription drugs from the market, eight of which caused greater health risks in women than men. The “serious male biases in basic, preclinical, and clinical research” behind these drugs meant that their effects on women weren’t revealed until after the drugs were commercially available. Despite these withdrawals, sex biases still continue in clinical trials, leading to adverse drug reactions and overmedication, among others, in women today.

Even if men and women are experiencing the same disease, women are diagnosed on average, four years later than men are – if the women are even diagnosed correctly in the first place. For cancer specifically, that diagnostic discrepancy is two and a half years. In other words, women with cancer spend over 912 days more than men enduring the time, financial, and emotional costs of seeing doctors yet getting incorrectly diagnosed, losing productivity at work, and missing moments with loved ones. “What could you do with two and a half more years of your life?” asks Ms. Bruzek. In fact, the gender health gap equates to 75 million years of life lost collectively per year due to poor health or early death.

Over the past two years, Evvy’s Equal Research Day has reached millions: from celebrities to key opinion leaders in the space. “And, every year, what gets people fired up and motivated are the facts [about this gap]”, says Ms. Jain. For this year’s Equal Research Day, Evvy brought those facts together for a limited-edition coffee table book, titled “100 Effed Facts About The Gender Health Gap: A Very Incomplete List of Ways the Female Body Has Been Left Behind by Modern Medicine”.

The coffee-table style of “100 Effed Facts” means that anyone, male or female, can easily pick up the book, understand its message immediately, and be shocked – enough to keep reading. Uniquely, every page of this book also has a glaring hole in its center: a purposeful design choice. “We wanted to make sure that there’s a visual representation of the gender health gap on every page,” explains Ms. Bruzek. The holes on the page, at times, obscure the page’s text or other images – just like the holes that they represent in healthcare can obscure correct diagnoses, effective treatments, proper care, and stories and suffering of the women affected by this gap.

“100 Effed Facts” became available for purchase on June 1, and Ms. Bruzek has already seen that buyers aren’t ordering just one copy but “three or four copies”: a sign that each buyer wants to share the book and the “effed” facts it contains. The team hopes it will see these copies not only on coffee tables in homes but also in the waiting rooms at doctors’ and other healthcare providers’ offices. “I believe in the power of a physical artifact to start conversations,” says Ms. Bruzek.

Each book purchase helps to advance women’s health too. Every cent goes to Women’s Health Access Matters (WHAM), a non-profit working to “increase awareness of and accelerate funding for women’s health research to transform women’s lives and impact the economy”. After all, advancing women’s health and improving the country’s economy go hand-in-hand: investing $350M in women’s health would generate $14B to the United States economy. The spirit of WHAM thus, echoes that of Equal Research Day, and “lift[s] up the type of work that we’re doing,” notes Ms. Jain. Additionally, Evvy will donate $1.00 to WHAM for every Instagram post in June that tags Evvy and #EqualResearchDay.*

WHAM is not the only organization involved in this effort, however. Over 50 companies support Equal Research Day and are committed to closing the gender health gap. That community and the work it has done has already helped spur recent advancements in women’s health: from the White House’s Executive Order on Advancing Women’s Health Research and Innovation to Melinda French’s recent announcement that she’d be investing $1B to advance women, including their healthcare.

As a result, the past few years – from when Evvy was founded to today – have been “like night and day in the world of women’s health. We’re still a pebble on the mountain, but that pebble didn’t exist four to five years ago,” Ms. Jain explains. Both she and Ms. Bruzek are excited about this momentum and cite the “amazing researchers and advocates” at organizations, like WHAM, the Office of Research of Women’s Health (ORWH), and the NIH, that have been pushing to bring women’s health into the spotlight. Specifically, Ms. Jain herself is looking forward to the NIH-wide effort to invest $200 million across 2025 in women’s health research: a full-circle moment for the NIH, which mandated that women must be included in clinical research only 31 years ago.

When it comes to Evvy’s own focus, the company wants to bring the vaginal microbiome into daily conversations with both patients and providers. Consumers are starting to be aware of and care about the vaginal microbiome. The company, in turn, hopes to leverage both that interest and the data it now has to improve the research, understanding, and de-stigmatization around this previously understudied aspect of women’s health.

“This is the moment to be working in women’s health,” concludes Ms. Bruzek. Ms. Jain adds, “It’s going to take all of us to close the gender health gap”. Evvy’s work with the vaginal microbiome, its Equal Research Day campaign, and its “100 Effed Facts About The Gender Health Gap” book aim to close that gap and mobilize “all of us” to do the same. In the process, the Evvy team can help ensure that everyone understands women’s health and women’s bodies: be they women’s health supporters already or random men stopped on the street for a Jimmy Kimmel Live segment.