In the analysis “Marketing empowerment: how corporations co-opt feminist narratives to promote non-evidence based health interventions” (BMJ journal), 10 researchers from Australia and Sweden explain how commercial entities use feminist narratives about women's autonomy and empowerment regarding their health to market new interventions, such as technologies, tests or treatments, that lack solid scientific evidence or ignore the available evidence.

This promotion of health interventions not supported by scientific evidence, or by hiding or minimizing available evidence, increases the risk of harming women through inadequate medicalization, overdiagnosis or overtreatment.

The authors emphasize that the problem is not in the use of technologies, but in the fact that these marketing efforts push such interventions to a much larger group of women than is likely to benefit from them. Furthermore, the commercial use of feminist narratives to promote interventions gives the impression that health and sex equality are commodities that can be purchased, failing to recognise or identify the social structures and other intersectional causes of privilege and disadvantage.

Two specific examples are analyzed:

• The anti-Müllerian hormone (AMH) test.

Blood AMH levels are associated with the number of eggs in a woman's ovaries. High AMH levels indicate the presence of more eggs and, in theory, greater fertility potential. However, evidence shows that the AMH test cannot reliably predict the likelihood of pregnancy, so it is not an appropriate test for women to make informed decisions regarding their reproduction. Even so, both fertility clinics and online companies market and sell the test to the general population. Women without signs of infertility request these AMH tests to check their fertility or inform their reproductive planning, even though current evidence shows that the AMH test is not valid for these purposes.

• Breast density notification.

Breast density is one of several independent risk factors for breast cancer. High breast density also reduces mammographic sensitivity, increasing the chance that routine screening exams will fail to detect cancer. This has led to increasing international calls to notify all women having screening about their breast density. However, there are concerns about these widespread reports, primarily the relatively non-modifiable nature of breast density and the lack of evidence that clinical pathways for women with dense breasts are beneficial. Complementary screening models (ultrasound and MRI) exist, but the long-term effects on advanced breast cancer rates and mortality have not been assessed. Additionally, reporting of breast density may also increase women's anxiety, confusion, and intentions to seek additional screening.

The authors state that greater wariness is needed of simplistic health messages that “any knowledge is power”, and call on health professionals and governments to ensure that understandable and evidence-based information is available.

The analysis concludes that we need to ensure that “the goals of feminist health advocacy are not undermined through commercially driven use of feminist discourse pushing non-evidence based care”.

More information:

• How to cite: BMJ 2024;384:e076710
• DOI: https://doi.org/10.1136/bmj-2023-076710