This article was exclusively written for The European Sting by Ms. Anastasia Kourti, a medical student at the National and Kapodistrian University of Athens and a member of the Greek Women in STEM network. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Being a physician in 2026 means looking beyond the pages of a textbook; it requires a deep understanding of how the environment affects and shapes people’s health. Climate change is widening gender-based health disparities by transforming environmental stressors into clinical emergencies. According to the World Health Organization (WHO, n.d.-b), of the 1.3 billion people living below the poverty line and already facing heightened health risks, 70% are women. How, then, does this environmental crisis manifest in the health of women, a population that already tends to be misdiagnosed or even undiagnosed?

Exposure to heat is a fundamental environmental factor. Physiologically, women have a different metabolic profile than men, experiencing higher core temperature sensitivity during physical activities and hormonal cycles. Combined with reduced heat dissipation through sweating and less efficient radiative cooling, women are more vulnerable to heatstroke and cardiovascular strain (Kuehn & McCormick, 2017). Furthermore, it is crucial to address the effects of frequent exposure to high temperatures on pregnant women. Hyperthermia increases the production of vasoactive substances and blood viscosity while also altering endothelial function. Consequently, reduced placental blood flow can lead to maternal hypertensive crises and an increased risk of stillbirth. Beyond this, hyperthermia acts as a teratogenic agent, disrupting the genetic sequences of organogenesis and elevating the risk of congenital abnormalities. These risks are compounded by restricted healthcare access for those from lower socioeconomic backgrounds and the stigma surrounding women’s heat intolerance, which is often dismissed as a hyperbolic reaction to the hormonal shifts during the menstrual cycle.

Additionally, poor air quality driven by fossil fuel combustion and increased ground-level O3 acts as a critical determinant of women’s respiratory, cardiovascular, neurological and reproductive health. Anatomically, females have smaller and narrower airways than men, even when adjusted for body size and height. As a result, women are more susceptible to absorbing a greater volume of particulate matter (PM2.5) per unit of lung surface. Constant inhalation of particulate matter can lead to chronic inflammatory respiratory diseases such as asthma and COPD, cardiovascular diseases, lung cancer and neurological disorders such as Alzheimer’s (Sorensen et al., 2018). Increasing evidence indicates associations between air pollution and reproductive health outcomes such as preterm birth, low birthweight, shortened umbilical cord telomere length as well as an increased neonatal and infant mortality. According to deSouza et al. (2022), ambient air pollution acts additionally as an endocrine disruptor, significantly altering menstrual regularity by inducing either short (<24 days) or long (>38 days) cycles.

As future physicians, we must recognize the urgent need to integrate environmental factors

into clinical assessments, specifically for women. It starts with us; we need to master comprehensive history-taking that captures the patient’s living context in order to ensure accurate diagnosis and effective treatment. Moreover, we ought to empower women to speak openly about their health, providing evidence-based guidance to dismantle systemic stigma. In 2026 and beyond, we cannot separate the health of the patient from the health of the planet.

References

deSouza, P. N., Castaldi, P. J., Luttmann-Gibson, H., Coull, B. A., Jha, S., & Hart, J. E. (2022). Ambient air pollution and menstrual cycle regularity: A cohort study. The Lancet Planetary Health, 6(7), e573–e582. https://doi.org/10.1016/S2542-5196(22)00115-8 Kuehn, L., & McCormick, S. (2017). Heat exposure and maternal health in the face of climate change. International Journal of Environmental Research and Public Health, 14(8), 853. https://doi.org/10.3390/ijerph14080853

Sorensen, C., Murray, V., Lemery, J., & Balbus, J. (2018). Climate change and women’s health: Impacts and policy directions. PLOS Medicine, 15(7), e1002603. https://doi.org/ 10.1371/journal.pmed.1002603

World Health Organization. (n.d.-a). Indicator Metadata Registry details: Proportion of population with primary reliance on clean fuels and technology (%). Global Health Observatory. https://www.who.int/data/gho/indicator-metadata-registry/imr-details/4744 World Health Organization. (n.d.-b). Population below the international poverty line.

Nutrition Landscape Information System (NLIS). https://www.who.int/data/nutrition/nlis/ info/population-below-the-international-poverty-line

About the author

Anastasia Kourti is a medical student at the National and Kapodistrian University of Athens and a member of the Greek Women in STEM network. Her interests lie in health promotion and fostering public dialogue on the unique health challenges faced by women in a changing environment.