Why Do We Still Not Understand Women’s Health?
Photo Courtesy: @diethylstilbestrol via Flickr
The UK has the largest gender health gap in the G20, with 8 in 10 women experiencing dismissal from healthcare professionals. Snubbing symptoms, late diagnoses, gaslighting, and lack of adequate treatment are all too common. A trip to the GP feels inconclusive and hopeless - women are being failed by the NHS healthcare system.
Since Ancient Greece, the medical field has been dominated by, and built around, men. Women’s health concerns have long been boiled down to hysteria, and this historical bias continues to pathologise the female body, and its health, to this day.
Century-old myths have ingrained medical misogyny into the ongoing disbelief, patronisation, and risk posed to women. The ancients believed female bodies had inverted male genitalia. Female sickness was supposedly caused by “womb wandering” - the cure being sniffing a bad smell to ‘scare’ the uterus back ‘into place’. Hysteria diagnoses, singling out women with impulsive and overactive behaviours, was supposedly remedied through sex, asylums, and even hysterectomies. We may look back at these ‘cure-alls’ as anachronistic and ridiculous, but it is shocking how little progress has been made.
Dr Henrietta Hughes highlights how healthcare remains this male-dominated system. Models used to train medics generally represent white males. Mesh implants for hernia repairs, heart valves, and replacement hip joints are not intended for the female anatomy, resulting in lower success rates. In the UK, over-the-counter Viagra was available six years before medicine was provided for UTIs. There is a knowledge gap in how universal health concerns, including cardiovascular disease and autism, manifest in women compared to men. This gap continues to hinder the treatment women receive.
For example, female chronic pain has long been misconstrued as caused by emotional and psychological factors opposed to biological ones. If women manage to receive a prescription at all, they are minor tranquillisers or painkillers that are inadequate for serious chronic pain.
Endometriosis – a condition causing extreme pain during menstruation, also affecting fertility – has also long been misunderstood. Most affected women had to visit a healthcare specialist 10 times before reaching a diagnosis, leading to delayed treatments and late diagnoses. A recent study on Bacterial Vaginosis (BV), a condition affecting 1/3 of women, is now proposed to be an STI in a recent study, contrary to what the NHS website says. The mesh and sodium valproate scandals left more than 40,000 with life-changing disabilities. Nadia Akbar, an NHS patient, was gaslighted into thinking her extreme fatigue was due to “motherhood stress”, when it was in fact thyroid cancer.
These experiences all testify to the lack of priority and research attributed to women’s health, PMS, menopause, maternal health conditions, cervical cancer and endometriosis. But so does the funding. These conditions made up less than 1% of cumulative research funding between 2019 and 2023. Moreover, 5 times more research is conducted into erectile dysfunction (affecting 19% of men), than premenstrual syndrome (affecting 90% of women). Yet, clinical research excludes women from studies due to the risk of “fluctuating female hormones” causing inconsistent results. When women are included, a study shows they only make up 22% of participants in phase 1 of clinical trials. Research under-represents female health. It is not surprising it is lagging so far behind.
This lack of data leaves critical gaps in policy leaders’ and health experts’ ability to understand, address, and invest in women’s health. This has a knock-on effect on curricula in schools, the development of treatments, the education of medical professionals, the roll-out of government policies, and access to reliable health information.
A survey shows that 70% of women inform themselves online and from loved ones as opposed to healthcare professionals. Lack of trust and low expectations within the healthcare system means women are turning to unreliable sources, doubling down on the inaccessibility to the care they need. Only 17% of women claimed to have enough information on menstrual wellbeing, 9% on the menopause, and 8% in gynaecological conditions.
Racial bias and the lack of ethnic representation in clinical research exacerbates these issues. Not only do women from ethnic minority backgrounds experience racial discrimination within the NHS – including longer waiting times and more delayed care – they are also put at higher risk through receiving more inadequate treatment. These women are three times more likely to die in pregnancy, and data shows that they are subject to increased rates of miscarriage, stillbirths, IVF-birth failures and pregnancy-related complications. Healthcare equipment also puts women of colour directly at risk – neonatal assessment tools and pulse oximeters are less efficient for darker skin tones, yet continue to be used routinely.
We don’t understand women’s health because of historical, misogynistic, and racial biases that are deeply rooted within, and perpetuated by, a male-dominated healthcare system. Our continued shortfall in funding, research, training, and compassion feeds into this inadequate treatment and healthcare. Women need to start being listened to.