Why we need to start believing women: exploring inequalities in reproductive healthcare

8 April 2020

“My doctor said I didn’t look like someone with a health concern and sent me home without a proper answer”

26-year-old Selena had been experiencing painful menstrual cramps and dealing with unexplained weight loss since the age of 13, only to be told that this is normal and something all women have to cope with. It was not until years later when she experienced difficulty falling pregnant, that her doctor sent her for a scan. She was diagnosed with Polycystic Ovarian Syndrome (PCOS), a hormone disorder that can disrupt the menstrual cycle, lead to conditions like diabetes and high cholesterol and in some cases cause infertility or even endometrial cancer. It can also bring with it a hoard of symptoms that affect physical appearance such as excessive weight gain, hyperpigmentation and unwanted hair growth amongst many others. Doctors dismissed Selena’s claims since she did not appear to have the physical signs of PCOS and left her without an answer for years. “I was almost glad I finally got diagnosed. For the first time in years I didn’t feel like what was happening to my body was my fault.”

The World Health Organisation (WHO) defines reproductive health as a “state of physical, mental, and social well-being in all matters relating to the reproductive system.” It is estimated that a third of women in the UK are living with severe reproductive health issues. These include conditions such as EndometriosisUterine Fibroids, issues to do with pregnancy and childbirth, certain cancers and the list goes on. These can have a detrimental effect on quality of life and general wellbeing but like Selena, many others end up making several trips to their GP, only to be told what they are experiencing is normal.

“I cannot tell you how many times my female friends have said they went to the GP with something they considered to be severely clinically wrong, only to be sent away with a generic painkiller or antibiotic. In some cases, 18 months later they receive a serious diagnosis and by then irreparable damage has been done.” (Harriet, 28)

“I had been complaining about symptoms to my GP since my 20s but wasn’t diagnosed with PCOS till about 3 years ago. The gynaecologist I was referred to was amazing but I was now too old to freeze my eggs or have IVF. Since I wasn’t in a relationship at the time, it became clear that my chances of ever becoming a mother were very slim.” (Jaspreet, 40)

So if reproductive health issues affect so many women and can cause serious and irreversible damage, why does it take so long to be diagnosed? Research into reproductive health is a deprived area to begin with; less than 2.5% of public funding is dedicated solely to reproductive health research. Amongst the research that is conducted, women’s health does not seem to be a priority. Author of Vagina: A re-education, Lynn Enright claims medical research is too male-orientated. “Women have been woefully neglected in studies on pain. Most of our understanding of ailments comes from the perspective of men; it is overwhelmingly based on studies of men, carried out by men”. This means more time and money is invested into conditions that either affect both men and women or solely men. For example, there is five times more research into erectile dysfunction, which affects 19% of men, than into premenstrual syndrome, which affects 90% of women.

This gap in research may stem from the dismissive attitude surrounding women’s health. Participants from a study conducted in 2018 by Public Health England expressed how they perceived pain as something that women biologically had to endure and often felt too embarrassed to ask for help in the fear of being judged. Many looked to other sources to educate themselves but this came with its own difficulties. Information that came from traditional sources like school, was described as ‘scientific’ and failed to reflect the reality of living with a reproductive health issue. Therefore, many relied on advice from friends and family or what they could find on the internet.

The gap in research and reliable educational resources makes it much harder to live with issues that severely affect day-to-day life. The dismissive attitude towards women’s reproductive health issues not only delays diagnosis, but can prevent a diagnosis from ever being made, potentially resulting in life-threatening consequences and negatively influencing quality of life. The sheer volume of women who still have to wait years to be diagnosed or are unaware that their pain is not normal is a major concern. We cannot bring about change in research and medical procedures overnight, but the very least we can do is start believing women when they tell us something is wrong.

Further Sources:

Cysters Support Group

Acacia Family Support

British Pregnancy Advisory Service

Wellbeing of Women

NHS Women’s Health

Women’s Health Concern 

You can find Shazelle on LinkedIn