Medical Misogyny and Menopause

Have you ever left a doctor’s appointment feeling dismissed, like your symptoms were too much, too vague, or just not believable? You are not alone, and you are not imagining it. Women with autoimmune disease, chronic pain, perimenopause, and countless other conditions report the same thing: being told to suck it up, that this is just what happens at your age, or that everything looks fine. One woman left her gynecologist’s office in tears and cried the rest of the day. Her doctor, for the record, was also a woman.

Menopause Is A Natural Process, Not A Disease

Let’s be clear about something. Although the symptoms women experience in perimenopause are common, they are most definitely not normal in the sense that women should just accept them and suffer through. Menopause is a natural process, much like puberty, not a disease to be cured. Help is available. Women are not alone in this.

That said, the frustration is real, especially when the medical support women need simply isn’t there.

For this article, the focus is specifically on women in their perimenopause years. A survey of 100 perimenopausal and menopausal women, conducted across social media, asked 10 questions. The results were not surprising, but they were sobering. Here are a few of them.

What 100 Women Said About Menopause And Their Doctors

Where Did You Learn About Menopause?

• Mother: 16
• Grandmother: 2
• Sister: 0
• No one: 36
• Myself (Google, internet, books): 26
• Doctor or gynecologist: 6
• Other: 14

At What Age Did Perimenopause Begin?

• 30 to 40: 12%
• 41 to 50: 73%

Did You Have A Solid Understanding Of Menopause Before Entering This Phase?

• Yes: 14%
• No: 86%

Was Your Gynecologist Helpful In Guiding You Through This Transition?

• Yes: 19%
• No: 81%

The other six questions asked women how they would define menopause and what symptoms they were experiencing. Ninety-two women answered the definition question. Here is a sampling of their answers:

• Annoying
• Horrible
• Hot mess!
• Exhausting
• As stressful as puberty
• Nightmare
• Uncomfortable
• Tiring
• Rollercoaster
• Complex and confusing
• Horribly difficult
• Tedious
• A struggle
• Challenging
• Life-altering
• Frustrating
• Like having a series of illnesses all at one time
• Unexpected nuisance
• Hellish
• Horrendous
• A slow erosion of who I am
• Hell of hopelessness
• Scary
• Hell on Earth
• Inconvenient

These are not the words of women who are overreacting. These are the words of women who were left without information and without support. Eighty-six percent had no understanding of menopause before entering their perimenopause years. Eighty-one percent received no meaningful guidance from their doctors. The suffering was not inevitable–it was a failure of the medical system.

Doctors are not receiving adequate education in women’s health, and specifically in peri and menopause, during medical school. To be clear, there are wonderful doctors out there, caring, empathetic, knowledgeable, and genuinely invested in women’s health. Finding one of those is worth every effort. But with over 6,000 women per day reaching menopause in the U.S., a median age of 51, and nearly one-third of all American women now post-menopausal, the fact that the majority of OB-GYN residency programs include little or no menopause curriculum is staggering.

As Dr. Mary Jane Minkin of Yale, a veteran professor of obstetrics and gynecology, has said: women are going into menopause miserable and not being treated, while doctors are neither asking about symptoms nor offering solutions.

Why Women Are Still Being Dismissed In Perimenopause

A Medical Education Gap That Goes Back Centuries

So why, in the 21st century, with all the medical advances being made, is there still such a profound gap in understanding the natural processes of the female body? To answer that, it helps to go back. A long way back.

In the 5th century BCE, the followers of Hippocrates published the Hippocratic Corpus, including a text called “On the Diseases of Women.” It promoted the “wandering uterus” theory–the idea that all of a woman’s health problems were caused by her uterus floating around her body, putting pressure on organs and poisoning her blood. This belief persisted for centuries in Western medicine.

It was eventually replaced by the “sexual fluid buildup theory,” which led to a diagnosis of hysteria by male doctors of the Enlightenment period. Hysteria was considered an actual female bodily disease. Its symptoms? Emotional outbursts, sexual arousal, and nervousness, otherwise known as normal expressions of female humanity. The prescribed cure involved purging those fluids. Married women were instructed to have more sex with their husbands. Single and younger women were brought to orgasm by doctors or midwives. This was considered medical treatment.

The Victorian Era And Freud Make Things Worse

The Victorian Era and Sigmund Freud arrived with a shift: hysteria was reclassified as a psychological disorder rather than a physical one. Freud’s theory was that it represented the sexual trauma of a young woman realizing she was not a man and therefore not “whole.” The treatment hadn’t changed, it just now involved a vibrator instead of a physician’s fingers. A medical license for what was, in effect, sexual assault.

During these centuries of supposed medical progress, the understanding of women’s health revolved entirely around her reproductive organs. Doctors had no interest in educating themselves further, because they were content blaming women’s suffering on the fact that they weren’t men.

A History Of Harm That Continued For Generations

The harm didn’t stop there. In the 1840s, surgical experimentation was performed on dozens of enslaved Black women by J. Marion Sims, still referred to today as the “father of gynecology.” He performed these procedures without anesthesia, sometimes on women who were pregnant.

During the Victorian era, clitoridectomies were performed on women without consent, with the stated goal of making “intractable” women into more compliant wives; in practice, a means of punishing female sexuality.

Women were committed to asylums and subjected to non-consensual sterilizations on the basis of being “mentally defective.” By the 1950s, doctors were prescribing tranquilizers to women experiencing what we would now recognize as common perimenopause symptoms: anxiety, insomnia, and depression. The medication made things worse, deepening the depression and hopelessness rather than addressing the root cause. And if you have heard the jokes about the “husband’s stitch” (the extra suture taken during postpartum perineal repair to make the vagina tighter for the husband’s sexual pleasure) know that it is not only real but documented. It provides no anatomical benefit and causes women significant pain during postpartum sex.

Medical Gaslighting Is Still Alive In Women’s Health Today

This is not just history. Medical gaslighting in women’s health is ongoing. The menopause research gap has been well documented, and the consequences are measurable. Women experiencing heart attacks present differently than men, yet this was only widely recognized within the last decade or so. Doctors are seven times more likely to misdiagnose a woman having a heart attack and actually discharge her in the middle of one. Women whose heart attacks are treated by male physicians are two to three times more likely to die.

The same dismissal extends to irritable bowel syndrome, autoimmune diseases, fibromyalgia, endometriosis, and chronic fatigue syndrome. Women frequently report being dissatisfied with the care they receive for all of these conditions. In a research landscape long dominated by men, concerns that primarily or disproportionately affect women have often been categorized as not quite real.

Good News: Women Are No Longer Waiting For Permission

Here is what is changing. The wellness industry has stepped up. Health coaches, functional medicine doctors, acupuncturists, aromatherapists, menopause advocates, and more are filling a gap that conventional medicine created. Women are talking openly about perimenopause and menopause — with each other, online, in their communities — in a way previous generations never did or never felt they could.

It is time to say adieu to the taboo. It is time to stop the unnecessary suffering. It is time for the second talk.

Sources:

1. https://ctmirror.org/2019/07/26/menopauses-long-learning-curve/
2. https://www.glamourmagazine.co.uk/article/medical-misogyny-wellness
3. https://askjanie.org/medical-misogyny-is-fueling-the-wellness-industry/
4. https://www.scarymommy.com/misogyny-in-womens-health-care/
5. http://fordhampoliticalreview.org/sexism-kills-medical-misogyny-and-ignorance-of-female-bodies/

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About the Author:
As a post-menopausal woman herself, Lorraine Miano discovered her passion of offering menopause advocacy, support and resources to women in all phases of menopause through health coaching, proper nutrition and preventive lifestyle choices. She received her certifications as a Health Coach and hormone health expert from The Institute for Integrative Nutrition. She has been able to help even more women by writing and publishing her first book, The Magic of Menopause: A Holistic Guide to Get Your Happy Back!

Lorraine loves to encourage her clients with her mantra “Menopause is NOT an ending! IT IS a new beginning!” When she’s not advocating for “the change”, you can find Lorraine traveling with her husband Richard, quite often to visit her 5 grandchildren who call her “Nonni”.