Medical Misogyny and Menopause

Menopause Kuel Category Expert: Lorraine Miano

As a woman, have you ever felt dismissed when presenting your GP or gynecologist with symptoms you are experiencing?  Especially when it comes to Perimenopause and Menopause?

This extends to woman who may have an autoimmune disease, chronic pain or symptoms and conditions not related to menopause at all. As a health and hormone coach, I’ve heard from multiple clients how they felt “unheard”, or were told basically, “Suck it up. This is what happens to women at your age” from their gynecologists.  One client, in particular, left the doctor’s office in tears, and continued to cry the whole day. By the way…. her doctor was a female.

Menopause Is A Natural Process

If you follow me on Facebook or Instagram, you’ll notice that the majority of my posts are positive and encouraging. I want women to understand and embrace that these can be the most magical years of their lives. They should understand that although the symptoms they are experiencing are “common”, they most definitely are not “normal”. Menopause is a natural process in a woman’s life (much the same as puberty), not a disease to be cured. There is help available and they are not alone. That being said, I’d also like women to understand that I hear them. I understand the struggles, discomfort, pain, and mental anguish they are dealing with on a daily basis. The frustration they must feel, especially when they are not receiving the medical support and help they are seeking.

For the purpose of this article, I’d like to focus specifically on women who may be in their perimenopause years. Although I have heard many stories relayed to me by my peri and menopausal clients regarding their medical experiences with menopause, I decided to conduct my own survey in the social media world. I surveyed 100 perimenopausal/menopausal women and asked them 10 questions. The results were not surprising considering the current climate surrounding menopause. Here are just a few of the results.

I asked of 100 women:

Where Did you Learn about Menopause?

1. Mother: 16
2. Grandmother: 2
3. Sister: 0
4. No one: 36
5. Myself: (Google, Internet Books): 26
6. Doctor/Gynecologist: 6
7. Other: 14

At What age did Perimenopause begin?

1. 30-40: 12%
2. 41-50: 73%

Do you feel you had a solid understanding of menopause either before, or upon entering this phase of your life?

1. Yes: 14%
2. No: 86%

Would you say your gynecologist was helpful in guiding you in understanding and moving through this life transition?

1. Yes: 19%
2. No: 81%

The other six questions were related to how they would define menopause, and what symptoms they were experiencing. Ninety-Two women answered this question:

Based on your experience, how would you define Menopause?

Here is a sampling of answers:

“Doctors are not receiving the proper education in women’s health”

I share this with you, not to scare you, but to point out that 86% of these women had no understanding of menopause before entering their perimenopause years and 81% received no guidance from their doctors. It is no wonder that these were the adjectives they used to describe their experience with menopause.   

There was no need at all for these women to suffer. The fault lies with the medical community. Doctors are not receiving the proper education in women’s health, and specifically about peri/menopause in medical school. Now just to be clear, there are WONDERFUL doctors out there! Doctors who are caring, empathetic, knowledgeable, respectful, and who take women’s health concerns seriously. You must search for one of those! Yet with over 6,000 women per day reaching menopause in the U.S., with a median age of 51, and nearly one third of all American women being post-menopausal, the fact remains that about 80% percent of obstetrics/gynecology residents are receiving no education surrounding perimenopause and menopause. 

According to Dr. Mary Jane Minkin, a veteran Yale University professor of obstetrics and gynecology, “A lot of women … they’re going into menopause. They’re miserable, but they’re not being treated…I have patients who have done all the right stuff and are stuck with miserable menopausal symptoms.” Part of the reason she says is that women are not asking their doctors for treatments, and doctors are not asking questions about the symptom’s women may be experiencing.

So Many Medical Strides; So Much Ignorance About Women’s Health:

So just why in the 21^st Century, where so many medical strides are being made, are we so lacking in understanding the natural processes of the female body?  Let’s start with a little background and time line of women’s health and the medical field. I’m rolling it back to the 5^th Century BCE as a starting point. This is going to get uncomfortable, so buckle up.

“The symptoms of hysteria were emotional outbursts, sexual arousal, and nervousness.”

During this era, the followers of Hippocrates, the founder of Western medicine, published what is known as “The Hippocratic Corpus.” Their views of the human body lasted for centuries in the West. One of the writings was entitled “On the Diseases of Women” which promoted the idea of the “wandering uterus” theory. Would you believe that the doctors of that time (2500 years ago) thought that all of the health concerns of women were caused by their uterus floating around their body, putting pressure on other organs as well as poisoning their blood? This lasted until the Enlightenment period where the wandering uterus was replaced by the “sexual fluid buildup theory” that led to a diagnosis of “hysteria” by male doctors of the time. Yes. This was considered an actual female bodily disease. The symptoms of hysteria were emotional outbursts, sexual arousal, and nervousness. You know, those normal occurrences of female sexuality. The cure? Purging those sexual fluids from a woman’s body! The doctors directed married men to have more sexual intercourse with their wives, however, for the single and younger women, doctors or midwives would force a woman to orgasm using their fingers. WHAT?

But Wait, It Gets Even Better:

The Victorian Era and Sigmund Freud arrive with the rejection of hysteria as a physical condition, and rather a psychological disorder. Freud suggested that “hysteria” is really sexual trauma as the result of a young woman’s realization that she is not a man, and therefore, not “whole”. The treatment, well that hadn’t changed …more sex with the hubby, but instead of a doctor using his fingers…a woman should be brought to climax by a doctor using a vibrator. Hmmmm.  Basically, a medical license allowing for sexual assault.

“during these eras where major medical advances were made, the understanding of women’s health and the female body basically revolved around her fussy sexual organs.”

So, during these eras where major medical advances were made, the understanding of women’s health and the female body basically revolved around her fussy sexual organs. No need to educate themselves regarding the female body and sexuality. Doctors were quite content blaming women’s ills on the fact that well, they weren’t men! Women were imperfect, and therefore suffered sexually.

And, Yet More:

There is so much more that happened in the following years. Actually, some pretty gruesome stuff. Get ready to be squeamish. I won’t go into all of the following in detail, but you’ll get the picture.

During the 1840’s, surgical experimentation was performed on dozens of female African slaves by J. Marion Sims, who is still viewed today as the “father of gynecology”.  Unbelievably, he performed these surgeries without anesthesia and sometimes when they were pregnant.

During the Victorian era, clitoridectomies (removal of the clitoris) were performed on women without their consent in the hope of making “intractable” women into “happy wives.” Basically, it was to prevent masturbation.

The List Goes On:

The list goes on, including sending women to asylums and non-consensual physical sterilizations of women deemed “mentally defective”. In the 1950’s “mental” sterilization began, when doctors started to “tranquilize” women who were suffering with what today would be considered common symptoms of perimenopause: anxiety, insomnia and depression (not sure that has changed much). This led to an even deeper depression and feeling of hopelessness for many women. Oh, and I’m sure you’ve heard the jokes about the “husband’s stich”? This is where the doctor takes an extra stitch or two during repair of the perineum after childbirth to make the vagina tighter for the husband’s sexual pleasure. This in fact does nothing to tighten the vagina, but does cause more pain during postpartum sex for the woman. 

Fast Forward To Today:

Medical misogyny is alive and well. There continues to be a lack of knowledge of women’s health, and from what I see and hear,  this is especially during the perimenopause years. In a research industry dominated by men, who don’t understand common women’s health issues, these medical concerns and diseases are often dismissed as not being “real”. To this day, women are basically treated as second class citizens in the medical community.

Some More Startling Facts:

“ doctors are seven times more likely to misdiagnose a woman having a heart attack and actually discharge her mid-attack”

Did you know that it was only in within the last decade that scientists and doctors discovered that women present with different symptoms than men when they are having a heart attack? Is it no wonder that doctors are seven times more likely to misdiagnose a woman having a heart attack and actually discharge her mid-attack? Or that women whose heart attacks are treated by male physicians are two to three more times likely to die? That is some pretty scary sh%t!

This lack of understanding extends to so many aspects of women’s health as well, such as irritable bowel syndrome, autoimmune diseases, fibromyalgia, endometriosis and chronic fatigue syndrome, leading women to frequently report being dissatisfied with the care they are receiving.

Good News:

It is good news then, that the wellness industry has stepped up and embraced the opportunity to support and guide women on their health journeys. They’ve heard our often-anguished cries for help. Beyond the conventional medical world there are numerous holistic options to be explored. Health coaches, functional medicine doctors, acupuncturists, aromatherapists, wellness advocates, menopause advocates, and more are filling the void.

We are encouraging women to be open in discussing their health concerns, especially when it comes to perimenopause and menopause. It is time to embrace this fabulous time of our lives and say Adieu to the Taboo. It is time to stop the unnecessary suffering.  It’s time for the “second talk”.

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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”.

References:

https://ctmirror.org/2019/07/26/menopauses-long-learning-curve/

https://www.glamourmagazine.co.uk/article/medical-misogyny-wellness

https://askjanie.org/medical-misogyny-is-fueling-the-wellness-industry/

https://www.scarymommy.com/misogyny-in-womens-health-care/

http://fordhampoliticalreview.org/sexism-kills-medical-misogyny-and-ignorance-of-female-bodies/