Reframing the Women's Health Conversation
You know how once you see something in a different light, you can never un-see it. You can never go back to the way you used to view it. Like that episode in FRIENDS when Phoebe caught Monica and Chandler kissing for the first time and she screams “My eyes, my eyes!”.
Sometimes real-life is like that too. Someone behaves in an unexpected way and you never see them the same way again or you hear a new approach to an old theory and it changes your frame of reference. It changes everything. And from then on, your thoughts are altered and you can’t go back.
This has happened to me over the last few years with how I view and understand women’s health issues. And it is slowly happening with the women I work with, who are preparing for or experiencing menopause symptoms.
Let me give you two examples.
Case Study 1:
A dear friend recently told me about a visit to the pediatrician with her 17 year old daughter. Her daughter was generally healthy, but hadn’t had a period in 4 months, was feeling run down, exhausted and experiencing some mild digestive issues. The mother wanted to know what to do and how to help her daughter, especially as she was having a busy and stressful time at school. So she went to the doctor, thinking she was doing exactly the right thing.
But then she told me how the doctor had responded to them.
“Let’s get some basic baseline blood tests done. But it could just be stress, or maybe you are eating something different, or maybe you are not sleeping as much. It will probably get better in a few months, it’s probably really nothing. It’s totally normal for girls to have breaks between their periods.”
So on the one hand – this doctor did nothing wrong. She ordered the standard tests, she asked some basic questions, she assessed in her mind no serious issue. She checked everything off her check-list and her job was done.
BUT – with my new insight when I heard this story I got really angry.
The doctor basically brushed off this girl’s experience. It was a standard 10 minute appointment with the doctor having little time to really join some of the dots of the girl’s health and wellbeing status and consider what this girl was really experiencing. There were no other recommendations made, no talking to her mental health, lifestyle or practical and tangible things that this girl could do. Assuming that please Gd her blood tests all come back clear, she was basically told to just wait around for her period to eventually come back.
For me THIS IS JUST NOT GOOD ENOUGH!
It is not the doctor’s fault. She did what she has been trained to do.
After speaking to my friend and understanding more of her daughter’s situation, I think stress is playing a big role in her irregular periods. Dealing with stress, look at what she’s eating, how much is she sleeping, is she moving at all or sitting for hours revising for exams – these are questions that the doctor ran through but didn’t stop to delve into and explain how significant they are to teen health.
I feel so sad, angry and disappointed at the dis-service that every woman is experiencing by doctors who are not asking the right questions and not taking the time to look at the larger picture. But it’s the way the Western medical healthcare system is structure and has worked for years.
But I believe that there is a different way for women to be supported. I believe that our bodies are complex structures, that we each have our own health story and there is a detailed spider’s web of health to unravel. It requires taking a much more holistic approach when dealing with our health issues. It requires time, attention and understanding, It also requires us to be proactive, to ask questions, and if we don’t feel that we have been seen or heard, if we are not satisfied with the response, we need to keep asking.
Case Study 2:
A woman came to see me who was really struggling with menopause symptoms, she was all over the place and about to get separated from her spouse.
She told me that at the age of 48 her life was not going well. She had low energy, could not get motivated to be productive in her work life. She wasn’t sleeping well and felt overwhelmed with the demands of her personal and professional life. Her libido was through the floor, her husband was driving her mad, she was moody the whole time, her body hurt her and she just wanted out. And worst of all, was that she had been a “super woman” in the years leading up to these changes. She felt frustrated and confused.
She had been to her doctor. He had ordered some blood work and to check her hormones to see if she was peri-menopausal. He then basically recommended a variety of different pills – sleeping tablets for when she couldn’t sleep, anti-anxiety to regulate her moods. He basically told her “it will eventually pass. And if things get worse, come back in 6 months.”
I was angry for her but not surprised. I hear this the whole time.
Women who are peri-menopausal or close to menopause not feeling seen or heard. The complexities of their symptoms are not being recognised. The way these symptoms impact their personal and professional lives not being understood. Being given band-aid medicine that doesn’t really address the full extent of their challenges. Six months of suffering and struggling until she can go back to the doctor again to see if he will recommend anything helpful.
Once again THIS IS JUST NOT GOOD ENOUGH!
Of course, it is not his fault. He is doing what he has been trained to do. Work through the checklist of questions, ascertain if he can make a diagnosis based on the symptoms, treat with appropriate drugs. But, it ignores the overall health and wellbeing of the patient. It ignores the physical, emotional and mental health relationships. And in this particular situation it totally ignores the complex ways that menopause can show up, how it can affect your life and practical strategies that can be easily implemented to support women.
Before I continue I want to add here a BIG DISCLAIMER:
I am NOT anti the Western medical care system. It is amazing and often miraculous. The healthcare professionals are doing the best they can, within the framework of which they work and the training they have received. I have seen first-hand how this medical care system saves lives day after day.
However, time and time again, I hear how this approach is failing women and their health concerns. How women are sent away to “just deal with it”. How it’s assumed “eventually things will sort themselves out, and if not just come back in 6 months time.”
I hear about women with endometriosis and poly-cystic ovaries syndrome who don’t get diagnosed for years.
I have heard stories, too many to count, of women who are put on anti-depressants for their menopause symptoms, because they have been misdiagnosed.
Part of the reason for this approach is the traditionally low percentage of medical research which included women data. For decades, until US Federal Law legislation changes in 1993, a lot of clinical research was done solely or largely on men and the results were extrapolated to women. Women were excluded from clinic drug trails in the early stages and so dosages were male driven.
(Read more about this here and here.)
But in 2021, things are changing, albeit slowly.
There is another way to approach women’s health and I have seen it in action.
There are some amazing doctors out there who think differently. Who understand that women know what’s going on in their bodies, and that if a woman has actually made time to come and get checked, that means she is struggling. I know there are health professionals out there who get how women’s hormones impact everything going on in our bodies. I know that a functional, integrative approach to women’s health is possible, to look at the whole body and assess what’s really going on.
I also know that unfortunately, muct of it is on on us to get educated, informed AND proactive about our own health journey. Today it’s not enough just to go see your doctor. Today you need to be more forceful to get the answers you want and deserve. Today you need to search for the “right doctor” who understands and embraces a different approach to women’s health and healthcare treatment.
There is a growing body of evidence-based research into the benefits of an alternative, holistic approach to health and wellbeing. Things like yoga, mindfulness, alternative therapies, deep breath work, supplements, plant-based medicine etc need to be included in our health management protocols.
I am NOT proposing giving up on our Western medical health-care system. Not at all.
However, I am saying that we need to start seeing it for what it really is – ONE pathway on our health journey. We need to start assessing how it supports us and how it’s failing us. We need to ask our healthcare professionals within this system to do better by us. And we need to get proactive to find the doctors and medical professionals who are pushing the envelope in thinking about healthcare in a different way. Who understand that the old system needs a reboot, and who understand that women’s healthcare needs to be done differently, specically because our bodies our different and the way we experience stages within our lifecycle is different! Because once you realise how your needs can be met, once you realise that there are doctors that can approach your health challenges differently, you can’t go back to the way you received treatment before.