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As soon as, Dr. Elizabeth Comen visited a affected person on her deathbed, and the lady apologized for sweating on her.
“I’ve had numerous girls apologize to me, really feel embarrassed and disgrace for both expressing regular bodily habits or … about their our bodies themselves,” Comen tells TODAY.com. “These come from the tales we’ve been advised, the tradition that we dwell in, and the one technique to change that’s to unravel what we’ve inherited.”
This story — which begins off Comen’s ebook “All in Her Head: The Reality and Lies Early Drugs Taught us about Girls’s Our bodies and Why It Issues Immediately” — highlights a standard theme she has seen in her profession as a breast oncologist: that girls really feel discomfort with their our bodies.
“A lot of what this ebook is attempting to do is unpack that legacy with egregious, horrible tales from the previous which might be mind-blowing, however true — but in addition to indicate how these threads proceed at the moment, maybe in additional insidious, refined, but equally dangerous methods,” Comen explains. “(There are) myths that we have to shatter, notably that by some means girls’s our bodies are extra vulgar or dirtier (and) that we have to be ashamed of our regular bodily operate.”
Whereas researching and penning this ebook, Comen usually felt stunned and “horrified” by what she was studying, she recollects.
“We will all acknowledge ourselves in these girls from the previous and surprise: Oh my God, if I have been anxious within the Nineteen Twenties, would I’ve had all my enamel eliminated?” she says. “If I went to my physician and mentioned I had a wholesome libido, would I be despatched to an asylum? Would I’ve had my uterus eliminated for stating my political opinions loudly?”
Engaged on the ebook has made her think about how medical care for ladies could possibly be carried out otherwise now and sooner or later.
“What additionally stunned me was actually simply how a lot of this legacy we’ve inherited at the moment and the way a lot we predict we’ve moved past the previous — however it’s not sufficient,” she says.
Listed below are three decadesold (or older) myths about girls’s our bodies that also affect medical care at the moment.
Myth: Women are tiny men
“One of many greatest myths is which you can simply research one thing in a person and assume that it’s going to apply, simply perhaps in a decrease dose, to girls,” Comen says. “Girls’s well being is head-to-toe completely different from males. We aren’t small males. The way in which we current with ailments might be very completely different.”
Take coronary heart illness, for instance. As just lately as 2022, a research discovered that signs of heart disease look different in women, and that probably contributes to why they’re recognized later than males, NBC News reported.
“Coronary heart illness is the No. 1 killer of ladies,” Comen says. “(However) we don’t think about {that a} girls’s well being difficulty.”
Considering of ladies as tiny males additionally implies that situations impacting solely girls are inclined to obtain much less consideration and funding. “There are such a lot of ailments that we miss alongside the way in which,” Comen says.
The medical literature on girls nonetheless trails behind what’s identified about males. It wasn’t till 1993 that the Nationwide Institutes of Well being required that girls and feminine animal fashions be included in scientific trials and earlier analysis levels, Comen notes.
“As a result of girls are seen as so hormonal and troublesome to check, that additionally translated to mouse fashions and the sorts of cells that we used within the laboratory,” Comen says. “It’s not simply the medicine and the scientific trials. It’s even earlier than that.”
Because of this, girls at the moment take medicines or use medical units which have solely been studied in males.
“That tells you simply how far behind we’re by way of gender parity,” she says. “(There are) medicines, testing units … which may be utilized in girls that will have by no means been adequately studied in girls.”
Myth: Women have estrogen and progesterone, and men have testosterone
Drugs has taken a “binary strategy” to fascinated with hormones, Comen says, pushed by the notion that estrogen and progesterone are in girls, and testosterone is in males. However the actuality is each sexes depend on all three hormones.
Nonetheless, stereotypes persist about males’s versus girls’s hormones. Take into consideration how girls are sometimes criticized for being emotional as a consequence of their hormones.
“Why is it that we malign estrogen and progesterone a lot, and testosterone is by some means this superb hormone that’s uniquely present in males and makes everybody virile and robust?” Comen explains. “The way in which that we take into consideration hormones has extraordinarily restricted our understanding of ladies’s hormonal well being.”
Medical doctors usually really feel much less assured about giving girls hormones as remedies, she says, including that not sufficient is known about “hormones in girls, notably as they age.”
In Comen’s expertise, many practitioners do not know when to prescribe testosterone to girls or hormone remedy in menopause.
“(How) we now have guided girls about hormone alternative remedy has been a wildly swinging pendulum — from everybody must be on it to nobody must be on it,” she says. “(We’re) simply now realizing that there are particular person circumstances which might be distinctive to every girls (and) fastidiously fascinated with hormone alternative could be applicable. These are the sorts of conversations we’d like to have the ability to have with our medical doctors.”
Myth 3: Women’s health is just reproductive health
Drugs has had a little bit of an unhealthy obsession with the uterus. Actually, the traditional Greeks believed the uterus moved round girls’s our bodies, inflicting their well being issues.
“The uterus has been (seen as) the supply of all of ladies’s ills … wandering across the physique, wreaking havoc alongside the way in which,” Comen quips.
For 1000’s of years, girls have been incessantly recognized with a psychological dysfunction referred to as hysteria, a time period that comes from the Greek phrase for uterus, hystera. The prognosis was not faraway from the medical lexicon till the Nineteen Eighties, many years after medical doctors discovered that the uterus was not the reason for hysteria signs.
“This looming specter of the hysterical lady reigns giant in our medical legacy,” Comen provides.
This deal with the uterus and different reproductive organs in treating girls implies that oftentimes different well being points are missed, particularly what occurs to girls as they age.
Comen says that menopause, cognitive well being and coronary heart illness for getting older girls are particularly necessary subject areas for additional analysis. “I didn’t even know that Alzheimer’s illness was two occasions extra more likely to happen in girls than males. So, plenty of issues have been missed alongside the way in which,” she provides.
“We wish to ensure that we’re conserving girls wholesome in all methods (and) that fertility isn’t the reductionist backside line of who we’re as full and full girls.”