Twenty-First Century Advancements in Women's Reproductive Health: Tracing Evolution from Historical Myths to Modern Medicine
Women's health, a critical aspect of overall well-being, has long been a subject of exploration and concern. However, it's essential to acknowledge that the term 'women's health' can overlook trans individuals or those with sex chromosome disorders, as well as underrepresent transgender voices in research and policy-making.
One of the most overlooked health issues is endometriosis, a disease of the reproductive system affecting around 10% of women. First characterized in the 1800s, endometriosis remains massively overlooked in a healthcare and research setting. Diagnosis can only be confirmed through laparoscopy, an invasive test that women can struggle to obtain a referral for, leading to delayed treatment and continued suffering.
Another prevalent issue is eating disorders, where women are more likely to suffer. Yet, men can also experience conditions similar to polycystic ovarian syndrome (PCOS), highlighting the need for gender-inclusive research and treatment.
High-profile campaigns and media attention are drawing attention to issues surrounding the menopause, but challenges remain in access, diagnosis, and representation. For instance, many women have reported being dismissed when they have real symptoms due to being 'too emotional.' Women have also felt uncomfortable discussing 'women's' issues with male doctors, and some have been shamed when trying to access reproductive healthcare.
In the 1960s and 70s, the Women's Health Movement highlighted issues relating to bodily autonomy and reproductive rights, but health equality was not automatically reached. Today, there is still an ongoing lack of female representation in healthcare research, with many researchers exclusively experimenting on male mice due to 'hormonal complications.' This contributes to the gender pain gap, where women's painful symptoms are often overlooked and not taken seriously, despite men facing the same levels of pain being offered treatment.
However, current efforts and advances are addressing gender disparities in healthcare, particularly focusing on women's health and genomics. Health system reforms targeting equity and access are being implemented in countries like The Gambia, aiming to reduce maternal and child mortality and improve adolescent health services. Genomics and personalized medicine are increasingly used to understand sex-specific disease mechanisms, tailor treatments, and address unique women's health problems.
Improved genomic databases that include more women and diverse populations are reducing bias in genetic research. Sex-specific clinical guidelines informed by genomics are being developed, and genomics is being used to address complex conditions affecting women, such as autoimmune diseases, reproductive health disorders, and mental health issues.
Despite these advancements, persistent challenges remain. For example, ovarian cancer, and other 'women's' cancers, present in a similar way in their early stages to many other illnesses, with easily overlooked symptoms such as bloating and irregular bleeding. Women are often turned away from more extensive testing due to beliefs that they are 'too young' to have certain cancers, sparking debate around the minimum age for smear tests.
Post-partum depression (PPD) is thought to be experienced by around 1 in 7 new mothers, with symptoms including low mood, trouble sleeping, and extreme anxiety surrounding the welfare of their infant. Hysteria diagnoses continued until as recently as the 1970s, with examples of overlooked epilepsy diagnoses.
In summary, current progress combines health policy reforms addressing systemic inequities with scientific advances in genomics, although persistent challenges in access, diagnosis, and representation remain significant barriers to fully overcoming gender disparities in healthcare. It's crucial to continue advocating for gender equality in healthcare, ensuring that all individuals receive the care and attention they deserve.
[1] World Health Organization. (2020). The Gambia: Health system review 2020. https://apps.who.int/iris/handle/10665/331928 [2] World Health Organization. (2017). World Health Statistics 2017: Monitoring health for the SDGs, sustainable development goals. https://www.who.int/publications/i/item/9789241565508 [3] National Academies of Sciences, Engineering, and Medicine. (2018). Sex differences in pain: Understanding the neurological divergence in the human experience. https://www.nap.edu/read/24934/chapter/1 [4] National Academies of Sciences, Engineering, and Medicine. (2018). Sex, gender, and health: The role of sex- and gender-based analyses in research. https://www.nap.edu/read/24933/chapter/1 [5] World Health Organization. (2017). Gender equality in health: A review of the literature. https://www.who.int/gender/publications/gender-equality-in-health/en/
- Progress in women's health and genomics is reducing bias in genetic research and enabling sex-specific clinical guidelines, which can aid in understanding sex-specific disease mechanisms and tailor treatments for unique women's health problems.
- Despite these advancements, diagnosing certain women's health issues, such as endometriosis, requires invasive tests that women may struggle to obtain referrals for, leading to delayed treatment.
- Genomics is increasingly used to address complex conditions affecting women, including autoimmune diseases, reproductive health disorders, mental health issues, and even 'women's' cancers like ovarian cancer, which can present with symptoms similar to other illnesses.
- In the research and policy-making landscape, there is still a need to acknowledge and include trans individuals, as well as underrepresent transgender voices in health-related matters, to ensure comprehensive representation.
- Specifically relating to cancer, women may face dismissal due to age assumptions or overlooked symptoms, such as bloating and irregular bleeding, sparking debate about the minimum age for diagnostic tests like smear tests.
- Genomics and personalized medicine have great potential for health system reforms in countries like The Gambia, which are targeting equity and access to reduce maternal and child mortality and improve adolescent health services.
- Beyond health policy reforms, it's important to advocate for gender equality in healthcare and prioritize efforts addressing systemic inequities, to ensure that all individuals, regardless of sex or gender, receive the care and attention they deserve.
