The systemic problem with the lack of education in women’s health and its consequences

We live in our bodies but, as women, we are not taught much about it. We rely on doctors’ expertise or advice from our friends to bridge the gaps in our knowledge. Is that all we need, though? We are, after all, truly the ones in charge of our health and our bodies. We have the right to be armed with the knowledge we need to be able to make educated and informed decisions about our health – and that is where the systemic lack of education in women’s health has failed us. Here we list 7 aspects of our health that are often overlooked when it comes to learn how our body works. 

Western society has put a lot of taboos on women’s health and body. Therefore these subjects are rarely a topic of conversation for girls and adult women. Not to mention that throughout history, women’s bodies have always been seen rather as objects, belonging to society or men, and as a means to procreate. Bodies, which must be covered to prevent men to be tempted, or which must be naked to meet men’s needs, according to men’s desires and not to the desires of the women living in those bodies. In other words, women have not been made aware of how their body functions because they were not supposed to be in charge of deciding what to do with their body. Until recent years, specialists and doctors were all men and were thought to be the only depositories of knowledge. And since men’s bodies are different from women’s bodies and experience different changes, women’s cycles and health have always been overlooked. 

# 1 Menstruation

What we are usually taught – You should have your period every 28 days and period pain is normal. 

However, this is not enough. How are we supposed to know if everything is okay with our period if none gives us more details while we grow up?

On the one hand, having cramps during menstruation is rather normal, as they are caused by the muscle contractions of the uterus. On the other hand, severe period pain is not normal, and many women are not aware of this. Often doctors and, more broadly, society tend to normalise period pain, even though strong period pain can be caused by syndromes such as endometriosis or polycystic ovary syndrome (PCOS). For this reason, e.g, endometriosis, which affects 1 woman out of 10, is usually diagnosed with a delay of 7 years. 

# 2 Anatomy

What we are usually taught – “Down there” there are some lips, a hole, and the vagina. 

Despite the embarrassment that usually permeates discussions about our genitalia, it is crucial to know our anatomy: which the different parts of our external sexual organs are and how they are called. This knowledge is very useful, for example, when we have gynaecological problems, and we describe our symptoms. Different diseases cause different symptoms in different areas of our body; therefore, giving the correct information to our doctor is crucial. Not to mention the importance that the knowledge of our body has when it comes to sexual wellness. How are we supposed to explain what we like to our partners or what is wrong to our gynaecologists if we do not know the right words?

# 3 Vaginal discharges

What we are usually taught – If it is white, looks like cottage cheese, and comes with an itching sensation, it is candidiasis. 

That is likely true, but things are much more complicated than that. Even so, who has ever talked to you about vaginal discharges and how to recognize the different types? 

If we are able to recognise the signals that our body sends us, we are more conscious of what is going on and if we should worry or not. Vaginal discharges are the perfect example of the cyclicity of our physiology: they change during our menstrual cycle. In normal conditions, the sequence of discharges is the following: bleeding during period (interesting fact: only half of the menstruation liquid is blood, the rest are secretions from the vagina and cervix, old cellular tissue, and mucin); sticky cervical fluids right after period; creamish discharges before ovulation; egg-white discharge during ovulation; after ovulation a reverse process takes us back to menstruation. Although the type and quantity of discharges can change from person to person, unusual discharges could signal a gynaecological problem that has to be treated (e.g., fish-smelly and greyish, clumpy and like cotta cheese, yellowish and foamy). 

# 4 Pelvic pain or discomfort

What we are usually taught – Not much. At most that, again, pain is normal, or it is due to our psychological condition. 

Though it is not. As we have already said in the first paragraph, severe pain during menstruation is not normal. Also, vulvar pain during sex or gynecological inspections, or in other situations is not normal.  

The pelvic area is full of nerve endings, and when painful sensations occur, something is going on and has to be investigated as well as when other discomforting feelings recurrently occur (itching, burning, etc.). Of course, in many cases, the problem might be easily solvable with medical treatment (e.g., if it is a one-time bacterial vaginosis or yeast infection). Nevertheless, if the pain or the other symptoms do not cease and last for several months, it means that the problem is more serious. However, as doctors and we have been accustomed to normalising women’s pain, syndromes associated with chronic pelvic pain such as vulvodynia or pudendal neuropathy have a delay in the diagnoses of more than 4 years, though they affect more than 15% of women’s population. Additionally, we must get instructed on how to take care of our pelvic floor. Being able to relax or contract it when needed is extremely important in many situations. 

# 5 Fertility

What we are usually taught – If you stop or forget to use contraceptives, you will get pregnant. 

Of course, not using any contraceptives makes the likelihood of pregnancy much higher than using them. However, we should be aware that our body is not as simple as we think: fertility depends on many factors, and once one has the desire to conceive, it might not be as easy as expected. Hormones and age, of course, play a role, but they are not the only ones. Vaginal microbiome, gut health, chronic syndromes (e.g., endometriosis), smoking, and lifestyle: these are all examples of other things to consider. About 9% of men and about 11% of women of reproductive age have experienced fertility problems in the US. As these numbers show, it is not an uncommon issue, even though usually people do not talk about it with friends or colleagues, or even family. This obstacle can, of course, affect the love life of a couple and their mental health. Being conscious of what our body needs to conceive and that other people are in the same situation would make women who want to get pregnant more prepared if they face difficulties in conceiving and have to start a fertility journey. 

# 6 Pregnancy and giving birth 

What we are usually taught – Well, concerning pregnancy, we receive contradictory messages: in some cases, it is a marvellous experience in a woman’s life. In others, it is the worst. Giving birth is usually depicted with scenes where mothers are sweaty and suffering and need to push. 

First of all, pregnancy is a mother’s personal journey, so it is not possible to classify it as either a good or a bad experience in general. What can, of course, help mothers and fathers to be more prepared to face pregnancy issues and the delivery of a child is to inform themselves and find a good team of professionals to rely on. Mothers should never forget that they, and not the doctors, are the ones delivering. They have to be knowledgeable about what happens in their body, e.g., when they are in labour. Pushing hard under the direction of a midwife is the so-called “directed pushing” or “purple pushing”. Even though this is the image that we all have in our mind, this approach is not recommended anymore, as it forces mothers to push when they are not ready yet and may cause severe consequences to their pelvic floor. Our body usually lets mothers know when it is ready to let the baby out. Not to mention episiotomy or other practices implemented to “help” women deliver without having them fully aware of the potential consequences.

# 7 Menopause

What we are usually taught – There will be sweat and no more period. 

Women do not enter into menopause from one month to the other. Usually, there is a transition period that lasts several years (though its duration varies a lot among women), which is called perimenopause. Perimenopause expresses itself with hormonal changes and irregular cycles (less and lighter or more frequent and heavier than usual), weight gain, and emotional and physical changes. It is essential to mention that similar symptoms may also be due to other factors (e.g., thyroid anomalies). Menopause instead occurs – according to the medical definition – when a woman has gone for 12 consecutive months without a period. Many symptoms are associated with menopause, not only the absence of periods, hot flashes, and night sweats but also, e.g., vaginal dryness, mood changes, thinning of hair, and dry skin. Being prepared for the possible transformations the body will undergo is crucial to respond better to them. Not to mention the importance of knowing which medical conditions become more likely after menopause (e.g., cardiovascular diseases, urinary incontinence, osteoporosis) and monitoring potential symptoms.