Where’s the focus on women’s health beyond motherhood?
I’m not a fan of naming days, weeks and months after diseases, populations or even favorite foods. But, as expected, May has been designated Women’s Health Month, and the days leading up to Mother’s Day as Women’s Health Week.
Not surprisingly, June is Men’s Health Month, which corresponds to Father’s Day (and National Donut Day, for some odd reason). I understand why we use any opportunity we can to highlight important needs and issues, but I wish that we would do it every day, and not just for a set period of time.
With all that said, let’s focus on women’s health. Until the latter part of the 20th century, women’s healthcare was considered more as “bikini” medicine than anything else. We would focus on breast and reproductive tissue, and the rest of the body seemed to disappear into a black hole, which resulted in significant inequities in healthcare and health. To this day, many are surprised to learn that heart disease is the leading killer for women and lung cancer incidence surpassed breast cancer in 1987.
Through the efforts of the federal government, including policies on the inclusion of women in clinical trials and disaggregating data by sex/gender, age and race, as well as an enhanced focus from the private sector on multi-and interdisciplinary comprehensive healthcare, we began to see improvements in women’s health.
Sadly, many of these advancements have been overshadowed by continual attacks on women’s reproductive health. We have moved back to an antiquated time when women feared for their lives as their reproductive freedom was stripped away.
Women’s health has traditionally been geared toward a reproductive-aged or premenopausal woman. This is, again, reflected today in the hypervigilant focus on what is happening in a woman’s uterus, which can impact the quality of health care for a woman even as she enters menopause.
Menopause marks the end of female fertility, and potentially, increased risks for cardio- and cerebrovascular diseases, cancer, osteoporosis, dementia and other conditions associated with aging. It’s a normal phase of life and does not need to be medicalized as a disease state as long as women have access to competent healthcare.
Signs and symptoms of menopause, which can last for years, include hot flashes and night sweats, insomnia, memory impairment, personality changes such as irritability and sadness and more. Every woman experiences menopause differently, but studies suggest that Black and Latina women may begin menopause earlier and have more severe symptoms, which may last longer compared to white women.
Women can be so incapacitated by these health issues that they may leave the workforce earlier — not reaching their full capacity for success and financial stability. These resignations can also significantly impair their organization’s and company’s productivity and economic goals.
In the United Kingdom, nearly 900,000 women have left their jobs due to menopausal symptoms and nearly 3 out of 5 women are negatively impacted at work, according to a 2022 House of Commons Women and Equalities Committee inquiry.
For women who are in lower-paying jobs, the impact can also be seen by limitations in their healthcare. Health insurance copays and deductibles for menopausal treatments can create significant barriers to access. For example, the Kaiser Family Foundation reported that 4 out of every 10 women claimed to have to pay out-of-pocket costs for regular medical exams and 6 out of 10 experienced difficulty paying for their medical expenses which can be seen as barriers to care.
Organizations such as Springboard Enterprises, a venture capital firm that invests in women-led companies, are now leading efforts to raise awareness about these issues, which can significantly damage the health of postmenopausal women. Women also need to be seen by clinicians who are trained to address health concerns during this phase of life. The American Medical Women’s Association and the North American Menopause Society are providing educational resources and tools for telemedicine to reach underserved and neglected communities. But much more still needs to be done.
In my book, “Stellar Medicine: A Journey Through the Universe of Women’s Health,” I describe how the first talk that I ever gave on menopause was in a San Francisco garage owned by a medical colleague who had a small apartment. It was the only space large enough for our group. Much like the cars in that garage, women’s health education and outreach needs to be maintained, occasionally tuned up and always respected.
Saralyn Mark, MD, is the founder of SolaMed Solutions, LLC, host of the “Always Searching” podcast and founder of iGIANT (Impact of Gender/Sex on Innovation and Novel Technologies). She is the American Medical Women’s Association’s COVID-19 lead and a former senior medical and policy advisor to the White House, the Department of Health and Human Services and NASA.
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