Ignored and Unheard: The Enduring Crisis of Women’s Health

London, 1857. A heavy fog clings to the cobblestones as Elizabeth Weston, a young woman in her thirties, climbs the steps of her physician’s townhouse. Her corset is laced tightly, but it cannot brace her against the weight of her pain. Years had passed since she delivered a stillborn child and the ache in her abdomen has grown sharper. Her periods are erratic, her joints swollen, her thoughts clouded in a relentless haze. She hopes for relief or at least an explanation.

But Dr. Harold Fletcher listens only briefly before delivering his verdict: “Hysteria,” he says, barely meeting her eye. “A woman’s constitution is fragile, prone to melancholy. A tonic and rest will suffice.”

Elizabeth leaves with a vial of laudanum (a 10% solution of opium powder in alcohol, widely used to treat everything from pain and insomnia to female disorders) and the unshakable feeling that her suffering is a mystery too inconvenient to solve.

More than a century and a half later, countless women echo Elizabeth’s experience. Medicine has advanced immeasurably since the Victorian era; antibiotics, anaesthesia, diagnostic imaging and digital records have revolutionised care. Women’s health, too, has seen progress: maternal mortality has plummeted, access to contraception has expanded and awareness campaigns for breast and cervical cancers have saved lives. And yet, the deep roots of neglect and dismissal persist.

From the excruciating pain of endometriosis to the debilitating effects of menopause, women’s suffering is still too often misdiagnosed, minimised or outright ignored in a medical landscape shaped historically by male perspectives.

A History of Dismissal

Elinor Cleghorn’s groundbreaking book, Unwell Women: A Journey Through Medicine and Myth in a Man-Made World, delves into the origins of these biases, tracing them from antiquity to the present. From Hippocrates belief in a “wandering womb” to the Victorian era diagnosis of “hysteria,” women’s bodies have often been treated as enigmatic, irrational and inherently flawed.

Historically, physicians overwhelmingly focused on women’s reproductive roles, reducing their broader health concerns to childbearing. Non-reproductive ailments such as chronic pain, fatigue or emotional distress were often dismissed as imaginary or psychosomatic This approach fostered a culture of scepticism towards women’s complaints of pain or discomfort, leaving their needs unmet.

Breaking the Silence: Women’s Voices in Healthcare

This neglect isn’t confined to history. BBC presenter Naga Munchetty recently shared her harrowing experience with adenomyosis, a condition where endometrial tissue grows into the uterine muscle, causing intense pain. Munchetty described feeling “broken” not just by the physical toll, but by the years of dismissal and misdiagnosis.

Her story resonated with thousands of women who felt similarly unheard. Speaking candidly about period pain so severe she would vomit or struggle to walk, Munchetty raised a critical question: why are women expected to endure such suffering without appropriate medical attention or societal understanding?

These experiences are not isolated. For many women with conditions like endometriosis; a disease affecting roughly 1 in 10 women of reproductive age diagnosis can take years. Patients are often told their symptoms are “normal” or psychological in nature. During this time, their quality of life deteriorates, careers suffer, relationships strain and mental health erodes.

Menopause: The Silent Transition

Perhaps nowhere is the disparity more glaring than in the case of menopause. Affecting every woman who lives long enough, menopause is still shrouded in silence, embarrassment and misinformation. Symptoms such as hot flashes, sleep disturbances, anxiety and memory lapses can be life-altering, yet support remains scarce.

A 2022 report by the Fawcett Society revealed that 1 in 10 women has left the workforce due to menopausal symptoms. Even more startling, two-thirds of women reported a lack of support or understanding from their employers. Shockingly, 41% of UK medical schools do not include mandatory menopause education in their curriculum (2021 study by Menopause Society).

While treatments exist, access and awareness remain patchy. Crucially, medical research into menopause and its management has lagged far behind. One must ask:

If menopause were treated with the same urgency as conditions like heart disease or diabetes, both of which can also disrupt daily life and carry long-term health risks; would we still be debating whether hormone replacement therapy was worth funding?

Imagine a chronic condition that causes memory lapses, anxiety, night sweats, sexual dysfunction and increases the risk of osteoporosis affecting millions.

Would we accept so few workplace accommodations, so little public education and such inconsistent medical guidance?

Modern Echoes: Long COVID and Medical Bias

The gendered neglect in healthcare continues with conditions like post-acute sequelae of COVID-19 or Long COVID  marked by symptoms like fatigue, brain fog, chest pain and cognitive dysfunction to name a few. Research shows that women are more likely to suffer from Long COVID. Yet many report being dismissed as anxious or stressed, echoing the same biases that have plagued women’s health for centuries.

The Cost of Being Ignored

The marginalisation of women’s health concerns has profound implications. Misdiagnosis, delayed treatment and underfunded research contribute to a healthcare system that consistently fails half the population. Even today, women are more likely to be prescribed sedatives or antidepressants than investigated for underlying physical conditions. Pain is less likely to be taken seriously and symptoms are more likely to be chalked up to anxiety or stress.

As Cleghorn argues in Unwell Women, the historical neglect of women’s health is not merely an oversight but a structural failing rooted in centuries of bias. While significant strides have been made, with advancements in medical research and increased awareness, there remains a pressing need to address the persistent disparities and ensure that women’s health concerns are fully recognised and prioritised.

Media personality Davina McCall has been instrumental in breaking the silence around menopause. Her Channel 4 documentaries, including “Sex, Myths and the Menopause,” chronicle her struggles with perimenopause, highlighting the lack of awareness and the societal taboos surrounding it. Her advocacy has inspired women to demand better care and workplace accommodations, but it also underscores the grim reality: only through celebrity platforms has this issue gained widespread attention.

Advancements in Research Methodology

In recent years, there has been a growing recognition of the importance of including women in clinical research. Historically, women were often excluded from clinical trials, leading to a lack of understanding about how various treatments affect them differently. This exclusion has contributed to gaps in knowledge regarding the efficacy, tolerance and side effect profiles of medications in women.

To address this, research methodologies and participant recruitment strategies have evolved. Modern clinical trials increasingly strive for balanced representation, acknowledging that biological differences between men and women can significantly impact health outcomes. For instance, the National Institutes of Health (NIH) implemented a policy in 2016 requiring researchers to consider sex as a biological variable in preclinical research.

These advancements aim to ensure that medical research is more inclusive and that findings are applicable to both sexes. However, challenges persist and continued efforts are essential to fully understand and address the unique health needs of women.

A Call for Change

The tide is slowly turning, thanks to celebrity voices and grassroots movements advocating for better menstrual education, menopause policies and women-specific research. However, true transformation will require sustained pressure, honest dialogue and comprehensive policy reforms.

It’s time we asked ourselves and our healthcare systems some hard questions:

-Are we doing enough to ensure that every person regardless of gender receives timely and effective care?

-Why do so many suffer in silence before getting a diagnosis or treatment?

-Shouldn’t open, informed conversations about all stages of health be the norm, not the exception?

Women’s health is not an unsolved medical mystery. Yet, despite a century of medical progress, many conditions that predominantly affect women remain under-researched and underfunded largely due to a healthcare system historically built without women’s needs in mind. Without systemic reform, women will continue to face disproportionate burdens not just in physical suffering, but in lost time, compromised dignity and a diminished quality of life.

If you’re interested in learning more, Elinor Cleghorn’s Unwell Women is a compelling and essential read that unpacks the deep-seated myths that still shape women’s healthcare today.