Sometimes It's Hard To Be A Woman

I am totally envious of Tammy's hair.  Not her song choice though.

The only good line in a terribly outdated sexist song.  But a good line nonetheless.
I feel this acutely at the moment.  Right now, for me, it feels hard to be a woman.

Me post surgery looking fly in hospital garb

To date, I have been hospitalised* 11 times.  82% of these hospitalisations were directly related to my biological gender.  And every surgery I've ever had, of which there are four, have been directly related to the anatomy of my sex.  All (bar one) were necessary for my survival.

For Mum, it's 13 hospital stays in total with 92% of those being related to her biological gender.  Of 10 surgeries, eight were lady specific.  And she's got another surgery coming up later this month.

A recent scan showed I have a large submucosal uterine fibroid.  I am hoping to avoid hospital this time by attempting to treat my symptoms naturally via diet and contraceptive pill (so I don't get periods**).  My GP is happy with this conservative approach so long as it's monitored well and effectively manages my pain.  If not, I'll be heading back to see yet more gynae specialists.

I know our stats may be disproportionate to the norm, so I wanted to share some more general stats about common women specific health issues:

• Women are 4 times more likely than men to experience bladder leakage issues.
• 30 - 40% of women will experience vaginal prolapse (these rates increase for women who've had more than two children or a hysterectomy).  And about 25% of women will suffer a uterine prolapse. 
• 25 -  80% of women in NZ will have fibroids.  Of these however, only 20 - 50% of women will be symptomatic. (Weird stats, but all I could find... feel free to research yourself)
•  3 - 10%*** of women in NZ suffer from endometriosis. 
• An estimated 5 - 10% of women in NZ suffer from PCOS (poly cyctic ovarian syndrome)
•  One study of 1200 women post partum found that 18 months on, 24% of women still experienced significant pain with intercourse (dyspareunia). 

 

Not Helpful Big Bang Theory        

So when I see sitcoms making fun of PMS and period pain and no bigger picture context, I get pissed.  We see girls bleeding through their dress at Prom, we see a Jekyll and Hyde like projection of women on or off their periods, we see 'frigid women' - portrayed as bitches, or someone who is later 'transformed' by the 'right man' (as opposed to them possibly being survivors of sexual assault, or gay, or suffering from painful or embarrassing medical issues, or lacking in esteem, or just genuinely not interested in sex).  Simplifying women's health issues to these basic tropes is unhelpful.  Especially when so many women suffer from an array of serious illnesses in relation to menstruation and the functions around our ability to build and carry new life. 

The average time between presentation of symptoms and getting a diagnosis for endometriosis in New Zealand, is eight years.  The most common symptom for this disorder is painful periods but others include IBS like symptoms and exhaustion.  For some women, the pain is unbearable.  Whilst I understand that this presentation is generic and could apply to many other disorders or combinations of disorders, eight years seems a long time to diagnose something with sometimes debilitating symptoms and, on average, affects 10% of the female population.

But I think the main thing that prevents diagnosis of this and other women's health issues, is that as women we are raised to expect that pain is just normal.  We get told that periods are painful.  And if we grow up in Christian households we are told this pain is to atone for Eve's sin**** so it's a natural part of 'God's plan' for us.  We see ads on TV for products designed specifically to help with period pain and for heavy flow days.  Our pain is just part of our experience as women.

'PMS isn't real Needy, it was invented by the boy-run media to make us seem like we're crazy.' - Jennifer Check (Jennifer's Body [2009])

Women's pain is normalised to the point where I have seen women try to tear those down who don't experience it.  As in, there is something wrong with women that aren't in agony once a month.  It's like the more pain you're in the more womanly you are perceived to be.  But, simultaneously you are supposed to be able to handle this pain.  It's like some weird competition in stoicism.  It's fucked up.

Take this and you'll feel better.  Just maybe not so keen on sexy times.

And when we go to our Drs and complain about this pain they too often will write this off as 'normal'.  Because women's pain is regularly not taken seriously.  To give perspective, ovarian cysts caused me so much pain that two drs (my GP and ED Dr) misdiagnosed it as appendicitis.  I am grateful they took me seriously at all.  I know for a fact that plenty of other women will have presented in this level of pain and been told to go home and take some panadeine.  The one thing Drs will often do for period related complaints is give us the magical cure-all - 'the pill' which often helps us feel better, but doesn't actually treat the underlying issue.

I started my relationship with 'the pill' when I was 14 years old.  I started menstruating when I was 11 and my periods had always been inconsistent and painful.  By the time I was 14 I realised this was affecting my ability to attend school.  Family Planning thought the mini pill was a good place to start and no-one questioned this choice at the time - least of all 14 year old me.  Because it really did help.

 But like most drugs, the pill is not perfect.  The common side effects of the pill I take now (Ava) are:

• nausea
• abdominal pain
• weight gain
• headaches
• mood changes
• breast tenderness
• lowered libido (listed as less common)

Also, rates of thrombosis and breast cancer increase for women regularly taking contraceptive pills.

So I take this magical pill which stops me from fainting at work and crying when I pick up my children, but I pay for this in other ways.  Like not knowing about random stuff growing in my own body (cysts/fibroids) because my symptoms were masked for years.  The side effects I get from any pill I'm on include an increase in IBS like symptoms, weight gain and lowered libido.

What's the point in birth control if you can't get it up?

I don't know why lowered libido is listed as 'less common'.  Almost every woman I've spoken openly with about this stuff has experienced either this, or the inability to orgasm, whilst taking the contraceptive pill.*****  My guess is that it was less reported in trials because people are not always that honest when it comes to how sexy they feel.  Why do you think there's no male pill yet?  I think it's because 'possible side effects: erectile dysfunction' wouldn't make for a best seller.

So why did do we accept this for women?  I think it's because we don't feel like we have much of a choice.  In my case I can live in intermittent chronic pain and have a sex drive, or I can live with lower pain levels and not.  And the nice side effect is that it also provides birth control, which for someone with my health history****** is actually the only contraception I can use besides condoms (and I have a latex sensitivity, son prolonged use of condoms gives me thrush).

Speaking of lowered libidos, I looked high and low to find information on when sex should stop hurting post childbirth.  Because after Etta, it hurt like a bitch.  Not just the first time, but for over the first year of 'attempting' it.  It wasn't just sex - it hurt to insert a tampon.  I went to my Dr and they did a physical exam, said I was fine other than having BV and said I should try some lube.  Thanks Dr Ali.  No-one tries lube before they come to the Dr to get their vagina uncomfortably examined.  You're a medical genius

It wasn't the BV that was causing me pain.  I talked on Mummies forums and I read as much as I could and then I learned that women who deliver via emergency C Section are twice as likely as women who laboured naturally to have pain with sex 18 months after delivery. My uneducated guess, in my case anyway, is that having a baby stuck in the vaginal passage may cause nerve damage which takes considerable time to heal.  After reading that, and considering my delivery, I wasn't surprised that sex hurt so bad.

My C Section scar.  Much less painful than my vagina.

My point in all this is that I wish there was better support for women's health issues at an education level, a medical level and a social level.

I wish that girls learned in school not just about STI's and periods, but about every day things that might happen to their bodies.  I'd like them to get a run down on the most common issues to affect women, their symptoms, and who to go to if they have concerns about any of these things.  If girls are learning this stuff in school now, I'd love to know, because we certainly didn't.  If they still aren't by the time my kids are that big I can promise you that that section of education is going to be taught at home.  And it will be taught thoroughly.  And I will happily teach any other kids if anyone will let me do it.

I wish that our health system was under less pressure.  I wish Drs were more able to spend time to talk to patients to form a more holistic view for more accurate diagnoses.  I was at my Drs yesterday and after a half hour wait with two squiggly sick kids she was very apologetic for the delay and was obviously stressed.  Our Drs always seem stretched.  And heading into hospitals it seems even worse.  My hope is that if the pressure came off GP's and hospital services, they might have a better chance of diagnosing these common problems earlier which would save bajillions of tax payer dollars down the line in surgeries whilst giving loads of people better quality of life. 

If there were more funding available for women's health issues, maybe more serious things could be diagnosed earlier.  A woman who's endometriosis is discovered when she's at stage 2 rather than stage 4 may still be able to get pregnant.  If my Mum's friend had had her fibroids discovered earlier, it is unlikely she would have had to have a full hysterectomy.  And if there were more understanding of how these issues impact on women's lives, maybe there could be more understanding and support from WINZ (in terms of disability allowance and thinking more appropriately in terms of returns to work), and more flexibility within the workplace (in terms of hours/breaks/time off).

If problematic fibroids are usually treated with steroids to reduce size, 

or using laproscopic surgery to remove them.  

I wish there was less focus on getting a Beyonce post baby body and more focus on how our bodies are actually recovering from child birth.  Rather than seeing a colleague gossiped about for going home for work 'just' because of her period, I'd like to see someone check if they are ok, and offer them support in getting help if it's a recurring problem.  I wish we would talk more openly about our prolapses and our weak bladders and our fibroids.  Because the more we share information, the more we educate each other and the stronger we can collectively feel.

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I just want to explain a few things about this post.  I have excluded STI's and cancers because whilst they present differently in men and women, this is an area that is fairly well understood and there are awareness campaigns for both men and women around many of these issues*******.  We learn about breast exams and smear tests and STI's at school.

Like most of my posts which centre around gender, this is not intended to be divisive, it is intended to be educational.  I strongly believe in equality, and often this means taking into account issues that stop the playing field being level - in this case, women's health issues.  Because we do not choose our sex.  And we certainly do not choose the issues that can affect us due to our anatomy.  What we can do is gain better understanding of these issues together so we navigate new ways forward.

In the same way I wish there were better provisions for PPL for Dads, and change tables in mens bathrooms (or at least unisex bathrooms with change tables), I wish these issues were common knowledge, so that women suffering from these conditions have the opportunity to live better lives.

I had three abdominal surgeries during the course of trying to conceive (and deliver) Etta.  

Two of which were life saving.  Following childbirth I suffered dyspareunia 

which had a far bigger impact on my confidence and relationship than losing my baby weight.

* By this I mean overnight stays excluding any minor procedures where I've been in and out in a day.
** The bleed you get on the sugar pills is not a period.  It's just a withdrawal bleed.

*** Varying stats given.  I'd say that 10 percent is likely more accurate given that US estimates of endometriosis sufferers are between 10 - 20%
**** Genesis 3:16: To the woman he said, “I will surely multiply your pain in childbearing; in pain you shall bring forth children. Your desire shall be contrary to your husband, but he shall rule over you.”
***** A friend was so sick of being unable to orgasm on her contraceptive that she stopped taking it before going on her honeymoon because she just wanted to have a fucking orgasm on her honeymoon.  Can you blame her?  This is how their first child was conceived.

****** Ectopic pregnancy = no IUD allowed (increases incidence of ectopics further).  Family history of mental illness + personal history of mental illness = robo-arm (Jadelle) and the injection are inadvisable.
******* I do wish there was more awareness around testicular cancer, and self checking like breast cancer.