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Women do not fare as well as men in our health system and medical mysogeny is a real thing, according to issues discussed at a recent women’s health forum hosted by Member for Robertson, Dr Gordon Reid.
By Jacquelene Pearson
Two out of the five Ministers who take care of the health portfolio in the Albanese Government attended a women’s health forum held at Umina recently: Ged Kearney, Assistant Minister for Health and Aged Care and Emma McBride, Assistant Minister for Mental Health, Suicide Prevention, Regional and Rural Health.
The forum was hosted by Dr Gordon Reid, Labor Member for Robertson.
“It never ceases to amaze me how many people always come along to talk about women’s health,” Assistant Minister Kearney, who was formerly a nurse, told the assembled forum attendees.
“Women do not actually fare as well as men in our health system,” she said.
The Assistant Minister said women doctors had particularly raised this issue with her, pointing out that there was a “systemic bias” in the system.
Kearney told the crowd to look up the hash-tag #medicalmysogeny.
“Now it is a harsh term and it doesn’t mean there are doctors out there in the health system that hate women. That is not what it means,” she said.
However, she gave some examples of how the system is pitted against delivering the best possible outcomes for women.
“If you are a woman and you have a heart attack you are twice as likely to die as a man and if you are a man you are twice as likely to be admitted to ICU. These are facts,” she said.
Why is that so?
Well, for starters, the guidelines for detecting heart attack symptoms are written for a 50-year-old man who lives in Pennsylvania, according to Ged Kearney.
“The guidelines are not written for women. The women who I know have had heart attacks, including a woman in my office, have different symptoms, they have general pain across the chest, pain in the tummy and they become very anxious.”
Even up until the 1980s clinical drug trials couldn’t be performed on women. Hormones, pregnancy, menstruation meant women were not deemed to be good models for trials.
She also told of evidence that women are over-medicated “because they take dosages that have been trialed on men.
“A study done more than a decade old now, but I think it is quite an interesting one, that showed hip prosthesis had been designed for men and scaled down for women.”
Ged Kearney said she would argue that such systemic issues can be fixed.
“When I talk to women in forums like this, there is a lot of women who present with symptoms and they are simply not believed or they are told it’s a women’s lot, you have to put up with pain.
“Endometriosis takes seven years to be diagnosed,” she said.
It is a crippling pain and young women often present with the symptoms when they are getting their menstrual cycle for the first time.
Women presenting with pelvic pain may have bowel cancer or polycystic ovarian syndrome
Mothers presenting with ill children are told they are just being an anxious mum.
“There are lots of biases in the system that are preventing women from getting the best care,” she said.
The Assistant Minister said she was having rounds of meetings with women because she wants to hear their stories.
“What are some of the barriers to you getting good health,” she asked.
The Albanese Government has also established the Women’s Advisory Health Council.
“We are looking at the system, the biases in the system and how we can change that to help women get better outcomes.
“We’ve announced 20 endometriosis pelvic pain clinics around the country and we are hoping to get more than that.
“We want to make sure women have access to specialty women’s health clinics.”
She said the government had four focus areas when it came to women’s health.
The first was research – where are the gaps, access to care and outcomes, safety – could be cultural for first nations people, for migrant women, it could be when you have been sexually assaulted you may not want a gyno exam.
The second was empowerment – “it is really about helping women feel confident enough to walk into a doctor’s surgery or ED and talk about their body, their symptoms and know they should be getting care”.
Kearney said there was still an element of shame when talking about women’s body parts – “you just don’t openly talk about your vulva or your vagina or your breasts”.
But that does not mean women should “just accept that is the way it is,” she said.
And then there’s menopause.
“We just don’t talk about it properly I don’t think and I am sure there are different ways we could manage it,” she said.
Dr Reid commented that, having worked in emergency, delayed diagnosis of women or their non-diagnosis was an impediment to their good health.
He introduced two women doctors who also addressed the forum.
The first was Dr Collette Hourigan who agreed that women “do face particular problems that men don’t”.
“We have to purchase more than men do. Women are the ones who have to purchase the contraceptives,” Dr Hourigan said.
“Then we move into the wild ride of perimenopause and menopause
“I have spoken to a number of doctors who have been shocked as to how it has impacted them.”
Perimenopause symptoms include huge hormonal surges, headaches, breast tenderness, then a sudden fall in hormone levels that can leave you tired, or with hot sweats.
Dr Hourigan calls it a “wild ride” that can go on for two years and then suddenly the “estrogen levels are like falling off a cliff”.
Low levels of estrogen mean serotonin levels can also be low and don’t adjust themselves.
Perimenopause and menopause coincide with a time period in a woman’s life when their kids leave home, there are changes at work and their relationship with their partner also changes.
“The changes are not visible so can be very hard to understand that. Libido goes off the cliff too.
“I think that to actually improve women’s health we have to empower women with information and choices.
“Let’s face it, it is all about quality of life.
“In the old days women used to die fairly soon after they hit menopause and now we’ve got 30 plus years after menopause and we want that to be a quality life.
“Women traditionally look after everyone else in the family and put themselves on the backburner and it is really important women prioritise looking after their health.”
She said it was important to find the right doctor.
Dr Hourigan has also done work on domestic violence. She spoke about the Love Bites school program.
“What we need to do is teach children what a normal relationship is. Unfortunately, on the Central Coast domestic and family violence is extremely high and, once again, it is not something that is talked about.
“I’ve been going around educating general practices so they can get an understanding of what it is like for women,” she said.
On average a GP is seeing five domestic violence women per week but they are not recognizing them.
“You actually have to ask the question because women won’t just turn up and say OK I am in a domestic violence situation. They will come in with a headache,” she said.
Doctors are meant to report domestic violence cases, she said.
Dr Kelly Teagle then shared her personal story as a women’s health care provider.
“The things that lead me to speak with you here today also have to do with the fact that I am a woman, a mother and I have been a recipient of health care many times,” Dr Teagle said.
She said her womanhood rollercoaster ride started in her 20s with problematic periods and never-ending search for contraceptive.
In her 30s Dr Teagle couldn’t fall pregnant and so had many cycles of fertility treatment.
She did fall pregnant and required a c-section.
“I literally was not believed when I was trying to tell people my surgical wound was breaking down, I could feel my stomach sloshing around,” she said, adding, “You can get patronizing doctors of both sexes.
“At the age of 42 as an elderly new mother, started to experience erratic mood swings, night sweats, I put two and two together, and started to think it was menopause.
“I realised it must be very difficult for other women to recognise perimenopause and menopause.
“I was lucky enough to be able to get on the right treatment and that lead me to learn a whole lot more about menopause and treat a whole lot more women about menopause. Women came great distances for my specialist menopause advice.”
That’s when she had the idea of providing the service via telehealth so in 2018 she started to see women with menopause symptoms via telehealth, a service called the Telehealth Menopause Clinic.
“Last year I was diagnosed with breast cancer and unfortunately the hormonal treatment was starting to go into freefall, so I was thrown very abruptly into a second menopause.
“That lead me to learn a whole lot more about non hormonal treatment for menopause symptoms. It is my unique journey but common to women all over the world.
“Do you know what the long term consequences are of menopause and perimenopause? What you have to understand is when estrogen levels decline, the risk of cardiovascular disease, dementia, bone density etc increase.
“One third of women die from dementia, one third from heart disease and strokes, the other third die of everything else.
“I think it is important that as a community we concentrate on the things that are most likely to cause suffering and chronic disease.
“Make sure you get that timely bone density exam, make sure you are doing the right kind of exercise, you can do the balance training to make sure you don’t have a fall.
“We know that one quarter of women over 50 who have a hip fracture will die within the next 12 months.
Assistant Minister McBride added that women in rural and remote areas have a shorter life expectancy than women living in cities.
The audience were then asked for their comments. Points raised included the importance of breast feeding. The risk of death as a consequence of not coping with the symptoms of perimenopause was also raised by the Iris Foundation and the Debbie Norton Foundation.
It was noted that there was no mention of perimenopause or menopause in Lifeline training.
The lack of bulk billing services on the Central Coast for normal checkups, breast scans, ultrasounds etc was also discussed.
Long COVID was mentioned and women were asked if they would see a nurse practitioner if access was easier. The need for funding for a women’s shed movement was also mentioned.
“We do have the women’s health strategy, we have got the advisory council working really hard around these issues. More and more these issues are being discussed and more and more,” Assistant Minister Kearney said.
She noted that over 50 percent of the Albanese caucus were women.
“Watch this space, we are all committed to making sure women’s health issues – it is about raising women up.”
Dr Reid said he wanted to provide a safe space for women to discuss women’s health issues and concerns.
“The Women’s Health Forum was an inclusive, safe space for women to come together with the Assistant Ministers and local health professionals to discuss health issues”, he said.
“The purpose of the forum was to better understand the difficulties being experienced by women and what the Federal Government can do to improve healthcare on the Central Coast.
“The forum was insightful and provided both the Assistant Ministers and I with feedback about how we can improve healthcare and access on the Central Coast.
“I will be ensuring this information is given to the Health Minister, The Hon. Mark Butler MP”, Dr Reid said.
Dr Reid will be hosting further health forums including a men’s health forum.
