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Breaking the taboo

Women's issues, including menopause and endometriosis, are becoming subjects discussed by mainstream media, but more needs to be done to raise awareness. Words by Harriet Rouse

Menopause. Endometriosis. Miscarriage. Infertility. All these hush-hush subjects that have been whispered about for generations are finally – finally - becoming subjects that are talked about regularly by mainstream media. Women are starting to talk more and – perhaps more importantly – talk louder.

From Davina McCall's 'Sex, Myths and the Menopause', to Caitlin Moran's 'More Than a Woman' and Kristen Scott Thomas's wonderful speech in Fleabag (worth a google if you've not seen it), suddenly women are openly talking about their symptoms and seeking answers and solutions. The last decade has seen a tangible movement towards talking about problems that have previously been off-limits. And thank goodness. It's about time.

Throughout medical history, the default for data has been The Average Man. From height to weight, everything from Crash Test Dummies to the data on heart attack symptoms to the size of your mobile phone (yup, men's hands, which explains why some of the larger phone models need a two-handed approach from women) has drawn on data that has been based on the male default. Caroline Crido Perez, in her book 'Invisible Women', explores this incredibly well, touching on so many aspects of our everyday life – and medical treatments – that simply do not consider how women are different from men.

However, female fertility, menopause, and chronic conditions such as endometriosis have always been largely ignored or talked about in hushed tones are uniquely female issues. So often, our symptoms are very much thought of as something that we need to suffer through in silence. The assumption that we moan too much about our pain, that we should accept period pains are just part of life. And heavy flow?! That's not something we need to talk about! And don't bring up clots, anaemia, debilitating pain or anything very much associated with periods. As for fertility, it's so easy to ignore it when a friend has a fertility issue, lest they actually talk to you about the challenging and emotional journey that they may be enduring. But sometimes it's OK to ask someone how they really are. And to listen to what they are experiencing. We might have been told that people don't need to hear the details, but perhaps sometimes we do so that we can all start to understand and support our friends, family and colleagues more openly.

"So often, our symptoms are very much thought of as something that we need to suffer through in silence."

Things are beginning to change. Perhaps because our generation has so many strong female voices to represent them, not just a front for what we are supposed to be. Maybe we are the first generation of women with immediate access to so many other women through social media. There has also been a seismic shift in the last fifty years, resulting in many more female doctors who can at least empathise with the symptoms that we have. Instead of accepting the brain fog and hot flushes as something we should get on with, or the monthly agony, or the desperate sadness of infertility, we are looking for answers. Instead of shutting up about it, we are looking for answers, they are looking for solutions, and we aren't accepting 'it's just part of life' as an answer for symptoms that not only impact day to day life but can put a tangible constraint on living it.

Endometriosis, a condition in which the lining grows outside of the womb, is another such subject that is finally entering the headlines. See, it turns out painful, heavy periods are not necessarily just 'part of life'; there is sometimes an underlying cause. Whilst diagnosis is still taking far too long (with far too few specialists for what is a highly specialised condition), it turns out there are loads of sufferers out there – and we are starting to talk.

Journalist Ria Wolstenholme has worked tirelessly to increase awareness of endometriosis. As she says, "growing up in a dominant female family meant next to nothing was off the table when it came to open honest discussion. So, for me, the taboo surrounding talking about women's health was alien to me until I first got told I "didn't need to go into detail" when discussing my endometriosis with a man for the first time. The idea that if your health issue is linked to your reproductive organs makes it a conversation only fit for the ears of other women or a health professional is exactly why so many women suffer in silence. Having endometriosis means I've had to get comfortable talking openly about my periods, pains and intimate details about my private life to doctors, friends and family alike. If I don't, then nobody would know what I'm going through. If I didn't speak up, nobody would be able to do it for me. And I hope that the more is done to stop trivialising and undermining women's health, the better we all get at speaking honestly and openly about what we're going through."

That women's health issues have been whispered about rather than openly discussed previously isn't entirely surprising. My Grannie remarked of my miscarriage that it was 'no doubt for the best, not out of cold-heartedness, but because that's what she'd told herself when she'd had one several decades earlier. When I asked a friend in their sixties for their experience of menopause, she said that it was very hard to explain symptoms of menopause to a male GP, or for a male Consultant to understand the difference between standard cramps and ones that were something to worry about.

Women only learned by talking to other women, and so much of it was deemed taboo. Even now, 'period chat' isn't one that you see many women entirely comfortable discussing.

"We need to create dialogue around the conversations that make women and men uncomfortable."

We need to keep talking, and we need to keep talking loudly. We need to create dialogue around the conversations that make women and men uncomfortable. If we talk about it, they'll start to not be things that people are uncomfortable hearing about.

We need to normalise miscarriage and baby loss; we need people to talk openly about fertility struggles and chronic debilitating conditions. We absolutely need to talk more about perimenopause, menopause, and the havoc that fluctuating hormones can play, because it's not something that we have to just put up with anymore. There are beginning to be viable alternatives to suffering in silence, and the scare stories surrounding HRT are being largely debunked. Thousands of women are realising that there is an answer… and even if it's not quite the answer they were looking for, they are not alone; they are certainly not going mad. Above all, though, we must always be honest with each other. The more we talk about these things, the more normalised they become.

The less we feel embarrassment or shame, and the more we understand what other people may be going through, we can strive forward in progressive treatments and medications that work. And, perhaps most importantly, we can cease to associate any sort of shame with not coping with symptoms. There is no shame. Half the population are there with you.


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