It has been over two months since the Advertising Standards Authority for Ireland (ASAI) received 150 complaints about the Tampax ad demonstrating how to insert a tampon, with 83% of complaints surprisingly coming from women. The complaints in one form or another illustrate the national shame Irish women have about periods. Understandably, the crimson wave is a private subject for some women who might not openly talk about it with their friends or family, but suppressing conversations about something that is often regular and normal for many women creates shame, embarrassment and misunderstandings about the inner workings of their own bodies. Some complainants argued that male issues concerning private areas would not be handled in the same way, but there simply isn’t a comparable issue for cisgender men. They will never experience the bittersweet monthly arrival of their aunt Flo.
“Polycystic ovary syndrome (PCOS) and endometriosis are thought to be very common; 1 in 10 women in the UK are thought to suffer with these conditions. That’s just as common as the amount of women who suffer with diabetes.”
The ASAI only upheld complaints of general offence, but it is important to recognise that the angry and quick dismissal of women’s routine reproductive pain is also a dismissal of women’s reproductive health in general. Discussion about periods amongst women is extremely important, as it allows each woman to distinguish the normal from the abnormal and encourages women to seek help from a GP if there is a problem. The reality is that there are women who struggle with their reproductive health, and there are more of them than one might think. Polycystic ovary syndrome (PCOS) and endometriosis are very common; 1 in 10 women in the UK are thought to suffer with these conditions. That’s just as common as the amount of women who suffer from diabetes. The lack of definitive testing for PCOS and endometriosis can make diagnosis very difficult, with the causes of both remaining unknown, and symptoms varying widely from irregular and missed periods to excruciating pain and difficulty losing weight. But of course, they are only the symptoms. The long term consequences can be more serious, potentially leading to infertility, obstructive sleep apnoea, and endometrial cancer. It is estimated that it can take up to seven years to get a conclusive diagnosis of endometriosis. There is no representation of either condition in the media, we are not educated about them in school, and there is not a huge amount of reliable information about these conditions or how one can potentially cure or manage them.
“Aristotle once characterised the female as a mutilated male, and if you take a glance at medical research within the last 70 years, you’ll notice that the research largely perpetuates this idea.”
When people are so quick to dismiss periods, and reproductive health more generally, it has much larger repercussions on the discussion around women’s health. The lack of knowledge and awareness obstructs women’s ownership over their health. This is reflected by the fact that there is no collective charity or organisation for endometriosis, PCOS or women’s reproductive health in Ireland. Furthermore, collective statistics of PCOS, endometriosis and women’s general health that might offer support to Irish women aren’t anywhere to be found. If anything, the ban of the tampon ad captures the culture of silence surrounding women’s reproductive health. The role the ad could have played in sparking discussion around menstruation and women’s health in the mainstream media, and enabling it to become a social norm within conversation has been lost. This is now improbable, and the ad’s removal is just another peculiarity of 2020 which will probably feature on Reeling in the Years.
“70% of women suffer from chronic pain, and yet 80% of pain medication has been tested on men.”
This disregard for women’s health has been perpetuated by medical bias in favour of cisgender men in clinical trials. This is especially prevalent for exploration and testing of research into women’s health. Aristotle characterised the female as a mutilated male, and if you take a glance at medical research within the last 70 years, you’ll notice that this idea is commonly perpetuated. Healthcare systems and relevant research have been carried out by men, and often fashioned with only cisgender men in mind. In fact, it was not until the early 90s that women were included in early stage drug trials by the Food and Drug Administration and the National Institutes of Health. Before then, all women were excluded from trials and it was considered that testing on women posed a danger to their ability to conceive and carry children because women are born with a finite amount of eggs. This is compared to men who normally produce millions of sperm within a lifetime. Not only did this consideration reduce women to vessels and baby making machines, but it also completely undermined any concern for how the drugs being tested would affect women’s health. It’s not just females of humankind that have been an inconvenience to clinical trials; female rodents have also been excluded from trials as the hormones produced throughout their menstrual cycle throw too many variables into research studies, potentially corrupting the outcomes. The stark reality is that women are unquestionably excluded in all consideration of clinical and drug trials. This is unbelievable considering that 70% of women suffer from chronic pain, and yet 80% of pain medication has been tested on men.
You might think that the mandate to include women in clinical trials is a positive step towards protecting and promoting women’s health, but in reality it’s just a meaningless one, as researchers don’t necessarily analyse the results of their studies by sex or gender. Either that or researchers tend to remain focused on male cells and animals in preclinical trials. It really is quite disturbing just how much women have been overlooked in the realm of medical research. In fact, medicine students are not even taught about the bias discussed above, or the fact that most things we know about human anatomy are in fact specific to men. Any effort to study female anatomy usually relates to obstetrics. The lack of research surrounding this means that conditions often present themselves differently in women leading to them being overlooked or misdiagnosed, under researched and misunderstood. This is significant; there is five times more research into male erectile dysfunction which affects 19% of men than women’s reproductive health which affects 90% of women. Less than 2.5% of publicly funded research is focused on reproductive health, despite the fact that one in three women will encounter a gynaecological problem once in their lifetime. It’s because of this that women are too often misdiagnosed with alternative conditions other than endometriosis and PCOS. It is these misdiagnoses that too often result in women being treated as reproductive vessels with hysterical tendencies and mental health conditions when in fact they have a reproductive condition that’s not fully understood and has yet to be thoroughly investigated and researched.
Trinity pride themselves in having pioneered research for so many diseases. Now it’s time to step up for reproductive research and women’s health. The success of research funding is often based upon the competitive nature of the area of research someone is looking to advance in. It’s unsurprising that women’s reproductive health is not one of these competitive areas, but if anything, it should only motivate researchers to push for more for funding for studies. If it’s not a feasible role for Trinity to play in pioneering research for women’s reproductive health, the College Health Service and GP should at least be committed to raising awareness about premenstrual conditions that affect 90% of women. Considering that PCOS and endometriosis only show up years after initial symptoms show up, they should also be committed to raising awareness about the indicators of both of these conditions so women are able to identify and track them in the future. Failing this, Trinity should at least draw attention to the fact that there is no existing charity or grant-giving bodies, such as Wellbeing Women in the UK, that raise awareness of collective reproductive issues for women in Ireland. But no more can women’s health be overlooked, underrepresented and understudied. This is not a conversation that can be suppressed any longer.