Hilary Koch: We need to talk more openly about women’s health

There’s a carrot ad on TV that’s impossible to miss. Educates viewers about a penile condition known as Peyronie’s disease and a drug that can help them.

This isn’t the first ad targeting men’s sexual health, but I’ve never seen one for women. When I think about how we raise boys and young men, conversations about men’s bodies are quite different than women’s bodies.

It is clear that we need to discuss women’s sexual and reproductive health more often and openly.

I had a hysterectomy three weeks ago and the experience was an eye opener. Facing a six to eight week recovery, I joined some online support groups for women who have had (or will have) a hysterectomy. I joined two, both of which have over 35,000 members. All questions are welcome.

Outside the band it’s a different story.

From the time we are young, through puberty, through our reproductive, perimenopausal, and menopausal years, it is taboo to discuss women’s bodies. Of course, we cover the essentials. For example, many women really don’t know much about perimenopause until they experience symptoms so severe that they either seek medical help or compare notes with friends. Pain is something we are taught to expect and tolerate. When our sexual health is discussed, it is done behind closed doors, among best friends.

When women seek medical help, it can be challenging. Because women are taught to be ashamed of their bodies and that pain is just part of being a woman, it’s common to ignore symptoms or put off seeing a doctor. Once inside the office, women report feeling uncomfortable talking about their bodies. And it doesn’t help that women have to fight to be taken seriously.

We know that there is inequality in the medical treatment of women and men. A study published in 1990 showed that when women had the same surgeries as men, they were half as likely to receive pain medication. Why? Because “health care professionals adhere to stereotypes [sic] sees women as emotionally unstable and more likely to exaggerate complaints of pain than men. Ten years later, another study showed that women who had a heart attack were seven times more likely to be misdiagnosed than men, in part because women’s symptoms present differently. Today, heart attacks are still misdiagnosed more often in women than in men.

In my case, I was late at the doctor. It was a combination of the pandemic and waiting for the pain to get so bad before I recognized that something was wrong. Unfortunately, my delay probably made my situation and surgery more complicated.

The people at Eastern Maine Medical Center were great and so was my doctor. But my uterus wasn’t playing nice. My robotic laparoscopic hysterectomy turned into abdominal surgery and I lost too much blood. I also lost an ovary. They only kept me one night though. Three days later I ended up in the emergency room.

My surgeon hadn’t done anything wrong, but complications do happen. However, based on what I’ve learned from my support groups, they are surprisingly common. And I’m sure a lot could have been avoided if women hadn’t been taken out of hospitals so quickly.

Additionally, women in my groups reported difficulty reaching their providers in a timely manner. Their problems range from excruciating pain, to vaginal cuff tears, to internal bleeding. These are women who may not have a license to drive and may not have someone at home to help them. Within minutes, they have their questions answered by their colleagues. For serious medical questions, the answer is often “Call your doctor” or “Please go to the emergency room as soon as possible.” Others just want to know if vaginal estrogen is as good as they’ve heard. And women need answers to questions that are not addressed in our release documents – because apparently doctors think that sex is limited to intercourse.

For my recovery, I was told not to bend, squat, or lift more than five pounds for six weeks. I have never known such exhaustion in my life. I could sleep for the whole six weeks. And I am privileged to have a family that can take care of me.

But I know most women aren’t as lucky as I am. I’ve seen pictures of them moving their lounge chairs closer to the bathroom or stable food stashes because they have to bravely recover on their own.

This doesn’t even begin to address the devastating emotional consequences of a hysterectomy. I felt relatively prepared. Yet I will admit that I still had a hard time coming to terms with the loss of a body part that had shaped so much of my existence. I have no doubt that I will be fine. Yet we often send women home on the same day of this life-changing operation without providing them with any of the mental health support that should be automatic.

This is how pelvic floor therapy should be. Wait! don’t tell me you’ve never heard of it? You are not alone. Let’s talk about it!

Hilary Koch lives in Waterville. She can be found at: [email protected]


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