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Image: Archi Banal
Image: Archi Banal

OPINIONSocietyApril 17, 2023

Why is the language of women’s health so aggressive?

Image: Archi Banal
Image: Archi Banal

‘Incompetent’, ‘geriatric’, ‘atrophied’… Ageing as a woman means being defined by the bluntest of descriptors, writes Amber Older.

“When was your last period?”

The question comes from the other side of the curtain as I strip from the waist down and climb onto the examination table. “It must have been…13 months ago,” I reply, as my doctor draws back the curtain and approaches the business end of the table. She holds a shiny silver speculum in her right hand. “Congratulations – you’ve made it through menopause. How has it been for you?”

“A total breeze,” I reply smugly, silently pitying those women who say their lives are upended by “the change”.

“A couple of hot flushes and – OW!!” The speculum, usually a benign instrument, has morphed into a malevolent shaft of broken glass wrapped in barbed wire. “I’m sorry,” says my doctor. “Exams like this can be challenging after menopause. Your vagina has atrophied.”

Atrophied? My vagina has atrophied? Atrophied – as in “wasted away”? Until this moment, I’ve always attributed this state of decay to the v-e-ry old, the v-e-ry infirm…and the v-e-r-y dead. Certainly nothing to do with my most vital female bits. 

I leave the office with a prescription for oestrogen suppositories (“insert one twice a week and see how it feels during sex”) and a monsoon of bad medical memories. Suddenly, it’s 12 years earlier and I’m in a different doctor’s office, breathlessly sharing the news that I’m up the duff. Having got pregnant quickly and easily in my late 30s, I am over the moon. 

I am also, my doctor informs me, a “geriatric pregnancy”. I can still feel my bubble of Yay-I’m-knocked-up joy breaking like the proverbial waters. For the next 39 weeks I live in fear about my developing baby, and I’m wracked with guilt about my own stupidity: How could I, by medical definition an old woman, bring a healthy babe into the world? 

Turns out, I could, and I did.

I recall another diagnosis, just a couple years ago, when a deep black-and-blue bruise mysteriously appeared on my lower left leg. A third doctor solves the mystery. “You have incompetent veins,” he declares. Translation: If the muscles and one-way valves become weak or fail, the vein becomes incompetent, and blood begins to collect in the vein rather than returning to the heart.

They might not be perfect, but surely “incompetent” is an overreach when describing my hard-working blood vessels? They’ve been right there with me as I crawled and toddled as a baby, hurdled and danced as a teen, walked kilometres around foreign cities, and strolled empty Aotearoa beaches. I leave the office as deflated as my veins. I’m convinced I’ll never safely hike, bike, dance or take long-haul flights again.

I also leave deep in thought, reflecting on the power of words when it comes to women’s health. 

Atrophied. Geriatric. Incompetent. Is it just me, or are there more to these labels than damning diagnoses of damsels in medical distress? I can only imagine the howls of outrage if men were labelled with comparable conditions. 

“The tests are conclusive, sir – your scrotum is atrophied.”

“You’ll have a hard time becoming a father with these geriatric sperm.”

“Take this little blue pill – it’ll help with your incompetent penis.”

The medical fraternity (and all its mighty – ahem – members) would rise up like a prized appendage and demand an end to this negative nomenclature.

In contrast, we women tend to take these diagnoses to heart, allowing clinical conditions to define not only our body parts, but to fill our minds with self-doubt (What do I know about having a baby at 40?), self-sabotage (sex after menopause is going to hurt – why would I even go there?), and self-loathing (I hate you, body, for letting me down!).

It’s not a new phenomenon, of course – women have been excluded from or excoriated by the male-dominated medical world for centuries. When I Google “male dominated medical world and women’s health”, a slew of answers appears: “The female problem: how male bias in medical trials ruined women’s health” (The Guardian), “The long history of gender bias in medicine” (Time magazine), “Women’s health ‘missing out’ because of male-dominated investment” (Financial Times). 

Last week, I returned to the doctor’s office for my annual exam.

This time, however, I was speculum-ready. I’ve taken a year’s worth of oestrogen “bullets”, so it should be smooth travels for that malevolent probe. “Remind me where you are on the menopause journey,” says my doctor as she gently inserts the cold metal.

I hold my breath, anticipating a shock of pain. Nothing. It doesn’t hurt. Hallelujah. Slowly, I begin to exhale. “It’s been two years since my last period. What’s happening down there?”

“You’re doing great, the oestrogen is working. Everything looks pristine.”

Pristine – as in “clean and fresh; spotless”.

This time, I leave the doctor’s office rejoicing.

Despite my geriatric womb, as blood flows through my incompetent veins, I have cheated the jaws of atrophy.

Like a phoenix rising from the ashes, I’m 100% resurrected, restored, and ready to fly.

Keep going!