Essay Series 4.1: Medical myths hurt women.

For thousands of years, the prevailing approach to women’s health care was to assume that:

1. Women were inferior to men.

1. Their health problems related to their reproductive systems.

1. Their physical symptoms of disease were expressions of emotional problems.

When women finally had a presence in medicine and medical research, the profession began to understand that women’s medical symptoms have biological causes. And treating women with torturous methods began to decline.

Ancient Societies’ Beliefs about Women’s Health

Ancient Greeks believed that men were superior and women defective, except for their ability to birth children. Greeks considered women inferior because their biology supposedly ruled their emotions, intellect, actions, and abilities. Hippocrates, the Greek “father of medicine,” and his followers believed that when women got sick, their uteruses were the cause. Ancient Greek medical theorists said that the uterus wandered throughout a woman’s body, causing health problems. The Romans also believed this.¹⁹⁷

By the 1300s, the wandering uterus theory started giving way to the assumption that women’s diseases could be the mark of the devil. The few medical schools that had trained women in Europe stopped doing so by that time. And doctors took over medicine from the women healers who had experiential knowledge about health practices and birthing babies.¹⁹⁸

The Christian religion added to women’s suffering by asserting that they needed to suffer pain during childbirth. This religion said that women were responsible for humans’ original sin when Eve gave forbidden fruit to Adam, and he ate it (no one forced him to do so). Childbirth pain was God’s punishment for Eve being a temptress. This early religious doctrine became part of the mythology about women trapping men into sinning, following the Devil, and being at fault for all sorts of problems, local and societal.¹⁹⁹

Blaming women for societal, health, and environmental problems became one of the justifications for the European and North American persecution of accused witches. This persecution lasted for centuries until it ended in the 1700s. Among the witch hunters’ targets were women healers and midwives. See Essay Series 2.5 for more information about witch hunts.

The Scientific Revolution

By the late 1600s, scientific revolutions helped European societies begin to discard the wandering uterus and devil theories as causes of women’s diseases. The medical profession adopted the idea that diseases come from natural causes. During the 1700s, hysteria as the cause of women’s diseases started being combined with “nervous disorders.” Women were considered more prone to nervous disorders than men because society assumed that women’s reproductive systems depleted their energy. During the 1800s, the medical profession continued to blame women’s diseases on their moods. The profession believed that only upper-class women had these nervous symptoms because women who were poor couldn’t be emotional and were less likely to feel pain.²⁰⁰

Physicians in the 1800s said that women were weak and could only do domestic work because they were physically, intellectually, and emotionally inferior to men and were sick during their menstrual periods. The medical profession also asserted that educating women would harm their reproductive organs and cause disease. Freud added that women’s diseases come from mental problems that change into physical symptoms.²⁰¹

During the 1800s, medical treatments for women included removing ovaries, burning their cervixes, and bloodletting, including on the vulva. Doctors applied these and other “remedies” to women who were considered mentally unstable or troublesome, masturbated, or were too erotic, among other reasons. It seems that being human could lead to doctors torturing women. In another form of torture, medical professionals treated women’s “hysteria” with enforced bed rest and lack of stimulation or activity for two or more months. This was fashionable starting in the 1860s and lasted through the 1920s.²⁰²

Somatization began taking hold as a theory of women’s disease in the 1920s. This term means that a person interprets her mental distress as medical symptoms or a disease. A new field of medicine arose called psychosomatic medicine. As examples of how off-track this theory was, asthma, ulcers, and hypertension were considered psychosomatic at one point.²⁰³ Among the other diseases that the medical profession believed to be psychosomatic were autoimmune disorders, where a person’s immune system attacks her body. These diseases include thyroid-related Graves disease, rheumatoid arthritis, and ulcerative colitis. Women are much more likely to have autoimmune problems than men as a matter of biology, not mental distress.²⁰⁴

Medical professionals also believed that pain and heavy bleeding were physical symptoms of emotional problems. Eventually, scientists found that endometriosis was often the source of such symptoms. Endometriosis happens when tissue from the uterus grows outside of it. The medical profession has under-diagnosed this disease in Black women.²⁰⁵

By the 1870s, some women were able to become doctors and began fighting the beliefs that women were defective and victims of their emotions. This began a slow turning of the tide toward taking a more rational approach to women’s health problems.²⁰⁶ However, women are still fighting 150 years later to have their medical symptoms taken seriously.

Post-World War II

After World War II, medical providers gained a greater understanding of the fact that women’s health complaints were due to actual diseases, not just emotions. This helped improve medical care for women to some extent.²⁰⁷

However, when women had conditions like chronic severe pain, depression, anxiety, or psychosis, prefrontal lobotomies sometimes were the treatment. A lobotomy is surgery that separates connections between the front part of the brain and the rest of it. People who had lobotomies had serious problems with their thinking and emotions after the surgery. In the 1940s and 1950s, doctors did up to 50,000 lobotomies.²⁰⁸ Most patients who received lobotomies in U.S. psychiatric hospitals between 1949 and 1951 were women.²⁰⁹

While lobotomies decreased over time, in the 1970s, medical students were still hearing the old stereotypes about women’s health. Women students in 41 medical schools responding to a 1973 survey said that their lectures were filled with stereotypes about women, such as hysterical mothers, hypochondriacs, and old ladies that doctors must “manage.” Women’s illnesses were assumed to be psychosomatic until proven otherwise. Medical students almost never heard that men had psychosomatic problems.²¹⁰

Starting in the late 1970s, some research studies began finding that physical diseases were the cause of women’s physical symptoms. However, this knowledge did little to improve general medical approaches to treating women.²¹¹

Somatization disorder was a new disease class in the 1980 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Doctors diagnosed somatization disorder when they decided that a person’s symptoms resulted from psychological problems. The medical profession considered women most likely to have this disorder. In 2013, this disorder received another name, somatic symptom disorder.²¹²

Unequal Treatment in Medicine

Modern medicine has assumed that men are the basic human model, and women’s medical concerns therefore are less important. Medicine has defined women’s needs and conditions in relation to their reproduction, menstruation, and menopause.²¹³

Men shouldn’t be the model because sex differences exist.²¹⁴ For example, autoimmune diseases affect up to eight percent of the population, but women make up about 80 percent of people with this type of disease.²¹⁵

In addition, there are sex differences in the workings of the heart and many other organs, down to the cellular level. For example, women commonly don’t have chest pain when they have a heart attack. And women with depression may respond better to one type of medication, and men to another.²¹⁶

Often, medical professionals don’t take women’s pain seriously. Doctors are more likely to prescribe them tranquilizers and antidepressants than pain medications. Medical professionals are less likely to refer women in pain for further diagnostic tests under certain conditions than they are men. Women often endure pain longer than men before receiving treatment. Medicine often assumes that Black women feel less pain because they are supposed to have “thicker skin and fewer nerve endings.” These assumptions lead to unnecessary delay or missed diagnoses, suffering, and death for women, especially Black women.^217,218

Women are also more likely than men to have their medical symptoms dismissed as stemming from mental health issues. Quite often, women are told they are imagining their symptoms. This contributes to women taking an average of 10 years to get a proper diagnosis of endometriosis in the United States. Women of color in this country are even more likely to face these types of barriers than White women.²¹⁹

Failing to take girls’ and women’s symptoms seriously goes all the way back to infancy. One small study showed that parents were more likely to think that crying boy infants are in discomfort than crying girls.²²⁰

Reflections

The history of women’s health care has several themes. One is that medical professionals have long believed that most women’s health problems relate to their reproductive systems or are due to emotional problems. Another is that men’s bodily systems have been the gold standard by which women’s bodies have been judged.

Finally, myths about women’s health have led to debilitating surgeries, such as removal of sex organs; loss of mental capacity from lobotomies; unnecessary pain due to lack of treatment; missed diagnoses; and prescriptions for medications at levels that harm women instead of helping them.

I dismissed my own health complaints as being psychosomatic when I was a young woman. Some health care providers ignored my pain during the same time period. While doctors of both sexes have dismissed my health concerns, this has happened less frequently over the past 10 to 15 years. I now see doctors, primarily women, who don’t dismiss my symptoms.

What have been your experiences with health care?