Report finds taboos in women’s health can limit access to knowledge and care

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Health Matters February 1: A new Heart and Stroke report highlights the health care inequities when it comes to women's heart and brain health. And a new Alberta survey shows the majority of respondents did not feel comfortable talking to their doctor about gynecological and reproductive concerns. Katherine Ward and Su-Ling Goh report. – Feb 1, 2023

Taboos around menopause, periods and conditions like endometriosis can limit access to knowledge and care, says a report by the Alberta Women’s Health Foundation.

The report, “Surveying the Silence: Exploring the Taboos in Women’s Health,” polled more than 2,200 Albertans who identify as women to understand their top health issues, concerns and experiences.

“Taboos are social customs restricting discussion on specific topics,” Sharlene Rutherford, president and CEO of the foundation, said during a news conference about the report Wednesday.

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“They create a culture of silence, it limits access to knowledge and care, and taboos can harm an individual’s health, an individual’s mental health and their well-being.

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“Taboos perpetuate discrimination, they perpetuate negative stereotypes, they can be isolating and they can contribute to inequities.”

Survey respondents reported an average of five pelvic health issues, including painful periods, pelvic floor dysfunction and regular yeast infections.

About two-thirds found it difficult to talk to their primary health-care providers about their concerns and only a quarter felt “very knowledgeable” about their gynecological and reproductive health.

The survey also found delays in treatment were common, with 85 per cent of women who had a more complicated diagnosis, such as endometriosis, reporting a wait for care.

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Kristina Jarvis, 40, said she was diagnosed with polycystic ovary syndrome — a condition in which a woman has increased levels of male hormones — at the age of 29.

“The first symptom … was actually hair loss around the age of 14 or 15,” she said. “My mom suggested it was probably due to stress.”

Jarvis said she then started having irregular periods and a doctor also suggested it could be stress.

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She had hormone tests in her late 20s that led to the diagnosis, but she was told she didn’t need to worry about treatment until she wanted to get pregnant.

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“I took the doctor at face value,” said Jarvis.

It wasn’t until she was 33 or 34 that she learned there could be other side-effects, including high blood pressure, insulin resistance and a higher chance of cancer.

“There is a disturbing lack of knowledge and care from many, but not all (general practitioners) and doctors,” she said.

“Doctors are definitely the experts, but we also need to be able to push back a bit when we think there is something to be looked at.

A patient going through perimenopause told the survey it adds “worry and stress because you don’t know what to expect and if strange new symptoms are indicative of something serious.”

Another woman, who experiences painful periods, said people often think she’s being dramatic when she needs to stay in bed.

Dr. Jane Schulz, chair of the department of obstetrics and gynecology at the University of Alberta’s faculty of medicine, said the survey responses resonated with her.

“It certainly is a taboo topic,” said Schulz, also a urogynecologist at the Lois Hole Hospital for Women in Edmonton.

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“I am really excited with the release of this publication in terms of breaking barriers and stigma of women’s health.”

Keeping women’s health issues taboo, said the report, plays a role in the disparity of care and lack of research on the topics.

Dr. Sandra Davidge, executive director of the Women and Children’s Health Research Institute, said the report provides critical insight into many issues affecting women’s health.

“Research with a specific focus on women’s health has been neglected far too long,” she said. “Right now, less than 10 per cent of federal funding from Canadian health research funding is dedicated to women’s health.”

Davidge said, however, that funding from the Alberta Women’s Health Foundation has led to important research that helps women.

“Research is a continuous cycle where knowledge moves from the laboratory to the bedside to the community and back, and we can see with this report that there are gaps in that,” she said.

“This report does provide that ample evidence of the culture of silence around some of the women’s health issues.”

As an example, Davidge said menopause affects 50 per cent of the population — people with uteruses — but there’s a gap in both care and research in the area.

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Some researchers, she said, are currently working to overcome the stigma associated with menopause by supporting women who have severe symptoms.

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