Introduction
I am 72 years old. I have a wonderful husband, three beautiful daughters and seven fabulous grandkids. For much of my career I have either run my own business or co-directed businesses as well as completing various degrees. These days, I chair a company, participate in an active transport advocacy group, sing in a choir, paint, attend poetry appreciation sessions, concerts, plays and films, frequently travel interstate and internationally, and generally enjoy my life. I am relatively fit in that I regularly exercise by swimming, walking, attending a gym and riding my bike.
However, from 1994 to 1997 my quality of life was significantly diminished because of my failing uterus.
I believe that the series of events that led to the ultimate removal of my uterus in early September 1997 were probably not unusual. When I first wrote about my experiences just after the hysterectomy, I was angry at the way I had been treated but also disappointed and flabbergasted at my own role in the experience. But life was too busy and so I never did anything more than document my frustrations.
And today, perhaps women feel more empowered and confident to gain the care that they need to maintain their gynaecological health, and hopefully clinicians are far more respectful of those needs than I think they were 30 years ago. Nevertheless, I am sharing my story as a reminder to women of my daughters’ and grand daughters’ generations of the importance of standing your ground and making sure that you get the clinical care that you need in order to live a healthy life.
While the last three years of my relationship with my uterus were not pleasant, this piece focuses on a series of events that occurred during the twelve months that led up to and culminated in me having a hysterectomy in September 1997. In writing about this time of my life, I would like to stress that my intention is not to blame but to encourage a more balanced understanding of the issues surrounding the advice given by doctors, and decisions made by women, in determining how to best deal with this aspect of their health.
Background
I always had very regular and I think comparatively heavy periods, generally lasting between six and seven days. From the age of 17 through to when I was about 41, except for when I was pregnant, I was on some form of oral contraception. Initially, the pill was prescribed by the family GP to help reduce period pain and what my mum thought was heavy blood loss. When I turned 41, I decided that I had had enough of the pill – probably because it dawned on me that I had been on it for a very long time and was unsure about its long-term effects on my body. After that, each period became increasingly unignorable – being occasioned by heavier blood loss and more pain.
The Events
October 1996
I visited my GP for a regular check-up including a pap smear test a couple of weeks before leaving for a business trip to India. The GP picked up a polyp on the cervix and organised an appointment with a gynaecologist in the next few days. The polyp was removed and proved to be harmless. The gynaecologist nevertheless suggested an ultrasound would be a good idea just to make sure that there were no other problems with my uterus.
November 1996
On my return from India, I had the ultrasound, and after another two weeks, having not heard from the gynaecologist, I contacted his surgery to get the results. The receptionist told me that the ultrasound showed a fibroid and another polyp in the uterus. Wanting to understand these results, I asked if I could either speak over the phone with or organise a consultation with the gynaecologist. The receptionist queried my request, asking me why I would need to talk with him. I told her that I would like to understand the implications of the ultrasound results: what they actually meant. I pressed her again and she reluctantly had the gynaecologist speak with me on the phone. He told me that there was really no problem, that there was no need to see him unless I’d like to, perhaps in another three to six months. So, I followed his advice.
December 1996
Blood on the grey velcro of the car seat cover looked shockingly red – especially in the presence of my 20-year-old nephew who politely pretended to not see it.
Early January 1997
By my calculation my period was due on the weekend that I was supposed to be in Perth for my brother’s wedding. I decided that I couldn’t handle the hassles of bleeding on my mother’s sheets or risking waking her with my frequent visits to the toilet throughout the night, so I booked into a hotel, much to the chagrin of my family and in particular, my mother. As it turned out, it was a good decision. The period was a ripper and lasted ten days. Thank goodness for the relative anonymity of hotels.
30th January 1997
Within minutes of the beginning of an all-day meeting in Sydney with an interstate client, I bled suddenly and very heavily. Fortunately, the purple jacket was long enough and the purple trousers dark enough to camouflage the stain on my trousers, which no amount of protection could have prevented. However, it was difficult to camouflage my embarrassment at having to slip out of the meeting hourly to sort myself out. This is not the first time this had happened.
My colleague with whom I had worked for nearly three years, told me that every month my frequent departures from meetings must have been very obvious to our clients, most of whom happened to be men. Every month over the previous three or so years had been marked by some similarly awkward or embarrassing event, like the time I walked the streets of Hobart early in the morning trying to find an open shop because I had gone though a pack of tampons and sanitary pads over night. Stuffed with wads of toilet paper, I made my way to the office at 8.30 am and sought the assistance of my female client who lent me a government car, which I drove around Hobart to locate a pharmacy.
Every month was the same. No amount of sanitary protection could stop me bleeding on the sheets, or ruining my clothes, or leaving stains on seats. Nothing would absorb clots. I wondered whether this what it was like for other women my age? Did the gynaecologists really believe that this was a normal loss. I kept picturing a thimble and recall once being told that most women lose no more than a thimble full, but I couldn’t see how a thimble could possibly hold what I would regularly lose.
February 1997
Without any trouble I walked the Milford Sound, a three-day, 55-kilometre hike through some fairly rugged terrain. In the six weeks leading up to the hike I trained every week and took a daily dose of the iron and folic acid supplement Fefol to manage my low iron level. However, if my period had fallen during the time that I was to go on the walk I would not have been able to do it. Apart from the inconvenience and embarrassment, there would not have been enough room for all my sanitary requirements in the little backpacks we carried.
March 1997
I took one of my daughters to Sydney. By the time I had reached Newtown, I was in trouble. Thank goodness for McDonalds. The loo was clean, but it felt so damned uncomfortable placing clean sanitary gear on blood saturated underclothing and denim.
March/April 1997
I received a letter from an insurance company rejecting my application for an income protection policy. My broker had tried to get me a better policy than the one I already had. The reason for the rejection was that the gynaecologist had written that a hysterectomy was imminent. This information shocked me. Had the gynaecologist withheld some information from me about my health? How did his report to the insurance company fit with his comments to me that I had no problem; that my heavy periods were normal; that the fibroid was very common and nothing to worry about or to take action on; that there was no need to see him – unless I’d like to. Never once had the possibility of a hysterectomy been discussed with me.
To seek a clarification, I went to see him. With eyes focused on papers that he was shuffling on his desk, he clearly demonstrated his confusion about who I was, why I had ever come to see him, and which report he had written. After a quick scan of the paperwork from the insurance company he apologised by saying that he didn’t realise that the insurance policy being sought was an income protection policy. He thought it was for life insurance. I still don’t really see the difference.
I later realise that I left his surgery without having found any real answers about my health. I think that what he told me was that I was all right: that eventually I might want to consider alternatives to a hysterectomy, but that at the moment I was all right. Nevertheless, this new advice was still quite different from what he had told me when I spoke to him on the phone in November, and not the same as his recommendation to the insurance company.
In retrospect I find my lack of assertiveness with this gentleman about his report to the insurance company puzzling. All I can put it down to is that I did not want to embarrass him or cause a fuss. More importantly, however, I recall being amazed at the fact that I walked out of his consulting room, having failed to reconcile his dismissal of the results of the ultrasound test with his report to the insurance company.
Mid-April 1997
I went to my GP to discuss options for contraception. I did not want to go back on the pill, but I was sick of using condoms. She suggested I could try a three-month injection that might also stop my periods. At the same time, however, she suggested that the bleeding might not stop completely because of the fibroid. Realising that I was again going to Perth, this time for my mother’s 70th birthday, I decided to have the injection.
That I was period-free for the 20th April when I was with my family in Perth was good news. However, by the 22nd April I had developed abdominal heaviness and pain (which basically stayed with me until I had the hysterectomy), and I resumed bleeding on 27th April.
At this stage I was becoming aware that even though I was taking Fefol, my iron level was falling. Some familiar symptoms were returning. I was becoming increasingly breathless, and my legs were going into spasms when I sat or lay down. Nevertheless, I tried to be patient about the bleeding, thinking that, as the gynaecologist had suggested, it was likely to abate after a while. I recall him saying this as if it was not a problem, not a huge deal, and nothing to concern myself about – when I had gone to see him about the insurance report.
Mid-June 1997
Feeling frustrated at the fact that the bleeding had not stopped, I visited my GP who suggested that a hysterectomy was really my best option. With this advice I organised a visit to another gynaecologist to organise a date for the operation.
I recall the gynaecologist asking me why I wanted a hysterectomy. I said that I had had enough of uncontrollably heavy periods and two and half months of continuous bleeding. I remember rationalising at the time that the reason he showed me no reaction to the fact that I had been bleeding for so long, was that he had heard the story hundreds of times before; that therefore there was nothing unusual or untoward about my condition. I recall concluding that perhaps I was making a fuss about something that was not much more than a social nuisance.
A discussion with him six weeks after the operation threw some light on his reaction. According to him, women’s estimation of their own menstrual loss varies greatly, and sometimes is significantly at odds with reality: typically, he said, women believe that they have heavy periods.
To his credit he explained all the risks of surgery, allowing me the opportunity to make my decision in the light of all the facts. It seemed to me that from his perspective I was making a lifestyle decision that would eradicate a problem that had been a nuisance. According to this gynaecologist, after all, 40 % of women have a hysterectomy. Hearing this information made me feel like a fake. But, having come this far I decided to book in for surgery at the end of July.
Understandably, I became disappointed when my husband Steve asked me to change the date because he would be overseas and wanted to be at home – just in case something went wrong. We both accepted the change of plans as a nuisance, not thinking for a moment that waiting another four months would really make much difference to my health.
August 4 – 10 1997
I travelled to Sydney for an important meeting with a prospective client who had brought together his management team to meet me. The trip was accompanied by uncomfortable pain in both my bowel and my uterus. As I stepped out of the car at Central Station, blood exploded from my body and splashed onto the bitumen. No amount of plugging and sandbagging could have prevented the flood from breaking. I made my way across Pitt Street and into the building where I was to meet my clients. With only ten minutes to spare I raced into a toilet where I counted six clots as they fell into the toilet bowl. I then used toilet paper, tissues and spit to clean myself up before meeting my clients.
Having haemorrhaged only minutes earlier, the situation seemed almost surreal as I participated in apparently – hopefully – intelligent dialogue about the organisation’s need to bring about change and how my company might be able to help them to do so. Internally, I laughed at my cheek.
After this episode, I decided that perhaps I shouldn’t have to tolerate so much bleeding and so asked my GP for some help. She put me on a program of Primolum: three a day for three days, two a day for three days and then one a day for three days.
August 11 – 15 1997
I worked in Melbourne conducting wall-to-wall seminars for the whole week. Steve was worried, but I assured him that I would be OK: that the Primolum had started to work, making my bleeding still heavy but manageable.
Friday 15th – Sunday 17th August 1997
Conveniently my body behaved well while I was in Melbourne and I only started to bleed heavily again when I made it back home to Wollongong. A change of sheets, pyjamas, eight or nine trips to the toilet: I just let it flow away. Clots, bleeding, overnight pads and super tampons, don’t leave much time for sleep. All weekend I felt weak, with any physical exertion being hard work.
Monday 18th August 1997
Early on Monday morning before leaving for Sydney to catch a flight to the Nhulunbuy in the Northern Territory, I made a frantic trip to my GP. The weekend had been terrible. I bled very heavily. The doctor gave me a new prescription of Primolum, advising me to maintain the dose at three per day. Suspecting that my haemoglobin level might be very low, she also prescribed two additional iron tablets per day and persuaded me to have a blood test before leaving for the airport.
Wednesday 20th August 1997
By this time the increased Primolum dosage had proved moderately effective: my bleeding had subsided to a level that had been familiar over the last few months (32 super tampons and about 15 overnight pads over about 7 days), complete with fist size clots.
On Wednesday morning work didn’t start until just before 9am, so I went for a walk through the back streets of Nhulunbuy. Regular exercise is an important part of my life and so one of the frustrating aspects of my physical condition during this time was that while sometimes I could do anything I wanted to, on other occasions I would really have to push myself. At the same time, once started, strenuous exercise tended to make me feel good. But on this Wednesday morning I was a bit concerned because it was difficult to pick up any speed without my legs feeling like lead and my heart palpitating. In hindsight it is easy to understand why this was happening with less than a full quota of blood. However, the symptoms were always confusing.
On that particular day I was struggling to walk at my normal pace, but only four days earlier I had swum a kilometre with ease. So, I found my experiences on that Wednesday a little frightening. Was it because I was carrying too much weight? Was there something wrong with my heart? (Two years earlier a check–up with a heart specialist for similar symptoms suggested I was OK.) I couldn’t understand how I could keep going with a challenging workload – sometimes 12 or 13 hours a day, complete a strenuous circuit at the gym but still feel breathless when I walked up stairs, or frequently wanted to just drop to the floor with weakness.
The results of the blood test showed that my iron level was normal but red cells and haemoglobin levels were both below minimum levels. The doctor’s advice was that I continue to take the iron tablets and then have another blood test in a month.
A walk the next day along the coast of the Arafura Sea felt better, so I picked up the pace and did a few sit ups and push ups. I felt refreshed afterwards, but the iron tablets didn’t take long to exacerbate my troublesome haemorrhoids, so I gave the tablets up because the pain was too much.
Friday 22nd August 1997
At Cairns Airport carrying a briefcase, my laptop and a shoulder bag – stop start, stop-start up the walkway to the plane tested my strength. I was aware that I was stretching the friendship with my body by lifting my gear into an overhead locker. Heart palpitating, legs aching, I fell into my seat, only to be told by another passenger that I was in the wrong seat. A double-booking meant that I had to stand and wait for a flight attendant to find me another seat. Seconds later I fainted. I felt embarrassed, and a bit of a fake or prima donna. From another perspective, it was a rather dramatic way of getting an upgrade to business class.
By the time I had reached Sydney, I was feeling particularly tired and weak. Another delay at the Thrifty counter at Sydney Airport had me waiting for a car to become available. Standing was too strenuous, so I sat on my luggage.
Having driven into the city centre, I had a two-hour wait for two of my daughters Domenique and Bronwyn who I was meeting for my third daughter Tessa’s Rock Eisteddfod grand final. The night was just great, but of marathon length. The eisteddfod finished at around midnight, and locating Tessa was chaotic and not to be achieved quickly among the thousands of excited kids there. Domenique and Bronwyn laughed at me for lying on a bench outside the Entertainment Centre. I was just too tired and weak to stand or sit. I must have looked a tad silly, but I was trying to save some energy for the drive back to Wollongong, which we reached at about 2.00 am.
Monday 25 – Friday 29 August 1997
For these days the bleeding was tolerable, with the Primolum[1] apparently doing its work. By this I mean my blood loss was about as heavy as a pretty heavy period – one that I had become accustomed to experiencing for the previous three years.
By Friday night the haemorrhoids had at last subsided; however, the bleeding picked up its pace. I counted 8 trips to the toilet throughout the night.
Friday 29 August 1997
During the day in Melbourne, I needed to rush off to the toilet probably every hour and a half to change my usual sanitary protection of a super tampon and an overnight sanitary pad. This was OK. I never thought about it; It was just a normal part of my routine that had been with me for the previous four months, day in day out. The 3 Primolum seemed to be working – I suppose this is what is meant by working. I was aware that my key preoccupation on this day was with painful haemorrhoids that had kept me out of bed most nights while in Melbourne. I surmised that the constant bleeding was just too much for my troublesome haemorrhoids, no matter how much Scheriproct ointment I used every day.
Saturday 30 August 1997
Heavy bleeding. By heavy I mean going through 16 super tampons and a packet of 10 overnighters.
Sunday 31 August 1997
When I collapsed in the kitchen just after breakfast, I was amazed at the contradictory feeling I had; on the one hand I felt frightened because I was at home by myself. Steve was away and all the kids were out. On the other hand, I felt stupid. For God’s sake pick myself up. The weakness in my legs and the palpitations were probably because I was frightened, I reasoned. All I had to do to stop trembling was to keep active, but for the next hour I found this very difficult to accomplish. I climbed into bed. Then I climbed out of bed thinking that there was nothing wrong with me. But when I tried to walk, I was overcome by limpness. This was getting a bit scary. What if something was wrong? What if it was not just bleeding? The specialists never indicated that there was anything significant in my bleeding, I reasoned. So, what is wrong? Do I have a heart problem? Why do I pant so much when I walk, get up, talk on the phone, or rush?
I worked from bed but because I became frightened at having collapsed, and at feeling very weak, I rang Wollongong Hospital Emergency Department and explained that I had been bleeding heavily for a number of months and had just collapsed. The doctor suggested that it was likely that I needed a transfusion and I ‘could be’ at risk of having a heart attack, but that I would have a long wait because the hospital was busy. The ‘could be’ along with the knowledge that I would have a long wait at the hospital, led me to decide to wait until the next morning to see my own GP, thinking that this would be a more efficient way of getting a transfusion.
Monday 1 September 1997
I decided to go ahead with a meeting I had organised with a prospective employee. This was too good an opportunity to miss. Besides talking with her was not going to affect my health. I recall being breathless in talking with her, and afterwards she told me that my lips were blue and my face grey. My breathlessness bemused me because the weekend before I swam a kilometre comfortably and afterwards felt refreshed.
I finally hit the sack at about 11.30 pm after spending time talking with my daughters and helping one of them to clean out her bedroom.
A strange sensation came over me as I tried to fall asleep. I could feel and hear my heart beating; my whole body seemed like a heavy drum beating. I try to turn over, thinking that I might be pressing on a sensitive part of my ear. I sit up. I lie down again and try lying on my back, but nothing seems to work. I get out of bed and pace up and down the bedroom. This works but I am becoming frightened. It is 1.30am and I can’t get to sleep because of the palpitations. And I am too frightened to fall asleep because I just don’t know what is happening to me. The words of the casualty doctor are coming back to me. I oscillate between fear and self-reprimanding that I am over-reacting, talking myself into something terrible.
t 2.00 am I rationalise that if I am over-reacting then I can cope with the embarrassment of Wollongong Hospital staff telling me so. But to try to ignore the palpitations which in any case are not allowing me to fall asleep is not particularly clever. So, I wake my 18-year-old daughter, Domenique and ask her to take me into casualty. I feel a nuisance for waking her. It is only a few weeks before her HSC exams and I am concerned that she gets all the sleep she can. On the way in I change my mind a couple of times, as I do again when I see other people with obvious distress sitting opposite me in Emergency. But when I am asked to get on the hospital bed I can’t make the climb and collapse on the floor.
I spend the rest of the night wandering in and out of sleep, the haemorrhaging continuing as usual, and my chest palpitating with every attempt to move.
The results of a blood test indicate that I need a blood transfusion which I receive throughout the next 24 hours, and I am booked in to have a hysterectomy at the end of the week, on 5th September, my second daughter Bronwyn’s 17th birthday.
Observations and reflections
Something needs to be said about the apparent irrationality of my procrastination. Why did I not take notice of the doctor at Wollongong Hospital that I spoke to on the phone on 31 August?
I am reasonably intelligent. A core part of my work at the time was helping managers to solve organisational problems, and teaching people in various industries how to effectively negotiate, so how did this happen to me? How come for more than two years and intensively for about another twelve months I tolerated, mostly taking for granted, sometimes not even noticing:
Breathlessness
palpitations
spasms in the legs
constipation
haemorrhoids
heavy and eventually continuous bleeding
sleepless nights
embarrassment
social inconvenience
loss of sexual opportunity and libido
loss of strength.
I offer the following suggestions as a starting point in understanding not just my procrastination prior to finally taking myself to hospital, but how I responded, and how gynaecologists behaved in response to my physical symptoms particularly in the year before my hysterectomy.
I wonder whether gynaecologists see so many women with menstrual problems that there is a tendency for them to lack appreciation or empathy for the impact that these problems have on our lives. A good start would be to listen more effectively to what the patient is saying in order to find out precisely what they are experiencing. Not once did a gynaecologist make a comment to me about the significance of blood loss on iron levels or haemoglobin or the level of oxygen in the blood.
I suspect that as soon as the gynaecologist has established that we do not have an immediately life-threatening condition, such as a cancerous tumour, he – or less often she[2] – dismisses any other condition as unimportant. While I understand that some hysterectomies may be carried out for the purpose of removing what clinicians might describe as quality of life annoyances, I am concerned that there is a lack of attention to conditions that if left will eventually have a significant impact on a woman’s ability to live her life in a physically and mentally normal way.
I am now convinced that in the 1990s there was a lack of reliable and clear information about how much blood loss was normal. One question I was asked was whether my blood loss had become heavier over the last two or so years. Until the last four or five months I just found it too difficult to make a reliable judgement. I had been told so many times that my loss was probably not as heavy as I imagined – that I just lost the confidence to make a reliable judgement. Besides any attempt to tell a gynaecologist that I thought my periods were very heavy, was always met with blank faced indifference. Would this happen today?
Over the last two or three years before my hysterectomy, my GP would frequently tell me that my body would not be able to cope with a low iron level indefinitely, and so I would take frequent courses of iron tablets. But as sympathetic and convincing as her messages sounded, they lost their impact and authority whenever I went to either of the gynaecologists. When I told them that I had suffered from low iron for more than two years, there was simply no response, no reaction. This led me to believe that low iron was not a big deal.
I recall my own mother suffering for years from periods that seemed to last for weeks at a time, and indeed for the last two or three years before she had a hysterectomy, she would spend hours most days in bed. This was 1969 and she was 43. To put her experience in context, Mum had given birth to six children, and she also had three other pregnancies, two of which had resulted in a miscarriage, and one that had sadly ended with my sixth brother being stillborn.
It was only happenchance that the gynaecologist on duty at the hospital that Mum arrived at in the middle of the night after a massive haemorrhage was not a Catholic. By contrast with the many Catholic specialists that dominated the sector in Perth at the time, he was not bound by the belief – implicit or explicit – that a woman should simply tolerate her condition. For Mum and the many Catholic women in Perth at the time, anything gynaecological including menstruation and childbirth and their impact on your physical and mental health were simply your moral – and sacred– duty to accept. Mum may have been tired, weak and irritable but never complained.
But when I was in my early 40s it had been 20 years since I had walked away from Catholicism. However, I sometimes wonder whether the cultural norms that I had grown up with in my home and in the community still lingered in my unconsciousness.
When I started menstruating at the age of 11, I was expected to comply with Mum’s no-fuss code. I recall once – I think I was about 14 – standing on the kitchen table while she used an old T Square to measure the hem on a dress that she had just made for me. It was the first or second day of my period and I was jiggling my legs as I tried to deal with painful cramps. Irritated, Mum whacked me on the legs with the T Square, insisting that I keep still so that she could accurately measure the hem.
Mum’s insistence that I silently and privately deal with my periods was no doubt intensified by her own personal history: she spent her three high school years living as an impoverished boarder at a Catholic girls school run by the Irish Mercy nuns, and prior to this as a small child during the Great Depression she was in their care for three years in an orphanage also run by the Mercy nuns who had brought their extremely narrow minded and moralistic understanding of a woman’s role with them from Ireland. So, the influence of their rigid norms about feminine modesty, piety and stoicism ran deep in her and would have rubbed off onto me, no doubt supported by my own 10 years at a girls’ school in Perth run by the Mercy nuns.
Hopefully my personal experiences have liberated my attitudes to my daughters’ menstrual experience and their gynaecological health, and in turn their confidence in dealing with this fundamental aspect of their humanity.
But I am not entirely sure that they and my granddaughters are completely free of the taboos that affected me. I suspect that this is the case for their peers too: that deep seated cultural norms, perhaps religious in their origin or simply just social – and with not much to do with Catholicism – still prevent women from seeking and gaining adequate health care related to their periods.
Nor am I confident that women can assume that their gynaecological problems will be treated with the seriousness that is appropriate.
The Period Pride survey in 2021 showed that the majority of respondents never felt embarrassed (59 per cent) when they talked about their periods. Nevertheless, that means that another 40% of women do feel some form of embarrassment and that ‘Long-held menstrual taboos of shame and secrecy can also prevent people from seeking adequate health care…’.[3]
Consistent with this reality, a survey of 1000 women aged 18 to 60 years, commissioned by healthcare company Bayer in 2022 found that ‘despite the high number (32%) of women who experience heavy bleeding, only 14% of the total surveyed have received a formal diagnosis of heavy menstrual bleeding (menorrhagia) from a health care professional.’ [4]
Astonishingly, the same study found that ‘19% of women felt uncomfortable, 7% felt ashamed, and 16% felt embarrassed to discuss their symptoms with a doctor.’
A number of recent studies and surveys suggest that women in Australia are treated less seriously than men by clinicians, and not just for gynaecological issues.
For example, the Inquiry into Women’s Pain conducted by the Victorian Department of Health and based on consultation with 13,000 girls and women in Victoria in 2024, delivered five key learnings:
1. Unmet healthcare needs
While most women seek medical care, many respondents stated their needs are not met. Experiences of dismissal, disrespect, and inadequate treatment are widespread, leading to distrust in the system.
2. Gaps in research and representation
Limited local and international research available on sex and gender disparities contributes to inconsistent and inequitable pain management, leaving many women and girls without appropriate care.
3. Gender bias in healthcare
Bias in pain perception leads to women’s pain being underestimated and inadequately treated. Cultural norms, language barriers, and stereotypes about women’s biology contribute to limited access and engagement with healthcare services.
4. Barriers across communities
Women living in regional and rural Victoria, Aboriginal and Torres Strait Islander women, LGBTIQA+ communities, and women with disabilities face greater challenges in accessing and navigating healthcare, often travelling long distances or experiencing systemic discrimination.
5. A call for change
Women want to be heard without bias or judgment, treated with empathy and respect, empowered to make informed decisions about their health, and access affordable, effective care easily.[5]
And in March 2024, a survey of ‘Almost 3,000 women, healthcare professionals and peak stakeholder groups’ conducted by the National Women’s Advisory Council and the Department of Health and Aged Care suggested that two out of every three women ‘reported health care-related bias and discrimination’. ‘Consistent themes included feeling dismissed and disbelieved; being stereotyped as ‘hysterical’ and a ‘drama queen’. Women reported that their symptoms and pain were often attributed to other causes such as menstruation, lifestyle factors or even ‘faking it’.’[6]
If there is any truth to these claims of gender bias in the way that men and women are treated by our health system, and more importantly, that women are still disinclined to be treated seriously by clinicians, especially in response to their menstrual experiences, then I hope that this memoir helps them to advocate for themselves and for each other.
[1] a prescription medicine containing norethisterone, a synthetic progestogen used to manage menstrual disorders, endometriosis, and to postpone menstruation
[2] In 2025 44% of gynaecologists and obstetricians are women, and 56% are men. In 1997, females made up just 17% of these professions. Australian and New Zealand Journal of Obstetrics and Gynaecology: Volume 59, Issue 2, Pages: 169-324, E5-E8, April 2019, Gender equity in obstetrics and gynaecology – where are we heading? Melanie Angstmann, Cindy Woods, Caroline M. de Costa
[3] Dr Jane Connery, July 2021, Period Report, Bloody Big Survey Findings, commissioned by Share the Dignity, Swinburne University of Technology, with data analysis by WhyHive
[4]‘The 2022 Period Perspective’ Survey of 1,000+ Australian women aged 18-60.
Commissioned by Bayer; executed by Researchify. https://www.bayer.com.au/en/the-menstrual-load-1-in-3-australian-women-surveyed-believe-they-may-have-undiagnosed-heavy#:~:text=THE%20UNSPOKEN%20IMPACTS%20OF%20A,mental%20impact%20on%20my%20performance.
[5] Department of Health Victoria, Bridging the Gender pain Gap: The Inquiry into Women’s Pain 2025, https://www.health.vic.gov.au/inquiry-into-womens-pain
[6] National Women’s Advisory Council, Department of Health and Aged Care, #EndGenderBias Survey Summary Report, March 2024, https://www.health.gov.au/sites/default/files/2024-03/endgenderbias-survey-results-summary-report_0.pdf
Meandering Thoughts 