When Wes Streeting relaunched the Women’s Health Strategy for England on Wednesday, he said that women are too often treated as if their pain is an inconvenience, their symptoms as an overreaction. As he set out measures to help women access the healthcare they need in a bid to tackle “medical misogyny”, he concluded that the NHS was “failing women” and promised to stop women being “gaslit” by doctors.
BBC Radio 5 Live presenter Naga Munchetty, 51, was recently diagnosed – after 32 years of severe pain – with adenomyosis, a condition in which the womb lining grows deep within the muscular wall of the womb. Since the age of 15, Munchetty experienced extremely heavy and painful periods, but was not diagnosed until the age of 47.
Munchetty, who also presents BBC Breakfast, and is author of the book, It’s Probably Nothing: Critical Conversations on the Women’s Health Crisis, shares her experience following the news.
From the age of 15, I suffered debilitating, horrendous pain: for the first three days of my period I would be fainting, vomiting, flooding, sleeping on a towel and setting an alarm to change my period products every three hours. It would stop after 10 days, then start all over again two and a half weeks later.
I dreaded going out. I was always concerned about having enough period products, especially when I started working on air for three-hour stretches. I’ve had to come off set while presenting BBC Breakfast because I thought I was about to pass out. I’d go to the toilet, throw up, manage to take a 10-minute break, get my make up redone after being covered in sweat, then sit down and present the next hour and a half.
I was scared a lot of the time: about flooding through my clothes and about not being sharp enough because I was exhausted; about not being able to give enough to my social life or my family. We are all trying to be the best we can and my untreated condition was preventing me from being the best I could be. I was constantly worried that I wasn’t fulfilling my potential. Even now, in my 50s, I still have that feeling.
For many women, it will have been refreshing to hear the Health Secretary say that our pain needs to be taken seriously, and that medical misogyny exists. For a Health Secretary to even say “medical misogyny” aloud is a bold statement. I have known doctors who have been told by their peers that they cannot use that term because they feel it is so inflammatory. Even though we know from countless people’s experiences that medical misogyny is a problem, it needs to be said by someone in authority – like Wes Streeting – for women to be believed. Many will feel this is progress.
But what I want to know is when will I – and when will women – feel the effects of this new strategy? When will women with very heavy and extremely painful periods stop being told – as I was, many times – that “women have periods – suck it up”?
Many doctors, male and female, said: “It’s probably nothing… you’ll grow out of it.” I was consistently dismissed. So I put up with it. But that didn’t stop me feeling that others were doing so much better at “being women” as they didn’t seem to be struggling or in so much pain as I was from something that was supposedly normal.
Part of the problem is that much of the training doesn’t always equip doctors to ask the right questions. It took me 32 years to get diagnosed, partly because I was never actually asked about my periods. I went to multiple doctors describing really heavy periods that made me feel tired and I was repeatedly told that was normal.
I was never asked, “Have you ever felt the need to take time off work?”, even though I would battle through the bad days and mask the pain with too many painkillers. They never asked how I was sleeping. If they had, they would know that before getting to work I would be screaming through the night and often had just a couple hours’ sleep.
When I finally did get the diagnosis, it made me bloody angry. It was very late. And, yes, being able to put a name to something that is so impactful rather than being made to think you should just be “coping better” is helpful. But there is no cure or even effective treatment for adenomyosis.
The only way to control it is with hormones or a hysterectomy, if it is only on the uterus, and mine isn’t – it has spread to other parts of my body. I was told by a gynaecologist that a hysterectomy “might help”, but my response was: “You are offering to cut out part of my body out in hopes that it might help?”
I am not blaming doctors. The lack of research means that doctors don’t always have the knowledge or tools to fix the problem. They are operating within a system created by men largely based on men; women’s bodies have been seen as “less than” men in terms of value and research, and that is evidenced by the fact that the amount of money towards women’s reproductive health only constitutes 2 per cent of the budget for public research. And if you look at the medical licensing assessment for doctors, which is mentioned in the Women’s Strategy report, it doesn’t even include adenomyosis, even though we’re being told that there is now going to be a concerted effort to understand hormonal and reproductive health.
One thing that I hope comes out of this is education. Girls and boys are not told anywhere near enough about menstruation and what the signs are of normal and abnormal periods. They are told it is a few teaspoons of blood over 3-5 days. They are not told that if it is more than that, or very painful, it might be a problem. They are not told about endometriosis, in which similar tissue to the lining of the womb grows outside the womb, fibroids, or hormone imbalances.
I still experience prolonged bleeding. It helps that I am on HRT, as I am perimenopausal, so my hormone levels are being managed more carefully. My doctor recently asked me what it is like, and comparing with what it used to be like, I said: “It is not heavy”. Her response was: “Naga, that is heavy.” She then referred me for a scan, for blood tests, and asked about my energy levels, as anaemia is something I have struggled with all my life. I now know it was down to bleeding so much, but it was never recognised.
It also helps that I have an added level of confidence and knowledge: I am articulate, educated. But it has been shown that others are not so fortunate, such as women of colour who are significantly under-diagnosed, and that health gap increases further when you start adding in people who have English as a second language or disabilities.
There needs to be more focus on the way all women are referred and treated. Until now, women have not been made to feel that good healthcare is their right. So many women are routinely told that “it’s probably nothing” by doctors; they need to be empowered to flag concerns about their health and they should expect to be heard – and treated if necessary. And we need to believe women.
As Dame Lesely Regan has said, at every medical appointment, a woman should be asked about her menstrual health. The system has to be better in terms of linking up different conditions and symptoms so you are not going to numerous appointments with little joined-up thinking, so women don’t find themselves saying to doctors: “I am sorry to bother you”.
We also have a role to play as patients. We have to make a point of using language where we prioritise ourselves. We need to say: I cannot be the best I can be at my job, or parenting, being a partner or a carer, without medical care. We have to recognise our importance – and make sure it is valued.
As told to Victoria Young
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