If a woman seemed psychologically stressed, or she started forgetting things, or she seemed emotionally volatile, like she needed too much attention, a physician might diagnose her with hysteria. Remedies ranged from sniffing smelling salts to having sex. A single woman would be advised to marry. Married women were advised to sleep with their husbands or to go horseback riding. Alternatively, in a not uncommon practice, doctors and midwives would use their fingers to stimulate women to orgasm, or “hysterical paroxysms” – basically a happy ending at the doctor’s office.
As recently as the late nineteenth century, nearly three-quarters of the female population were deemed to be “out of health”, including women with “a tendency to cause trouble”. Since their issues generally couldn’t be resolved in just one visit, these women represented America’s largest therapy services market.
In 1980, “hysterical neurosis” was finally dropped as an official diagnosis by the American Psychiatric Association.
Just another reason to be grateful that you’re a lady.
THE FALL OF BIKINI MEDICINE
If you ask a female doctor in her fifties about the model for human anatomy she studied in med school, she will tell you about the 70kg (approximately 11 stone) man that was the example for her medical training – and his female companion, the 60kg (approximately 9½ stone) man with boobs and a uterus. Medical students were not trained to treat the male and female bodies as all that different, except when it came to the reproductive organs – the areas covered by a bikini. Hence the nickname for the medical education of the era: bikini medicine.
Bikini medicine was the product of centuries of misunderstanding about female anatomy that began with all that hysteria about hysteria. The fall of this antiquated model and the rise of our more accurate understanding of female biology is tied in large part to the strides made by a generation of thinkers and speakers and brave, determined individuals who demanded change as a part of the Women’s Rights Movement. The modern view of women’s health we take for granted today only began in the 1960s, as women in Western society sought information about their biology and demanded better-quality medicine, including better reproductive care and uninhibited reproductive rights. They made it clear to lawmakers and medical professionals that women’s legal rights and medical welfare were inextricably linked.
Here’s one example: the year that I was born, 1972, was the same year that the federal government allowed unmarried women legal access to birth control. Think about that. If you were a single woman in 1970, it was actually illegal for you to take charge of your reproductive system. In 1989, when I was seventeen, Congress allocated funds specifically for the study of women’s health. By the 1990s, 30 per cent of ob-gyn specialists were women, up from just 7 per cent in the 1960s. Their efforts, along with the efforts of countless other doctors and scientists, increased the focus and attention on women’s health, including the health of older women, setting the stage for the healthcare we will all receive in the years to follow.
A BRIEF HISTORY OF WOMEN’S MEDICINE IN THE UNITED STATES
1916:
Margaret Sanger opens the first birth-control clinic in Brooklyn. Ten days after it opens, the police shut it down and put her in prison. Contraception is illegal.
1916:
Planned Parenthood is founded.
1920:
Women get the right to vote
1960:
The birth-control pill is approved by the Food and Drug Administration (FDA).
1960s:
The women’s health movement begins.
1963:
Congress passes the Equal Pay Act.
1967:
The National Organization for Women (NOW) is launched.
1971:
Ten per cent of medical students are women.
1972:
Eisenstadt v. Baird establishes the right of unmarried women to use the birth-control pill.
1973:
Roe v. Wade gives women the option of a safe and legal abortion.
1989:
The Supreme Court allows states to make abortions in public hospitals illegal.
1990:
Congress passes the Women’s Health Equity Act, and dedicates federal funds to research on women’s health.
1993:
Congress mandates that scientists must include women in clinical trials in order to be eligible for federal funding.
1996:
Perimenopause is defined by the World Health Organization.
2013:
It is reported that women taking the sleep-aid drug Ambien fall asleep while driving. At the urging of the FDA, the manufacturer of the drug cuts the recommended dosage for women in half.
2014:
The NIH mandates that female cells must be included in all federally funded medical studies.
HOW YOUR SEX AFFECTS YOUR DRUGS
During our visit to the NIH, we spent valuable time with Dr Janine Clayton, the director of the NIH’s Office of Research on Women’s Health (ORWH). The ORWH has been around for only about fifteen years. Its mission is to promote women’s health initiatives in the medical community, educate the public about issues related to women’s health, and fund programmes that explore the role of sex and gender differences in medicine. Dr Clayton and her team have been working for years to encourage her colleagues at the NIH to prioritize women’s health issues and needs in their research.
We asked Dr Clayton some questions about sex and drugs, and she told us that your female sex affects the efficacy and the potency of the drugs you take. This is especially important for Americans because, as a nation, we take a lot of drugs. But while women are being prescribed more medications than ever before, not all of those medications are properly tested for use by women. And it has been proven again and again that drugs don’t affect men and women the same way.
When we swallow a pill or get an injection of a vaccine, the medicine travels throughout the body via the bloodstream and is distributed to our tissues and organs. However, medicines affect women differently than they affect men for several reasons:
WE HAVE DIFFERENT ORGANS:
A female liver metabolizes drugs differently than a male liver.
WE HAVE DIFFERENT BODY WEIGHTS:
Men are usually bigger and heavier, and have bigger organs, requiring higher dosages of drugs than a smaller woman does.
WE HAVE DIFFERENT BODY