Women's health is sometimes – it's time that the system catches up
Historically, women’s health status is insufficient – underfunded, underresearched, often misunderstood. Despite the increased interest and investment in complex women’s health, we are still a long way from providing meaningful results for women.
Example: Endometriosis is a debilitating and life-limiting disease, with 1 out of 10 reproductive eras around the world, but it still takes 4-11 years to accurately diagnose and treat. Similarly, polycystic ovary syndrome or PCOS affects 70% of women worldwide, and 70% of women without diagnosis.
These gaps continue to shape the medical experiences of today’s women and perpetuate the culture of underdiagnosis, delayed diagnosis, treatment, and ineffective and expensive procedures. I spent my career advocating for a more inclusive, patient-centered approach to women’s health care, and I was inspired by an industry that ultimately (if slow changes) – partly driven by women’s refusal to accept the symptoms of routine firing and demanding better, more personalized care.
Whole-person method
In women's health, fragment care and symptom treatments are very common by individual experts. Women have anxiety and depression in the therapist or psychiatrist, cardiologists of cardiologists, migraine neurologists and long-term fatigue scientists of rheumatologists – all of which may be associated with metabolic and hormonal disorders. Whole-person healthcare approaches can provide more effective, compassionate and personalized care. However, extending this approach is still a challenge.
Women need comprehensive health solutions from menstrual period to the last few years of menopause to improve direct health problems such as pain and fatigue, while also improving long-term happiness and quality of life.
For example, women with endometriosis can relieve pain without hysterectomy by combining a new diet with medication and iron supplements. Women diagnosed with osteoporosis may need help developing a plan to avoid falls and incorporate high-intensity intensity training, which requires high-intensity strength training in addition to or in place of standard medications that have significant side effects for many people.
However, these proactive treatment plans are often overlooked or worse, or even considered. More importantly, as a profession, we still do not have standardized methods to track and measure active treatments for women. As the saying goes, unobtained measurements have not been improved.
Shared decision model
The healthcare industry increasingly reflects an understanding that actively engaging patients in decision-making leads to better adherence and outcomes.
A shared decision model supports ongoing two-way conversations between providers and patients. It recognizes that the job of healthcare professionals is to provide patients with all the information they need to make the best choice for themselves.
This is especially important for women, given the medical attention to them and the frequent research and understanding of their condition, which may lead to competitive treatment options. By providing information about all the options available to women, we can help them understand the pros and cons and consider how these treatments align with their personal health and lifestyle goals. We also clearly discuss what is known, thinking that it is real and that her condition and treatment choices are simply unaware of.
By adopting this approach, we remove the patriarchal model and expose the care and treatment decisions of female partners to their personal values, preferences, health goals and living environments.
Confident move forward
Too many women experience the effects of living under gynecological conditions while feeling fired and struggling to take care of. Women deserve better, and as we collectively challenge outdated norms, we are starting to see improvements.
Still, there is still a lot of work to be done. Although women’s health may sometimes be, we have not closed the gap in research and providing equitable health outcomes.
The best starting point? By listening to women telling us what’s going on in our bodies, by listening to their voices. From there, a more conscious and coordinated approach to regulation, research, treatment and care is needed to truly impact change on a large scale.
Photo: Asnidamarwani, Getty Images
Barbara Levy, MD, FACOG, FACS, is a lifelong advocate for improving the quality of women’s health. Dr. Levy is in private practice and serves as the Medical Director of Women and Children Services in Franciscan Health Systems. She was elected the first female president of the AAGL from 1994 to 1995. She has built a quality, safety and informatics team dedicated to supporting women’s healthcare improvements. Her research interest stems from the results of minimally invasive gynecological surgery to optimize care for women with chronic pelvic pain. Her clinical work focuses on evidence-based, equitable, and comprehensive care for women throughout their lives. Today, Dr. Levy is Chief Medical Officer at Visana Health, a virtual women’s health clinic that transitions from menstrual period to menopause.
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