The unspeakable secrets of women’s health

The essence of "unspeakable secrets" in the field of women's health has never been that women are "shy, unable to let go, and unwilling to speak out." It is the systematic result of the combined effects of the specific physiological structure, the gender-stigmatized environment, and the lack of suitability of medical services - Department of Gynecology, a tertiary hospital in Beijing 20 23 years of outpatient follow-up data show that 90% of women have encountered at least one health problem in their lives that they cannot openly talk about. Nearly 60% of them will choose to deal with it or search for information on informal channels for self-diagnosis. Only less than 30% will go to a regular hospital for treatment as soon as possible.

Last week, I accompanied my 27-year-old junior sister to go to the gynecology department. She lingered at the triage table for almost 10 minutes. The nurse asked what was wrong. She held it in for a long time and could only manage to say, "It's a little itchy down there."

After reading it, she told me that the symptoms had been lingering for almost half a month. At first, she thought she was suffering from a fever, so she secretly bought an Internet celebrity lotion to wash it. The more she washed, the more itchy she became, and it even hurt when she walked. She didn't dare to tell her mother, for fear of being scolded for "not paying attention to hygiene". She didn't dare to ask friends around her, for fear of being misunderstood. She had a messy private life. She even registered at a hospital 10 kilometers away from home, for fear of meeting acquaintances.

Friends who do public health research always say that the root of such problems lies in the lack of sex education and social stigma. Where is the data from the 2022 National College Student Sexual Health Survey: 47% of women will default to "not being hygienic" for vaginitis, and 30% of them even think that "girls who go to the gynecologist are not good girls." This deep-rooted prejudice is the culprit that makes everyone shut up.

But a gynecologist I know doesn’t think so. She always said that many people ignore the most basic physiological differences: women’s reproductive tract, urethra, and anus are close to each other, so they are more prone to infection than men. The scenes of many symptoms are embarrassing enough - you can’t just pull someone and say “I leaked urine when I sneezed”, right? The most exaggerated case she has ever encountered in the clinic was a 42-year-old mother of two children. She had been leaking urine for 5 years. She had been using sanitary napkins for 5 years. She didn’t even dare to dance in the square. It wasn’t until her child went to elementary school that she had to run with her at a sports meeting. After running two steps, her outer pants were completely soaked due to leakage. She was asked by the child, “Mom, have you peed your pants?”, so she bravely came to the hospital. The most common type of pelvic floor muscle relaxation was found after examination. After 3 months of rehabilitation according to the course of treatment, it can be basically recovered. I have suffered for 5 years for no reason.

Ah Shuang, a blogger who promotes women's health science, complained to me before that there is another issue that is easily overlooked, which is that the adaptability of existing medical services is really not enough. Many gynecological outpatient clinics are unable to even perform basic doctor-patient interactions. The room is full of patients queuing up, and the doctor opens his mouth and asks in front of everyone, "Have you had sex recently?" No one else would be embarrassed to tell the truth. She had previously received a submission from a fan. A girl went to see her for irregular menstruation. The doctor repeatedly asked her in front of more than a dozen patients whether she had sex. After she denied it, the doctor got angry and said, "If you don't, you can't be pregnant. You'd better tell the truth." The girl cried on the spot, and she didn't dare to enter the gynecological clinic again for two years.

Speaking of which, I had a similar experience myself. I had a urinary tract infection the summer before last. I always thought it was a minor thing and I was embarrassed to say it at first. I drank water for two days until it hurt to the point of urinating blood, so I panicked and went to the hospital. The doctor said that if I arrived two days later, the infection would have ascended and become pyelonephritis. Now I'm scared to think about it. Later, I got together to chat with my female friends, and I discovered that almost everyone had hidden such a "little secret": Some people had fungal vaginitis and were afraid to go to the doctor. They used medicine indiscriminately and caused bacterial flora imbalance, and they struggled with it over and over again for more than half a year. ； Some people have leaked urine after giving birth, but they dare not tell their husbands for fear of being rejected, so they avoid even being intimate. ； Someone had a lump on his chest and checked whether it was breast cancer at home every day. It took him half a year to dare to check. The result was an ordinary fibroid. He could go to work the next day after the removal.

Oh, by the way, I came across a community health event before. The serious promotional page that said "Gynecological Examination" was completely changed, and the gifts were changed from soapy towels to milk tea, facial masks, and lipsticks in popular colors. The number of people who came to participate was actually three times more than before. Many young girls even took the initiative to approach the doctor to ask about the precautions for vaginitis. You see, in fact, everyone is either unwilling to face it, or they are afraid of being labeled and looked at with strange eyes.

Is there any innate "unspeakable secret"? To put it bluntly, we have been taught too much "to be sensible, decent, and shy" since childhood, but no one tells us that when we are not feeling well, the first priority is always to take care of ourselves, and the opinions of others are not worth mentioning at all. Really, those symptoms that you feel ashamed to talk about are as common as colds and fevers in the eyes of doctors. Don’t punish your body with other people’s prejudices, it’s a shame.