I’ve lived and worked in multiple countries across three continents, and I’ve observed that female health is viewed differently in different locations.

“Hygiene de vie”

In the United States, Canada, and Asia, gynecological checkups are treated as an uncomfortable chore. With some exceptions, the experience is sterile, brief, cold (speculum included)—and, for many women, shameful. There is little discussion or exchange beyond the very basics of tests and results.

In France, on the other hand, female gynecological health is considered an integral part of the hygiene de vie, or healthy living. Women understand that it is essential to see their gynecologist once a year, and most do so religiously. There is very little modesty and shame in a gynecological checkup—both on the part of women and from medical providers themselves.

On the day of my first gynecological visit in Paris I walked in with the usual hesitancy and lack of comfort. The doctor—who was male—conducted the examination with a sense of normalcy and matter-of-factness that snapped me out of my shame mindset and into a state of presence and engagement.

In France, providers expect to have an open and rich conversation with their patients. This also took me by surprise as, immediately, my doctor began a very in-depth discussion with me. When he saw that there was much about which I was not informed, he quickly ran me through the important points and suggested areas where I might investigate further. As a woman in my twenties, he said, I needed to understand certain things that would empower me in my current life and also give me the best chances for health and fertility (if I so desired) later on. He also put the onus on me to be better prepared with questions to shape the discussion next time—after all, my gynecological health was a vital part of my overall health as a woman, and I needed to have a full understanding of what was happening and act accordingly.

For the first time in my life, I felt like a medical provider had treated me as a responsible adult. I felt empowered and secure in what I needed to do. I walked out of his office somehow taller, with my head up, thinking, “Why was I so afraid of that before?”

I left France over ten years ago, and I still miss those visits and conversations with my OB-GYN. Now, in Hong Kong, my experience is similar to what I dealt with back home in Canada. I returned to treating my yearly female health visits as an inconvenience rather than something I looked forward to.

My friend, who is a nurse from France, gave birth in Hong Kong. When the doctor came to examine her one day postpartum, she shared that she was experiencing some pain. “May I see your backside?” he asked.

“Why do you want to see my back?” my friend replied, confused.

With great shame and discomfort, the doctor whispered, “Your anus. I need to see your anus.”

“Oh, yes. That makes complete sense as that’s where I’m having the discomfort.”

Later, she shared, “It was so funny that he was afraid to say it. It is his job, no? Why did he have to whisper to me as if there was something wrong about my anus?”

Pain is not normal

When I moved to Hong Kong, I found a completely different approach to women’s health than I had known in France. Some of what I saw was troubling—like the tendency toward extreme modesty in both women and providers—but some of it was highly empowering.

I met Gigi Ngan after the birth of my first child (an experience I’ll share more about later in this book). Gigi is a practitioner of Traditional Chinese Medicine and has had some enlightening things to say about what is actually “normal” for women.

I remember telling her during one of our conversations, “Well, you know, there’s a certain amount of pain that comes with being a woman. It’s just normal.”

Gigi’s eyebrows rose. “What do you mean, pain is normal for women?”

“Oh, not serious pain, just menstrual pain. It’s normal to have some, isn’t it?”

All of a sudden, Gigi was very concerned. “Do you have menstrual pain, Anca? Because if so, we need to address it.”

“No, no,” I reassured her. “I’m fine. But most women I know do have discomfort.”

“It’s not acceptable to experience any pain around the menstrual cycle. Why would you even think that? The menstrual cycle is like a report card on the health of the woman! When I hear that there is pain, mood disturbances, or other symptoms, I work with the woman to bring her body back into balance. Even the flow, duration, and color must be looked at to understand an imbalance before it snowballs into more serious health concerns. Where there is balance in health, there is no pain.”

This conversation blew my mind. Part of me thought she was just wrong—after all, how could the entire Western world, including the incredible OB-GYNs in France, have missed the mark so completely on what is “normal” with regard to a woman’s cycle? On the other hand, how could it be that many, if not most, women in the world think it’s acceptable to live with pain every month?

Between the sex-related disparities inherent to the medical system and the fact that we have been conditioned to normalize pain as inherent to our womanhood, is it any wonder that some women live with symptoms for years (or decades) before receiving a diagnosis?

The experts agree: women need to speak up

Seeing the incredible differences that exist globally in the approach to and support around women’s health made me realize the importance of bringing together a diverse panel of experts from all corners of the world. There is incredible wisdom and knowledge in certain places that women elsewhere can’t access.

What I didn’t expect was that these experts, regardless of specialty or geographic location, spoke of exactly the same issues around women’s health. The consensus among these researchers, physicians, physiotherapists, reproductive endocrinologists, and TCM and Ayurveda practitioners who make up OM’s expert panel have different experiences working within cultural norms, but all say with the same conviction:

• Women should not accept pain as a part of the female experience.

• Women’s health is not “messy” or to be feared.

• Women’s health is not a dysfunction or deviation from medical norms.

• No part of a woman’s health journey should be minimized or discounted.

So, if experts from every corner of the globe agree on these fundamental truths, why do women still have such an issue accessing compassionate, informed care? 

This extract is taken from Why Women Aren’t Winning At Health (But Can), by Anca Griffiths, Alyson J. McGregor, MD, and Marjorie Jenkins, MD, available now.