Women’s health matters

[摘要] There has never been a better time for women’s health in the UK. The ‘strategies’,1 ‘plans’,2 and ambitions of the devolved nations’ governments have promised to reduce the inequalities that women experience.This editorial uses the phrase ‘women’ throughout. This is not aimed at being exclusive but is inclusive of the trans population, recognising that not all those born with female reproductive organs identify as a woman and not all women have female reproductive organs.CASE FOR CHANGE For too long the physical, psychological, and social wellbeing of women has been compromised because of periods, pregnancy, or menopause. For too long research has been focused on male physiology and anatomy forgetting that, as quoted by Caroline Criado Perez in her book, Invisible Women. Exposing Data Bias in a World Designed for Men, that ‘women are not, to state the obvious, just men’. And for too long women of colour have been compromised more than others, creating a further inequality within an existing inequality.3,4The disproportionate impact of the wider social determinants of health on women is also undervalued, requiring system- wide change from social care, employers, voluntary sector, and the public if women’s health and wellbeing is to improve.There are many reasons that a spotlight on women is essential:women in the UK live longer than men but spend longer in ill health and disability;5women represent 51% of the UK population and 49% of the workforce, and undertake the vast majority of unpaid caring roles in society;6,7 andthere is a lack of data and evidence about conditions only affecting women, and those conditions affecting both men and women but exerting their impact in different ways, leading to missed symptoms and late presentations.For those of us working at the frontline of health care trying to provide a holistic, life course approach, it is painfully evident that the current system of episodic care, inadequate women’s health information, and siloed commissioning consistently fails women; particularly those who find the system- wide barriers particularly hard to navigate. Some gynaecological conditions, including endometriosis, polycystic ovary syndrome, and premature ovarian insufficiency, require a long-term condition management approach. They should receive the same parity of esteem as other long- term conditions rewarded for management in primary care. Many women suffer with menstrual problems, tolerating them far too long because of the stigma associated with discussing ‘period problems’, not knowing what ‘normal’ is. An estimated 50% of pregnancies are unplanned,8 with an increasing number of women requesting abortion.9 Many perimenopausal women suffer unnecessarily in the workplace and feel forced to give up their careers or reduce their working commitments and ambitions.Women’s health care would also benefit from focusing on prevention and early intervention to optimise preconceptual health and wellbeing to improve pregnancy outcomes, reduce the impact of common menstrual disorders by easier access to intra-uterine system insertions, improve gynaecological cancer outcomes by prevention, screening, and earlier diagnoses, and optimise long-term health in the post- reproductive phase of their lives.

[学科分类] 卫生学