Yesterday, I ran across an interview in the New York Times “In Her Words” series between Mara Altman, journalist, and Luce Brett, memoirist, where they discussed embarrassing bodily functions and problems. One of the points they brought up was how taboo those topics are and how that leads to both feelings of aloneness and perhaps even worse, lack of understanding and treatment. Luce’s book is about her experience with postpartum incontinence, and one part Mara pointed out was how so many people focused on the health of the baby and not Luce’s birth experience and aftereffects. It made me think about one of the biggest problems in women’s health care: the unwillingness to bring up something that may be an issue because it’s indelicate to discuss and because we think it’s unimportant anyway.
Self-advocacy in the medical arena is difficult for so many reasons, and yet it’s vital to ensuring both our lives and the quality of our lives.
Some symptoms are easy to talk about: they’re objective and they’re in many ways public. Things like coughing and sneezing, fevers, acute injuries like broken bones or sprained ankles. Others are barely whispered about because they’re dirty or shameful somehow. Things like peeing our pants, weird smells coming from our vaginas, or just vague feelings that something doesn’t feel right or hurts too much. We feel like they’re not to be mentioned aloud even to a medical professional, certainly not to friends, and heaven forbid, a stranger. Just contemplating the idea makes us blush or feel ashamed about what might be wrong with us. After all, functional adults are able to control their bladders and bowels, don’t give off strange odors, and aren’t complainers or malingerers.
However, not talking about these issues can be as life-altering as daring to talk about them. During the interview, Mara says: “While researching my book, I spoke to a colorectal nurse, Theresa Porrett, who really brought it home when she told me that ‘people literally die of embarrassment’ — the taboos are so strong around some parts of the body that people won’t bring up troubling symptoms with their doctor until it’s too late. Then there are also the everyday activities and joys that women miss out on when these issues take over their lives.” Being willing to tell a doctor or insist on an examination for one these types of symptoms can result in catching a potentially deadly illness early enough for effective treatment, or in management or a cure so that you will no longer be plagued by that symptom. And being willing to tell friends and even strangers can help destigmatize the surrounding conversations so that you can all learn whether what’s going on is normal or treatable, or if further exploration is needed.
It wasn’t incontinence, but I was having trouble with my long-time birth control pill and unpredictable spotting. Taking it continuously has become an integral part of my physical and mental health treatment plan, for both convenience and mood management reasons, so stopping wasn’t an option. Like many women, periods aren’t a normal part of conversation for me and my good relationship with my gynecologist didn’t really extend to “so Doc, I’m ruining all of my underwear, way more than I’m used to, what should I do?” Besides, I was convinced that it was just something I had to live with – a disappointing, but unavoidable side effect. When I was finally convinced to raise it with my doctor, he was immediately able to offer a number of potential solutions, including one I hadn’t thought about: using an IUD to prevent spotting while my pill could continue to do its work managing my unsteady hormones. So far, so good, but nothing I would have been able to arrive at if I hadn’t decided that the positive health effects of staying on the pill for me were important enough to overcome my unwillingness to talk about my period.
I suspect no few women have similar stories…or would if they, too, could break the taboos surrounding some of our bodily functions and dysfunctions. Perhaps you’d be willing to share here? If you don’t want your name attached, PM me and I’ll post for you and keep your confidence. Because I think we all benefit by bringing these topics into the light.
