How the NHS failed me and mine.
What it did, to the most important person
in my life and how it could happen to you unless
we do something about it!

Sunday, 22 January 2012

Health Misogyny

Health care in general and the NHS in particular, places far too much reliance upon the notion of prevention and 'early' detection of disease, or rather the 'markers' of what is assumed to be a possible or maybe disease, or condition. This particular trait, and it is redolent of all health care models throughout civilisation, is directed more at women than men.

Perhaps the concept of women being fragile, vulnerable to all sorts of ailments diseases and conditions, that are either particular to, or more predominant in their sex than males, is where this founded. And, of course when this process of labelling all women as potential harbingers of their own doom came to pass, it was men who set about building the edifice of treatments, allocated specifically to the 'fairer' sex, to save them from their 'treacherous' hormone ravaged bodies. And what a crock of s**t, it has all turned out to be.

Mammograms, Cervical Smear Tests, Hormone Replacement Therapy, Vaccines targeted for Cervical Cancer, 'Medicalisation' of Pregnancy, Osteoporosis treatments (mainly for women) and the general consensus that women need 'protecting' from the ravages of their own predisposition to ailments arising from their femininity. Men and some women, are unable to resist the urge to prod, poke and peer into the extremities of women simply to reassure themselves, and vulnerable women, that all is as it 'should be'. A whole industry in Medicine and Health care has sprung from this, including the desire of men, often imposed upon women, to aspire to a stereotype image of the size 10 with big breasts and shapely bottoms. Culminating of course in the Breast Augmentation, Reduction and Botox protocols that has spectacularly 'gone wrong' in the case of the PIP debacle.

I have written at length about Screening for Breast Cancer in the past and  more evidence has comes to light about it's futility for most, and the lie perpetrated that many are 'saved', when in fact the so called cancer found, is not really 'cancer' at all. And it would have likely responded to 'watch and wait protocols' rather than going in with the knife, radiation and chemotherapy. The 'treatment' of Ductal Carcinoma In Situ (DCIS) is redolent of this mindset. Studies conducted also continue to find that mammography seems to increase the incidence of breast cancer than reducing it. The main problem is however that women are treated as pawns, and deprived of the information needed to make an informed decision about whether or not, to submit to this 'testing' (sic) protocol.

Cervical Smear Tests are also 'sold' to women as essential to health and whilst there is little harm invoked by them, when an abnormality is detected the 'system' once more tends to 'overtreat' and frighten women into interventions that can be counter productive. Firstly the incidence of cervical cancers is quite low at 2.4 per 100,000 (European age standardised mortality)  and certainly screening young women (up to 30 years) has been shown to be of little worth. The trend also has been been downwards for the past thirty years (from 7.1). As the mortality rate for Prostrate Cancer is rising and  close to 10x  higher at 23.9 per 100,000 it seems strange that this is not targeted, when Cervical Cancer is. But of course 'overdiagnosis' is really the problem in oncology, especially for treatment protocols directed at women and it continues, without abatement.

We now have the HPV vaccine, targeted (again) at young women to prevent cervical cancer and genital warts yet the vaccine (Gardasil/Cervarix) is only admitted as being effective against two strains of the Virus (types 16 and 18) and there are allegedly thirty strains that are cancer promoting. As the target cohort is 11 to 13 years old females (although now men are now being targeted too!) prior to likely sexual activity and protection is only afforded for ten years at most, it seems perverse to leave them without protection in the years when activity is likely to be elevated, so is it worth it? Even of course if you even think that the vaccine is any good in the first place, which viewing the evidence it seems not, to me. I personally feel that the whole concept of an 'epidemic' of HPV infections is pure hype to sell an unproven vaccine, mainly to women, for their daughters, to swell the coffers of  'Pharma' at a time when the 'blockbuster' drugs are coming off patent. Do young girls need a pretty useless vaccine for a relatively easily treated disease of very low incidence? Make up your own mind, your informed mind. This JAMA editorial may help.

And what of HRT? It was proffered as the panacea for menopausal symptoms and the retention of 'youthful vigour' in women of a certain age and although for many it did precisely that, it exacted a price; breast cancer. Even with short term use, risks of both cardiovascular disease and thromboembolism were also increased tremendously and the ovarian cancer risk increased in the oestrogen only cohorts by some 60% (relative risk). Except for extreme cases, it is used rarely for menopausal symptoms today, but that did not stop 'Pharma' from reaping tremendous profits, from an ill conceived and dangerous drug that is now seen as being counterproductive despite its benefit for the prevention of osteoporosis (but not treatment).

Way back in history we had thalidomide, that was targeted at women to eliminate or ameliorate the problems of 'morning sickness' in pregnancy. As most will know, it wreaked terrible havoc with lasting and appalling effects, but now new information is coming to light about a virtually forgotten drug called Diethylstilboestrol (DES) which seems to cause a rare form of cancer of the vagina and cervix called 'clear cell adenocarcinoma' or CCAC, in the second generation .The Independent on Sunday of today, has highlighted this, but the story has been around for some time with $1.5bn paid out already to victims. Surprisingly, this drug is still used in the UK (but rarely) under the 'Apstil' brand for prostrate cancer and advanced breast cancer in post-menopausal women. (Another crock of s**t?). It was another drug invented for the 'medicalisation' of pregnancy.

It is quite rare in fact for any women to have a home birth. They are taught to fear this in case of complications and the need to ensure their offspring are 'safe'. The truth is in fact that home is a much safer place than hospital, as many of us will know, when we went to hospital for one problem and ended up with many more. The following are some interesting statistics.



Births
(  percent of total )
Perinatal Mortality
( per 1000 births )
1958 1970 1958 1970
Hospital 49 66 50.1 27.8
GP Unit 12 19 20.3 6.1
Home 36 12 19.8 4.3
 ( Statistics resulting from 1958 and 1970 perinatal surveys in Britain. Sources: Sheila Kitzinger, Homebirth and Other Alternatives to Hospital, and Marjorie Tew, Journal of the Royal College of General Practitioners, August 1985.)

Prospective mothers will be told that they are putting their baby 'at risk' if they stay at home for their birth, and I would be the first to advocate that any at risk should be hospitalised, but for healthy women, especially in their second pregnancy, with no known risks, it is cheaper, safer and less traumatic for mother and baby. Yet a whole industry has grown up in the NHS to foster the idea that no other protocol should be countenanced.

Women are continually treated as if to be female is an illness in itself and that your whole life has to be conducted under the microscope of the Health care Profession. Many of the ailments that women are heir to have their risk inflated out of all proportion to reality. many, as I have pointed out are very low; much lower than many that are completely ignored by medicine. We continue along the road of epidemiology and genetics as twin pillars of research but it is a blind alley, especially for women, who have suffered more than men in this construct of blaming their ills upon hedonistic lifestyles, stupidity, and poverty. Most if not all of the breakthroughs in medicine have been due to luck more than insight. Failed aspirations are in fact the predominant factor in Health care, and the 'expert committee' the death knell of common sense.

To treat women as the 'milch cow' of medicine is patronising, condescending and it is without doubt misogyny. Doctors and Clinicians should cease this continual search for things they can 'invent' to fill in their time before their wealth laden retirement. Perhaps they have; children. But that must wait for another day.

By writing this post I could perhaps be accused of the sin I am trying the exemplify. I really hope not.

4 comments:

  1. Misogyny perhaps too srong a term - but nevertheless a fine post!

    As a sufferer of femaleness I find much truth in your writing and indeed have to muster up what limited intelligence exists in my frail mind to attempt to convince a GP - on a rare visit there - that I am not bonkers.

    You are correct in that children are fast becoming the new 'milch cow' of medicine and it very much appears that some in the medical professsion are colluding with Big Pharma in this very medicalisation of childhood.

    Such is life.

    Anna :o]

    ReplyDelete
  2. I did hesitate in the use of the word Anna, but then the situation in Health care I think warrants it. When one gathers it all together, and there are some areas I did not touch upon for reasons of lack of research data, it seems to me, brought up in the late 50's and early 60's that women are now subjected to many more protocols that were not heard of then.

    Women had their children in their own bed, on the sterile encouchment sheet provided by the Midwife and never went near a hospital. Many births also took place in GP units that now are all but extinct. The sexual freedoms of the 60's has reaped rewards such as the 'pill' which gave two generations of young women release from the tyranny of unwanted pregnancy, but it too had a high price for some. So no, the long answer is that I feel the word was warranted. And no, you are far from 'bonkers'.

    ReplyDelete
  3. I believe in this point of this article. The health care system views women as an easily exploitable gold mine in terms of generating revenue for "preventive" measures. The whole breast cancer "awareness" movement is a wash.

    ReplyDelete
  4. I like the ѵaluablе іnfoгmаtion уou prονіde in youг articles. I'll bookmark your blog and check again here frequently.

    ReplyDelete