All in Her Head: The Truth and Lies Early Medicine Taught Us About Women’s Bodies and Why It Matters Today

by Elizabeth Comen

But the emotion I encounter most in the examination room, more potent and insidious than fear, is shame.

The role of women was proscribed in medicine as in society, bolstered by the stereotype of the female nurturer: Doctors cured. Nurses cared.

Women remain underrepresented and overlooked in medical research, even though many treatments interact differently in a female body than in a male one.

One recent study revealed that women operated on by men have significantly worse outcomes, including death, than when operated on by women. (As for the men, their outcomes were the same whether a man or woman operated on them.)

We need to stop apologizing for our medical needs, and start asking the questions that lead to better knowledge, better health, and better lives. We need to ask how to cultivate a relationship with our bodies that is not just comfortable, but joyful; how to know when something isn’t right and to advocate, not apologize, for our needs; how to navigate a healthcare system that will never be perfect but could be better; how to be as assertive, as informed, and as confident in the care we deserve in a doctor’s office as we are in the rest of our lives.

Today, the practice of cosmetic medicine is one that walks the line between empowering women to control their bodies and trapping them in a gilded cage of punishing beauty standards.

it’s a story about men with the power to make women beautiful, and the authority to decide what “beautiful” looked like.

In addition to the idea that being immobilized was no big thing for women, patients suffering from frozen shoulder also appear to have been up against another form of prejudice that is by now familiar to any student of medical history: the notion that any problem mainly afflicting women must have a psychosomatic component.

How athletic could a woman be before she didn’t count as a woman anymore?

‘Well, I failed, I didn’t have enough up top. They say I can’t run and I have to go home because I’m not ‘big’ enough.”

maintaining a certain amount of muscle mass, even if it means sitting at a higher weight, is far more important to overall health than keeping the number on the scale low. That resistance training that builds muscle will make the body far more resilient than the calorie-burning cardio exercise to which most women gravitate.

the Female Triad: disordered eating, irregular menstruation, and loss of bone density.

In 1995, the seminal study establishing that aspirin could reduce the risk of heart attack included 22,000 men—and, again, zero women.

“When your estrogen peaks during ovulation, it’s not only body temperature that goes up; the heart rate goes up, too, by about two to four beats. Meanwhile, we’re at the lowest level of estrogen and progesterone right before the period starts, and that’s the time that women are more likely to have arrhythmias.”

“Grinch Syndrome” (also called postural orthostatic tachycardia syndrome), which is allegedly characterized by an undersized heart, goes overlooked in the women it disproportionately affects because their hearts tend to be smaller to begin with.

Too many don’t know that the systemic inflammatory and autoimmune disorders that disproportionately affect female patients also predispose them to heart conditions.

It also might be the first documented instance of the phenomenon known as “woke capitalism,” in which corporations sold products to women under the guise of helping to liberate them.

smoking put women in control—of their lives, their futures, even their appetites.

Rates of lung cancer, for which the imagined “standard” patient is a male smoker in late middle age, have risen 84 percent in women since the late 1980s, even as they drop in men.

Every year, more women die from lung cancer than from breast, uterine, and ovarian cancers combined,

The signs of strangulation in women aren’t always obvious. For every patient who presents with obvious ligature marks around her neck or a constellation of burst blood vessels on her cheeks or in the whites of her eyes, there is another who shows no signs at all—and many survivors suffer hypoxia-induced amnesia about the attack itself, owing to the effects of strangulation on blood flow to the brain. This may be why strangulation assaults are underreported by victims; it is also why they too often go unrecognized by doctors in emergency room settings.

10 percent of all women in the US will suffer a nonfatal strangulation incident in their lifetimes.

Medical history is full of moments in which a woman suffering from a functional illness—that is, an illness with no apparent cause—was told that her condition was psychosomatic, all in her head.

endometriosis, which is strongly linked with—and sometimes mistaken for—interstitial cystitis, since endometriosis can create cell buildup on either the inner or outer wall of the bladder, causing pain, inflammation, and urinary issues.

American Plan, and under its auspices, vast numbers of women were essentially kidnapped, imprisoned, and forcibly treated with dangerous drugs in the name of the common good.

American Plan, author Scott W. Stern

The pity of it is, every wife can hold her lovable charm by simply using Lysol disinfectant as an effective douche. —Lysol ad, circa 1950s

Women were told that putting the powder in their underwear would reduce odor, only for a link to emerge suggesting that talcum powder could cause ovarian cancer. This information came to light in 2006, when the World Health Organization issued a warning—and in 2007, Johnson & Johnson agreed that they would stop marketing talcum powder as a genital deodorant . . . to white women. (In 2023, Johnson & Johnson settled a $8.9 billion lawsuit regarding talc as a carcinogen.)

Women are 80 percent more likely to suffer from autoimmune disorders than men,

Many of these diseases are “undifferentiated,” which is to say, not classifiable—and because of the way the medical apparatus currently functions, a disease without an official diagnosis becomes a patient without a path forward. Those who suffer from undifferentiated diseases are not included in clinical trials or other policy measures; these women, and there are millions of them, simply fall through the cracks of a system that has no means of registering their existence.

researchers virtually never track the impact of treatments on menstruation unless the treatment is specifically fertility-related.

among respondents, 71 percent of women on birth control and 66 percent of postmenopausal women reported breakthrough bleeding within two weeks of getting vaccinated.

The problem, doctors said, was anxiety. The truth was, they didn’t have a clue.

estrogen. The latter, which regulates the female menstrual cycle, was discovered—and named—in 1920. Its etymology is telling: it comes from the Greek oistros. It means “mad desire.”

Almost as if it remains less important for women to understand their bodies than it is to keep those bodies under control.

Andrew M. Kaunitz, attempted to correct the record in 2016 with an article titled “Menopause Management—Getting Clinical Care Back on Track.”

Rebecca Jordan-Young notes in her book Brainstorm: The Flaws in the Science of Sex Differences,

two-thirds of all breast cancers are estrogen-driven,

beginning in the 1930s in Puerto Rico, nearly one-third of all women between the ages of twenty and forty-nine were forcibly sterilized as the result of a population control program supported by the US government.