Unwell Women

for millennia, the medical understanding and treatment of women’s health has been profoundly shaped by misogyny and patriarchal structures, reflecting social and cultural biases as much as scientific knowledge. since ancient times, male anatomy has been considered the standard, with women’s bodies viewed as mere deviations or inversions of men’s, leading to centuries of inadequate study and understanding of female anatomy. 

these historical biases continue to reverberate through modern healthcare, where women face systemic challenges in receiving proper medical attention. women are less-frequently referred for diagnostic care and disproportionately affected by chronic conditions that remain understudied. 

understanding today’s medical discrimination requires examining the centuries-long shadow cast by the medical profession’s historical treatment of women. through a series of revealing historical snapshots, this chapter illuminates how past medical practices and attitudes toward women’s health continue to influence modern healthcare disparities and challenges.

the history of women’s health is riddled with misconceptions, but few have been as persistent and influential as the “wandering womb” theory, first popularized by hippocrates on the greek island of cos. while hippocrates is celebrated for advancing medicine as a science by rejecting the notion that diseases were divine punishments, his understanding of women’s health was deeply flawed and shaped by the social structures of ancient greece.

in a society in which women were largely unable to seek paid employment and couldn’t own property, and their primary purpose was to bear and raise children, it seemed logical to ancient greek physicians that the uterus would be the source of all female ailments. hippocrates developed the theory of the “wandering womb,” which suggested that an “unfulfilled” uterus – one not engaged in its “natural” function of sex and pregnancy – could actually migrate through the body, disrupting other organs and causing a wide range of symptoms from convulsions and hallucinations to pain and paralysis. the prescribed cures? marriage, sexual intercourse, and pregnancy.

this concept persisted well into the middle ages, when women’s bodies were further burdened by religious shame stemming from the biblical story of eve’s temptation and original sin. medieval moral laws even prohibited medical professionals from examining women’s bodies, deepening the mystery and misunderstanding surrounding female anatomy.

ultimately, the most effective treatment of women’s health issues came from women themselves. in eleventh-century salerno, women began training as physicians, with trota emerging as a particularly influential figure. her comprehensive work, the trotula, while still reflecting some contemporary biases about female weakness, made the groundbreaking assertion that the womb could not actually move within the body (except, to some extent, in cases of prolapse). however, because trota was a woman and women’s health was not considered a serious medical concern, her ideas failed to gain widespread acceptance. by the fourteenth century, women were banned from practicing medicine across europe.

the wandering womb theory’s remarkable longevity extended even into the early twentieth century, where it evolved into diagnoses of “hysteria,” demonstrating how persistent medical misconceptions about women’s bodies can be. this ancient idea exemplifies how cultural biases and social structures have historically shaped – and continue to influence – medical understanding and approaches to women’s health.

the complex history of women’s pain in medicine is vividly illustrated by the 1812 account of playwright fanny burney’s mastectomy. with only wine cordial and a handkerchief over her face, burney endured excruciating pain until she mercifully fainted. at the time, breast cancer was thought to be caused by various factors, including women's “unstable emotions.” scottish surgeon john rodman typified contemporary medical thinking, attributing the disease to women's “feeble structure” and emotional disposition – particularly those of middle- and upper-class women.

this perception of feminine sensitivity was deeply racialized: while wealthy white women were viewed as exceptionally delicate and sensitive to pain, poor women and women of color were assumed to be more resistant to suffering – a dangerous misconception that continues to affect medical treatment disparities today. black women, in particular, still see their pain being systematically undertreated or dismissed in medical settings.

the medicalization of childbirth in the mid-nineteenth century brought these attitudes to women’s pain into sharp focus. a prevailing myth held that the agony of childbirth was divinely ordained, making mothers more devoted to their children. scottish obstetrician james young simpson challenged this belief by pioneering the use of anesthesia in childbirth. after discovering chloroform's “blissed out effect,” he administered it to jane carstairs, whose previous labor had lasted three grueling days. the success was so remarkable that carstairs named her daughter anaesthesia.

however, simpson faced fierce opposition from colleagues like american obstetrician charles meigs, who claimed labor pain was both natural and necessary, erroneously calculating that women only experienced 25 minutes of pain per labor. the tide began to turn when queen victoria received chloroform during the birth of her eighth child, describing the experience as “soothing, quieting, and delightful beyond measure.” yet pain relief remained a privilege of wealthy women who could afford it.

throughout medical history, women’s pain has been consistently minimized, moralized, or dismissed entirely. from burney’s mastectomy to modern labor wards, the treatment of women’s pain reflects deeper societal attitudes about gender, class, and race – attitudes that continue to influence medical care today, often with devastating consequences for women’s health outcomes.

the history of gynecological medicine reveals how deeply cultural fears and moral panic about women’s sexuality have shaped medical practice. at the center of one nineteenth-century controversy was an seemingly innocuous tool: the speculum, a duck-bill-shaped instrument that revolutionized cervical examination. before its invention, doctors relied on abdominal palpation to diagnose conditions like fibroids, cysts, tumors, and cervical erosion – a far less accurate method.

despite its potential to save lives by enabling better diagnosis and treatment, the speculum faced fierce opposition. critics worried it would destroy the hymen (considered a crucial marker of virginity) and feared it might provoke “hysteria” or create “sex-crazed women” through penetration. the fact that it helped diagnose sexually transmitted diseases only fueled the controversy.

physician robert brudenell carter exemplified the period’s medical anxieties, warning that the speculum could stimulate dangerous sexual desires leading to hysteria or “womb heaviness.” he particularly feared it might encourage what he euphemistically called the “solitary vice” – masturbation. the prevailing belief held that women’s sexual desires could only be safely expressed within marriage, and that clitoral stimulation could lead to nervous derangement.

the medical response to female sexuality could be brutally extreme. while gynecologist samuel ashwell recommended rest and cold baths for slightly enlarged clitori (though we now know the clitoris, with its 8,000 nerve endings, can naturally vary in size), more “serious cases” were treated with clitoridectomy – one of medicine’s most shocking interventions. london gynecologist isaac baker brown advocated this procedure, claiming that clitoral stimulation could cause paralysis, blindness, and mania.

this moral panic paralleled growing awareness of contagious diseases like cholera and typhus. female masturbation was similarly framed as a disease threatening domestic morality. the same harsh judgment extended to women with sexually transmitted infections like syphilis or gonorrhea, who were condemned for “wanton habits” while the possibility of transmission from their husbands went unconsidered – a stark example of how medical attitudes reinforced social double standards.

the early twentieth-century fight for birth control access reveals both the desperation of women seeking reproductive autonomy and the complex, sometimes troubling history of the movement. in 1914, margaret sanger faced indictment for distributing “obscene material” through her newsletter the woman rebel – which included rudimentary contraceptive advice like douching with vinegar or ice-cold water, and taking laxatives and quinine to prevent suspected pregnancies.

while sanger temporarily fled to england, her work inspired others like mary ware dennett, who had endured three traumatic pregnancies without receiving any contraceptive guidance from her doctor. together with clara stillman, dennett founded the national birth control league, driven by the belief that women could never truly enjoy their bodies until freed from “forced reproduction.” she authored the sex side of life, a revolutionary anatomically precise sex-education guide that encouraged young people to embrace sexual pleasure without shame, though she still reflected contemporary prejudices against masturbation and sex work.

upon returning to the us, sanger – whose work as a visiting nurse in new york’s tenements had exposed her to the horrific consequences of botched back-alley abortions – opened america’s first birth control clinic in 1916 with her sister ethel byrne. the clinic saw 400 women in just ten days before authorities shut it down.

during her time in england, sanger connected with marie stopes, whose own sexually traumatic marriage inspired her influential book married love. stopes explained women’s cyclical sexual desire, emphasized the importance of foreplay, and discussed contraception options like sheep gut or vulcanized rubber condoms. in 1921, she established britain’s first mothers’ clinic in london.

however, this revolutionary movement had a dark underpinning: both stopes and sanger viewed birth control as a means of limiting reproduction among poor, disabled, and non-white families, even supporting sterilization in some cases. this troubling truth – that the birth control movement that has liberated countless women was also entangled with the oppression of marginalized groups – highlights how even progressive movements can perpetuate harmful biases and discrimination.

throughout history, menstrual pain has been simultaneously pathologized and dismissed – a paradox that exemplifies medicine’s problematic approach to women’s health. in the nineteenth and early twentieth centuries, as gynecology became increasingly professionalized, male physicians perpetuated the idea that debilitating period pain was both inevitable and evidence of women’s inherent weakness. enter clelia duel mosher, a pioneering researcher determined to challenge these assumptions.

mosher conducted groundbreaking research to demonstrate that severe menstrual pain wasn’t universal – many women experienced minimal discomfort, and those who did suffer could find relief rather than resignation. her rigorous methodology involved studying over 3,350 menstrual cycles across 400 women, tracking everything from cycle details and blood pressure to subjective experiences through patient diaries. this contrasted sharply with male gynecologists’ tendency to inflate abnormal cases, promoting the misleading notion that all women were incapacitated one week of every month.

mosher developed an exercise regime known as “moshering” to strengthen core muscles and alleviate cramping. her approach was informed by her groundbreaking research on female respiration, which revealed that women's supposedly “natural” shallow breathing was actually caused by restrictive corsets – a simple but revolutionary observation that had escaped her male colleagues.

while some physicians dismissed severe menstrual pain as feminine oversensitivity, others prescribed extreme solutions. fibroids, which affect 70 percent of white women and 80 percent of black women between the ages of 30 and 50, were often treated with hysterectomy – a dangerous surgery with a 70 percent mortality rate in the nineteenth century. even survivors faced serious long-term consequences, including chronic pain, decreased libido, and vaginal prolapse. yet hysterectomy remains a common treatment for fibroids today.

the medicalization of women’s discontent in the 1950s reveals how pharmaceutical companies and doctors interpreted social issues through a lens of individual pathology. at the center of this story was the drug miltown (meprobamate), the first widely distributed minor tranquilizer. released in 1955 by wallace laboratories, it was marketed as a miracle cure for everything from arthritis and asthma to anxiety and multiple sclerosis. within a year, it became america’s most-prescribed drug.

marketing specifically targeted housewives, promising to fortify them for daily tasks from grocery shopping to pta meetings to marital duties. however, the anxiety these women experienced often stemmed from oppressive gender norms rather than medical conditions. moreover, many symptoms treated with miltown – chronic fatigue, unexplained pain, rheumatism – were actually manifestations of autoimmune diseases like lupus, me, and ms, which predominantly affect women and remain poorly understood even today.

when meprobamate reached the uk in 1956, it quickly became the most-prescribed drug there as well, treating a range of “feminine” complaints from insomnia to “weak nerves.” the consequences were severe: between 1954 and 1956, barbiturate overdose caused 271 accidental suicides among women in england and wales. long-term use led to blurred vision, drowsiness, nausea, and addiction.

betty friedan’s the feminine mystique later contextualized this epidemic of female anxiety as “the problem that has no name” – the profound dissatisfaction of women forced back into domestic roles after experiencing independence in the wartime workforce. however, as bell hooks and other feminist critics would later point out, friedan’s analysis primarily addressed the experiences of white, middle-class women, overlooking how race, class, and economic necessity shaped different women’s relationships to both work and domesticity.

this history illustrates how medicine often serves as a tool for maintaining social order, substituting the prescription of pills for addressing society’s systemic inequalities. instead of recognizing women’s discontent as a rational response to restrictive gender roles, the medical establishment pathologized their feelings and medicated their resistance, a pattern that continues to influence women’s healthcare today.

the main takeaway of this chapter to unwell women by elinor cleghorn is that women’s bodies have been misunderstood by medicine for centuries, from ancient “wandering womb” theories to modern dismissal of chronic pain. the medical establishment has historically pathologized normal female experiences while simultaneously dismissing serious health concerns, with race and class deepening these biases. though pioneering women fought back, many of these prejudices continue to shape healthcare today.

okay, that’s it for this chapter. we hope you enjoyed it. if you can, please take the time to leave us a rating – we always appreciate your feedback. see you in the next chapter.