“Medical examination does not take menstruation into account”

The origin of the calling of Carme Valls Llobet There’s no need to look for it as a doctor’s daughter – who influenced – but in something much more intimate: her periods were terribly painful. Understanding the menstrual cycle that gave her such a bad life didn’t just make her an avid endocrinologist. It also made it a ‘nuisance’ to the health system designed by and for men up to four days ago.

Their struggle to include a gender perspective in health care has been successful. Not long enough, he says. In Invisible Women for Medicine (Captain Swing), a now updated classic, unleashes arguments.

-What used to be, medicine or feminism?

-I came to feminism through biology. My first impact was in my fifth year of medicine, in 1966: women came to the emergency room with fractures and bruises that didn’t fit “falling down the stairs,” and the boss decided, “Stay away, it’s a private affair. . ” And in medical history, we pointed to the injuries in silhouettes of men.

– Was your conscience born there?

-I would say it was the result of the organization of the first Congress on Women and Quality of Life, in 1990, where I asked the question, “Are there differences in mortality and morbidity between men and women?”

-And the answer is there are.

-Yes. I don’t accuse science of being macho. In the hospitals were men, and medical science was born from the hospitals. They thought that what happened to men also happened to women. But women’s lives are traversed by the menstrual cycle. It permeates all systems of the female body: all skin cycles, it affects the metabolism of the heart, cholesterol … From 14 to 50 years old, they emphasize that it is not important; But if you don’t have your period, they say you’re going to have problems now. Let’s see, does it matter or not? There are hardly any research articles covering menstruation. And 70% of the rats used for drug studies are male.

-Difficult to correct course.

-Marcia Angell, head of the New England Journal of Medicine, demanded that scientific works that do not differentiate by gender should not be accepted.

-How do you explain women’s conformity?

-When we were nomads, the woman –with a fisheye– warned of the lion’s arrival, and the man –with tunnel vision– stabbed the spear. There was equality and motherhood was highly respected (they saw the baby come out, but not how it “come in”). That put an end to ownership of the land.

-The Zero Minute of Patriarchy?

-The men wanted to be sure that the children were theirs and they locked up the one who gave birth to them. To achieve this confinement, it was concluded that the woman was inferior. And for those who already had period pain and had given birth and were definitely anemic, it was good for them. If not, it is not understood that there has been so much domination and guilt in all cultures.

– Debt sabotages?

-If you feel guilty, don’t protest. And the stereotype was installed and perpetuated even in women themselves. The Bible made it clear that Eve was responsible for the Fall. Just two centuries ago, Olympia de Gouges said women should have the same rights and was beheaded. And last century ran that the female brain was smaller, although it was later seen that the difference is water, not neurons.

-Is inequality sick?

-Yes. The double shift, which means that when the woman comes home, the man rests and does not get sick from a cardiovascular point of view and causes anxiety.

– Would you dare to apply the term ‘gender violence’ in healthcare?

-If the science of difference is lacking, it is violence. The fact that they don’t listen to you during the consultation is violence. Being forced into unwanted treatment is violence. The attitude of doctors to the patient is sometimes aggressive, imposing, dictatorial.

“The dual shift of women makes them sick from a cardiovascular standpoint and gives them anxiety”

– Ignored on the one hand. On the other hand, perfection is required of them.

– That tension causes fear. It’s actually an imaginary conflict: you are worthless, but you start a race to be perfect. They project it on having the perfect home, on being the perfect mother or the ‘super woman’ who does everything and destroys herself inside. Because it is a social and cultural problem, you cannot dismiss it as “you are depressed” and treat it with psychotropic drugs.

– The girls are not that willing.

-The young women have progressed, but are not yet in the lead. And those who are may not have a gender perspective. The feeling of guilt in women must be removed in order not to lapse into medicalization.

-An illuminating example.

-A study by the Galatea-CAPS Foundation examined what Catalan doctors stress the most. They have a higher premenstrual syndrome than any other profession, more breast cancer and more obstetric risks. We found that this was in large part due to the stress caused by the lack of decision-making ability about their own work. The medical school’s response was to take an anti-stress course. No! They want a health organization geared not to men, but to life. More now, that the pandemic has revealed that of all contaminated toilets, 70% are female.

-The virus attacks them more, but kills them less.

-The virus contains angiotensin converting enzyme receptors (ACE receptors) and the woman’s body has more, although it can produce ACE-1 and ACE-2, the last protector against inflammation.

– Will Fernando Simón know?

-Insurance. It would be good if it provided data on the covid by gender. And that the public exhibition is shared with members of his team, such as Marina Pollán Santamaría, who leads the serological study across Spain, and Raquel Yotti, the director of the Carlos III Institute.

“The symptoms of heart disease are different from those of men. After treatment, mortality after an infarction is higher”

– What do women die most from?

The first cause is ischemic heart disease. Because the symptoms – which are different from those of men – are not identified, it takes longer to apply treatment and the mortality after the infarction is higher. Patricia Healy coined the term ‘Yentl syndrome’: women should go to the cardiologist dressed as men. Has progress been made? Something. Women are now involved in 38% of cardiovascular disease studies.

– He doesn’t recommend aspirin.

The first 50,000 people they experimented with were men. When they have admitted women, it has been seen to cause more gastrointestinal bleeding.

– Then there are creams, shampoos, dyes.

Most breast cancers are due to excess estrogens, natural or environmental factors. It is normal to have less than 80 cm³ of blood loss each month, and the parabens in shampoos and creams – which mimic the effect of estrogen – have been seen to increase this; and that the dyes can cause non-Hodgkin’s lymphoma. Anything that mimics the effect of estrogen accumulates more in the fat cell, and women have more fat cells than men.

-We have the worst part in all areas …

Being a woman in an androcentric society hurts us. Medicine does not see us, but they have already given us everywhere for that: insults in adolescence, stress in motherhood – 25% develop autoimmune thyroiditis -; working life, where there may be toxic substances in the environment. They come to the consultation and report that everything hurts, and they are given a contraceptive or a sedative. That is not possible! The covid leaves behind chronic fatigue syndrome in women.

“It has been seen that the cells of the female body have different proteins”

Part of feminism is uncomfortable to highlight the differences.

– Some say if you get too organic, you will provoke macho arguments. But the difference does not mean unequal rights. The cells of the female body have been shown to have different proteins. And the corpus callosum, which connects the left and right hemispheres of the brain, is three times the size. We have the right to be viewed in our differences.

– Distribute a recipe to roll.

-We have to start to be what we want. Restore our wishes. Only people who are no longer victims get better at becoming protagonists of their health. You have to give yourself five flavors every day.

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-Which do you give yourself?

-I have regained my desire to regain those of the others.

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