• Stephanie Drax

The Gender Pain Gap: Dr Anne Sebert gives women relief

Recent studies have proven that women with ailments wait longer in emergency rooms than men, and are less likely to be given painkillers. In fact, we're more likely than men to be given prescriptions for sedatives over the pain medication we want. Why? Because our pain is often dismissed as psychological and quickly attributed to stress, anxiety or depression. And often we minimise our own pain and suffering - think monthly periods and menopause - as normal facts of life. 

Dr Anne Gauthey-Sebert is a GP in London with a special interest in women’s health. She’s French, a feminist, and a former deputy mayor for the 18th Arrondissement in Paris (in charge of public health and drug use). She’s Stephanie’s go-to doctor for pre and postnatal care because she’s as disarmingly honest as she is expert. Dr Sebert dispels some medical myths for Storytellhers and explains how the “normal” physical pain and suffering that most women endure can easily be avoided. 

Dr Anne Gauthey-Sebert

Your life and health are affected by the hormones and cycles that come with being a woman. You can’t compare these issues with men because they are specific to women, and there is a tendency within the medical profession not to take them seriously - and to attribute them to anxiety and stress.

The normality of suffering starts with your first period, and then it never stops. At 13 or 14 you start to bleed for 4 or 5 days a month, and you get pain, mood swings, fatigue, and sometimes can’t face school. This comes at an age when you need to excel at school and sport, and this will have an impact. But do I get teenagers coming in with mum and dad for help? No, I don’t - because it’s considered normal. That’s why women often feel they don’t want to bother a doctor with issues later on - because they consider them ‘normal’. If you think of the definition of health as well being, then women’s health is very much affected every month.

You only need to have your period when you want to have a child. We have methods to stop periods completely or to make them lighter and not painful, such as the Mirena coil (an intrauterine device with progesterone.) 60% of women with this coil don’t have periods and can keep it in for up to 5 years. You don’t have to suffer once a month, and it can literally change your life. Unfortunately, there are rumours that the coil can affect fertility and that it’s bad to put hormones in your body. This is completely false. I hope that we can find a way to thin the uterus and help all women to stop having periods until they are ready to have children.

50% of women who have had a vaginal birth will suffer stress incontinence of the pelvic floor. It’s due to the bladder, the rectum and the uterus and their position in the pelvis. Again, women think that incontinence is normal – which it is up to the 8-week postnatal check, but after that it’s something that can be treated. Women will only come to me when it’s really severe, and often this is because they feel ashamed. It’s something that’s presented to me at best as a “By the way, doctor…” comment at the end of a consultation. Sometimes pelvic floor exercises are not enough, so I refer women to a physiotherapist or gynecologist for effective treatment. Surgical treatment is also successful in severe cases and offers a long term cure.

I’ve met women who have lived 5 -7 years with the symptoms of menopause before coming to see me. It can have a devastating effect: hot flushes, palpitations, low mood, sleep disturbances, vaginal dryness (pain during intercourse and smear test), low libido, concentration and focus issues (which can affect performance at work) ageing skin, loss of muscle tone and osteoporosis. Women are afraid to ask for HRT (Hormone Replacement Therapy) because they worry that it will increase their risk of breast cancer (stated in a study from 20 years ago). This is true, but the life expectancy of a woman on HRT is the same as a woman not on it - and the quality of your life on HRT is so much better. One of my clients is a CEO of a London company whose symptoms were so bad she risked losing her job. Now, on HRT, she says: “I’m back.”

Talking about the clitoris is still uncomfortable for people. It used to be that in children’s and school anatomy books a penis would be shown but a clitoris was not in the picture (and I hope that’s not the case now). I see a lot of women who have suffered Female Genital Mutilation (FGM). I treat a large community of Somalian women and I talk very openly with them about it. There is a lot of pain involved in the mutilation, as well as risk of infection, difficulties in childbirth and pain in having sex. The main reason for this practice is for the woman not to have pleasure in sex (so that they are not tempted by other men or women) and this is rarely articulated. I’ve been to many talks by doctors and gynecologists on this subject, and it’s often presented as an old practice, a ritual in the culture, that keeps a woman pure and marriageable. It’s not a religious practice; and it’s now often justified as hygienic. 90% of Egyptian women suffer FGM, and I often think how almost the entire female population of that country has no sexual pleasure.

I feel there is still a stigma attached to women who choose not to have children. Women without children tell me in consultations that others assume that they have children at first, and when they say they don’t they feel like they are being judged. I say to them: “Do you have brothers and sisters? Then you will be the cool auntie, with the advantages of having a child but at a distance.” I have three boys, and it’s been a joy, but also stressful – I’ve been “on duty” for 30 years. Since our children have grown up and left home, my husband and I don’t argue like we used to. We feel like students again!

Dr Sebert with her eldest son at his wedding

I think it’s our responsibility to educate our sons to be feminists. I have educated my sons about girls’ bodies and their functions, and brought them up to know how to treat a woman and how to do the housework. It is now natural to them to express their feminine side and not to encourage violence. Gender stereotypes still exist in books and advertisements and each of us can do something to combat that. I have always worked. In Norway it’s compulsory for men to take 3 months paternity leave and take charge of the children and the household. Until we introduce that here, we are far from being equal.