Medical Inequity: The Stark Contrast Between Erectile Dysfunction and PMDD
In the world of medicine, not all conditions are treated equally. While certain conditions receive significant attention, funding, and research, others are left in the darkness, affecting millions with little support or understanding.
The stark contrast between the focus on Erectile Dysfunction (ED) and Premenstrual Dysphoric Disorder (PMDD) underscores a troubling pattern rooted in patriarchal biases within the western healthcare system.
The Disproportionate Focus on Erectile Dysfunction
Erectile Dysfunction, a condition that affects approximately 30 million men in the United States, has garnered significant attention from the medical community. Pharmaceutical giants have poured billions into developing treatments, resulting in a market flooded with options like Viagra, Cialis, and Levitra. The success of these medications has not only provided relief for many but has also led to a surge in research, with studies continuously exploring new treatments and underlying causes.
In 2020 alone, the global erectile dysfunction drugs market was valued at over $3.4 billion and is projected to reach $4.9 billion by 2027. This financial investment reflects a broader societal and medical prioritization of male sexual health, emphasising the importance placed on conditions affecting men.
The National Institutes of Health (NIH) has funded extensive research into ED, with millions allocated annually to understand its physiological, psychological, and social impacts.
The prominence of ED in medical discourse and research illustrates how a condition primarily affecting men can receive swift and substantial attention.
This focus ensures that men suffering from ED have access to a wide range of treatments and ongoing advancements, highlighting a healthcare system responsive to their needs.
The Neglect of PMDD
In stark contrast, Premenstrual Dysphoric Disorder (PMDD) remains under-researched and poorly understood. Affecting an estimated 5-8% of people assigned female at birth, PMDD is severe and characterised by intense physical and emotional symptoms.
These symptoms can be debilitating, often disrupting daily life, work, and relationships. Common symptoms include severe mood swings, depression, irritability, suicidal ideation and physical symptoms like bloating and chest tenderness.
Despite its prevalence, PMDD receives a fraction of the attention given to ED.
Research funding for PMDD is minimal, and treatment options are limited. Many healthcare providers are inadequately trained to recognize or treat PMDD, leading to a significant gap in care.
Patients often report feeling dismissed or misunderstood, with their symptoms being trivialised as mere PMS. This lack of recognition and support contributes to prolonged suffering and a lower quality of life for those affected.
A 2016 study published in the Journal of Women's Health revealed that funding for women's and people assigned female at birth’s health issues, including PMDD, lags significantly behind other areas. The study highlighted that conditions like PMDD are often overlooked in favor of more "mainstream" health issues, leaving those affected without adequate resources or support.
Patriarchy and Medical Bias
The disparity in attention and resources can be traced back to deep-seated patriarchal values within the medical community. Historically, medical research has been dominated by male perspectives, prioritisng conditions that directly impact men while sidelining those affecting women and people assigned female at birth. This bias perpetuates a cycle where male health issues are deemed more urgent and worthy of investment.
The origins of this bias are rooted in a historical context where men controlled medical research and practice, often disregarding or devaluing the health concerns of women.
This patriarchal structure has resulted in a healthcare system that is not only biased but also myopic, failing to adequately address conditions like PMDD that predominantly affect women and gender-diverse individuals.
Colonialism has further entrenched these disparities by imposing Western medical practices and values on diverse populations, often disregarding indigenous knowledge and holistic approaches to health.
This has resulted in a healthcare system that is rigid in its approach, failing to accommodate the diverse experiences and needs of those assigned female at birth. The lack of intersectionality in medical research and practice continues to marginalise those who do not fit the dominant narrative.
The Gendered Impact of Medical Neglect
The neglect of PMDD and other menstrual-related conditions reflects a broader issue of gender bias in healthcare. The traditional medical model, shaped by patriarchal values, often views the male body as the standard and the female body as "other."
For example, heart disease is often considered a "man's disease," leading to under-diagnosis and treatment in women. Women experiencing heart attack symptoms are more likely to be misdiagnosed and less likely to receive appropriate care compared to men.
What Needs to Change: A Call for Inclusivity and Understanding
To truly address the needs of people living with PMDD, the medical community must adopt a more inclusive and comprehensive approach. Here are some crucial steps:
Increased Research and Funding: PMDD needs dedicated research to understand its causes, symptoms, and effective treatments better. This requires significant funding and a commitment to exploring menstrual health beyond the narrow confines of the traditional medical model.
Education and Awareness: Healthcare providers must be educated about PMDD and trained to recognise its symptoms. This includes understanding the distinction between PMDD and other menstrual-related disorders, and recognizing the severe impact it can have on mental health and daily functioning.
Patient-Centered Care: Medical professionals should listen to and validate the experiences of those with PMDD. A patient-centered approach that prioritises the individual's experiences and symptoms over rigid diagnostic criteria is essential. This involves taking a holistic view of health that includes mental, emotional, and physical well-being.
Accessible Mental Health Support: Given the significant mental health challenges associated with PMDD, including depression and anxiety, accessible mental health services are crucial. This includes counseling, support groups, and therapies that specifically address the emotional toll of PMDD.
Development of Effective Treatments: Current treatments for PMDD, such as hormonal therapies and antidepressants, do not work for everyone and often come with significant side effects. There is a pressing need for the development of more effective and less invasive treatment options tailored to the unique needs of those with PMDD.
Breaking the Stigma: Societal attitudes towards menstrual health need to change. By breaking the stigma and fostering open conversations about menstrual disorders, we can create a more supportive environment for those affected by PMDD.
Gender-Affirming and Gender-Neutral Perspectives: Understanding PMDD from a gender-affirming and gender-neutral perspective is essential to ensure that trans, non-binary, and gender-diverse people are included and supported.
PMDD affects individuals of various gender identities, not just those who identify as female. Inclusive language and tailored care practices are crucial in recognising and addressing the unique challenges faced by gender-diverse individuals, ensuring they receive the compassionate and comprehensive care they deserve.
A Future of Hope and Understanding
The traditional clinical model's failure to adequately address PMDD reflects a broader issue of systemic bias and exclusion within healthcare. By adopting a more inclusive, patient-centered approach, we can begin to rectify these shortcomings and provide the support and relief that people with PMDD desperately need.
As society moves forward, it is imperative that we challenge the status quo and advocate for a healthcare system that truly serves everyone. This means recognizing the impact of patriarchal and colonial biases in medicine and working towards a more equitable distribution of resources and research.
Only then can we hope to provide genuine relief and support to those living with conditions like PMDD, who have long been overlooked and underserved. By championing the voices of those who have been ignored, we can create a healthcare system that is inclusive, compassionate, and responsive to the needs of all individuals, regardless of their gender, race, or medical condition.