When I opened my clinic in London in 1998, I soon found I was receiving many more women than men as patients—and the same is true today. Women have embraced complementary therapies more readily and, while not turning their backs on conventional medicine, recognise that a blend of the two, and a more holistic approach to health, provides more satisfactory answers to their problems and concerns. This is exactly what integrated medicine does.
Why women need their own guide
Family health still rests primarily in a woman's hands. Far more women than men care for the family's well-being: they prepare the food they eat, make appointments with doctors, nurse them through illnesses and read about healthcare. So it's important that women's health is taken care of properly.
It's important that a woman's health should not be considered and treated exactly the same as a man's. This means taking into account the less obvious ways in which women differ from men, ways that are not visible on the surface but which can make a big difference to the way women are affected by illness.
It is up to you to learn about how your own body functions, to recognise how it [your body] responds to different stresses and circumstances, and to know how best to treat it in the hope of being rewarded by a long and healthy life. A vital part of this is to understand something of the many ways in which women differ from men—differences that go far beyond body shape and the ability to have babies—and how very varied women themselves are, so that what may be right for your sister-in-law or your neighbour may not be right for you.
Women’s health and wellbeing
Wellbeing goes beyond health. You can be technically healthy and yet not feel great. Someone afflicted with, for example, migraine, menstrual cramps, chronic fatigue syndrome, general aches and pains, irritable bowel syndrome, frequent coughs and colds, insomnia, depression or panic attacks will probably show no, or very little, variation from the norm in physical health checks such as blood tests. Many women have perfectly normal periods and show no hormonal irregularities, yet they cannot conceive naturally. A medical examination can reveal so little of such suffering.
Treating the disease rather than the person can be of particular disbenefit to women. To give just one example: steroids are commonly prescribed to sufferers of rheumatoid arthritits or MS. But men and women react to them very differently. A woman will find she gains weight and her face puffs up; she suffers from fluid retention and often has problems with her periods; she is likely to have trouble sleeping and have terrible mood swings or become aggressive. Men are much less likely to have any such troubling side-effects. Further problems that afflict women, such as excess body hair, hormonal weight gain, hair loss and PMS, are often misunderstood, misconstrued or dismissed as ‘vanity matters’.
Artificial hormones, antibiotics, painkillers and other regularly prescribed drugs can have horrendous side-effects.
An additional, major contributor to women’s ill-health is one that is mostly overlooked or underestimated: the stress brought on by the conflicting demands of modern life.
A change in emphasis
It is my firm belief, based on years of experience that the pattern and strains of modern life have altered the way a woman feels, looks and behaves. In traditional families women reign the affairs of the family and were called ‘housewives’ as they worked at home. The power they held was real and their pre-eminence in matters such as child-rearing, family health, domestic spending and, in wealthier homes, staff training and discipline was undisputed. However, in a money-based economy, wealth equals power and a healthy balance of duties and responsibilities can easily become distorted in favour of whoever holds the purse strings. Women discovered they had to work harder than their male counterparts to ‘prove their equality’.
Working women with family often found the larger part of household chores and of maintaining the ‘family glue’ still fell to them, testing their energy levels to the limit; they would juggle job and family commitments and wrestle with guilt when one detracted from the other. Women who chose not to follow a career or paid employment found they lost status, and became defensive about their choice or guilty about not contributing to the family finances.
When body and psyche are put under strains like this, it obviously reflects on general health but also rebounds on women in perhaps an unfair way—on their womanhood itself. Stress hormones [such as adrenalin] are akin in nature to male hormones, and an increase in male-style hormones is one of the most unnatural things that can happen to a woman. Many conditions on the increase today—including polycystic ovary syndrome, infertility and some forms of obesity—stem from this shift in hormonal balance that stress induces.
Listening to nature
A woman’s body is perhaps more attuned to nature than a man’s. One of the main reasons for this is that the effects of hormonal cycles are more prominent. It has frequently been noted that hormonal-based problems respond better to natural treatments than when tackled with strong medicines—fertility treatments with medicines often fail while natural ones [herbs, relaxation, diet] are more successful. Many couples, having given up trying for or having adopted a child, subsequently have their own, when the anxiety of not conceiving has gone. And heavy periods, menstrual cramps and pain, endometriosis, polycystic ovary syndrome, amenorrhoea and PMS, usually treated by hormones, often come back when the medicines are stopped.
The difference between men and women
As I pick up the pen to write this, one thought comes straight to my mind—that this is a daring subject, practically taboo.
Most women in the developed world have been brought up, rightly, to see that they are the equal of men. This has led to a widespread, but wrong belief that they are the same as men. The societal distinctions between men and women in terms of rights and power have been man-made.
When intellect and mental capacity are compared, it is difficult to find any distinction between the two sexes. If anything, it is boys and men who seem to have the greater struggle and, even within the restrictions of purdah, Middle Eastern universities turn out more women graduates, with higher degrees than men.
So, if not intellectually, where do the differences lie, beyond the obvious physical ones, and how may these affect a woman’s health and wellbeing? Recognising the deep and very real differences is a step towards improvements for everyone, especially women.
The body is built for the functions it carries out. Most people know that women’s hips are wider than men’s to make childbirth easier, but a woman’s body has a further refinement on this. Just before the baby is due, hormones in the placenta trigger a calcium loss that causes the relevant joints to ‘de-fuse’, helping the baby pass through without any hitch.
Female bones are also more prone generally to loss of calcium, however, leading to a greater prevalence of osteoporosis [brittle-bone disease], polymyalgia rheumatica [general body aches], cramps in the toes and legs, rheumatoid arthritis and fracture more easily and, if there are serious hormonal problems or a chronic disease such as diabetes, she will generally heal more slowly.
The muscular system develops according to the genetic structure of the body, developed over millions of years. Men therefore tend towards a V shape, with broad shoulders narrowing to the hips, whereas women are the opposite, with less emphasis on the shoulders and wider at the hips.
Women gymnasts, ice skaters and ballerinas are more flexible and graceful than their male counterparts because their structure allows them that freedom, but men have the edge in a performance that demands muscular strength. Unless specifically trained, women do not have powerful biceps, calves, pectorals, or abdominal or shoulder muscles. The muscle bulk-building hormones in the body are by nature similar to androgens or male hormones, and in excess cause the female body to change for the worse.
The key to all sorts of physical activity is oxygen, carried by blood to the muscles. Proportionate to their size and weight, women have fewer blood cells than men, and a lower volume of blood. It is also slightly thinner. [Menstruation is not a factor in this: menstrual blood is built up over the month in the lining of the womb and its loss has little consequence for the body’s general stamina or energy.] A higher proportion of blood, supplying a greater muscle bulk, is what gives men a natural advantage when it comes to power and speed.
Oxygen allows the conversion of glucose to carbon dioxide and water, and so a smaller supply of oxygen will lead more quickly to muscle cramps and fatigue. So, unless specifically developed, women’s muscles tire more quickly.
Digestive system and eating habits
A man’s digestive system [in full health] is inclined to be more robust than a woman’s as it has evolved to support harder physical work [so it produces more bile, for instance, to cope with greater amounts of food].
Women are more prone to reflect psychological problems in their eating patterns. Eating disorders such as anorexia and bulimia are so much more common among women that they are sometimes wrongly believed to be exclusively a female problem. Stress and bodily changes are also more likely to trigger an alteration in dietary habits: a craving for sweets is common premenstrually, for example, and the cravings of pregnant women can include oddities such as clay or chalk.
A major influence on mood, and therefore outlook on life, is hormones. Both men and women have hormones, of course—after all, they are the deciding factor in whether we are male or female even before we are born—but the hormonal changes in women are more prominent and so the cycles of moods are more noticeable. Premenstrual tension, post-natal depression and behavioural changes in the early stages of pregnancy are some examples of the hormone-induced mood changes in women. Many of the problems and conditions explored from menopausal anxiety to weight control, have a hormonal element.
Once, women’s internal workings were considered a mystery and their minds unfathomable. Nowadays, all too often, the real differences between men and women are ignored or minimised. But equality doesn’t mean sameness. Somehow, we have to reach a true equality that allows for a woman’s feminine nature to be an integral part of her life and health care.
What makes you a woman?
We all begin our life as female. The sex chromosomes in our genes — XX for female, XY for male—are there from the moment of conception, but it is only after six weeks of development in the womb that the first secretions of male hormones trigger the initial stages of development into a boy; until then male and female embryos are identical.
In the earliest stages the rudimentary external genitalia look exactly the same in both sexes. Under the influence of male hormones, what is the clitoris in a female becomes the penis in a male, the larger folds of the vagina become the male scrotum and the smaller folds of the vagina become the shaft of the penis. The testes begin to develop in the male abdominal cavity and descend slowly into the scrotum around the time of birth, while in the female the ovaries remain inside, held in place by ligaments so that they do not drop with gravity.
Sometimes, despite the genetic programming, an embryo is not exposed to male hormones at the appropriate time and the reproductive organs will not modify in this way [and the reverse is also true: a genetically female embryo exposed to an excess of male hormones at this time can develop genitalia with male characteristics.] Although these intersex conditions are not common they occur more often than is generally realised and indicate that nature, in its infinite variety, is not easily pigeonholed into X or Y.
Excerpted with permission from Dr Ali’s Women’s Health Bible: the essential guide to your health and well-being.
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