#When I went to type in menstruation 'menstruation tw' was the 1st result

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For three months this year, I bled nearly every day. My doctor doesn’t know why. Google doesn’t know why. The condition is simply called “postmenopausal bleeding,” and medicine’s best guess as to the cause is that the postmenopausal hormone-replacement therapy I started last November suddenly made my endometrium, the lining of the uterus, “unstable.” All scientific knowledge added up to “If it’s still happening in six months, get back in touch.” (I’m still bleeding intermittently, and I don’t know why.) This is the kind of massive medical shrug that anyone with female anatomy has probably encountered.

Despite major advances for women over the past 100 years—the invention of the contraceptive pill, greater access to safe abortions—much of female biology is still woefully underserved by science. There are reasons for this, most notably the historical exclusion of women from medical and pharmaceutical trials, partly because our awkward hormone cycles were thought to skew results. There’s also the fact that some scientists still project findings from research on men onto women, seeming not to realize that women aren’t just small men: Women are different down to the cellular level, meaning that many of our immune responses, experiences of pain, and symptoms (including, for instance, those that accompany a heart attack) may be different from men’s. Are you having a nasty, unexpected side effect from your medication? That could be because most drugs were developed with male bodies in mind. A 2020 review of 86 common medications, including antidepressants, cardiovascular drugs, and painkillers, found that women were likely routinely overmedicated and suffered adverse reactions nearly twice as often as men.

The lagging science is particularly apparent when it comes to periods and female hormones more generally—the subject of the anthropologist Kate Clancy’s new book, Period, a scientific and cultural history that purports to tell the “real story of menstruation.” Clancy’s book makes clear that a lack of data is to blame for many of the ills that women and girls face concerning their reproductive health, like doctors’ failure to diagnose painful conditions such as endometriosis.

My severe endometriosis was discovered only when I was 41, accidentally. For decades, I had been given prescription-strength painkillers, and my doctor never seemed to wonder whether the amount of pain I was in was abnormal. When I published an essay about my menopausal depression in 2018, a deluge of women wrote to tell me that when they were going through something similar, their doctors had told them they were imagining their brain fog or panic attacks, or had put them on antidepressants that didn’t work because many depression drugs are inadequate to treat the symptoms of fluctuating estrogen.