Unwell Women summary

The complex history of women’s pain in medicine is vividly illustrated by the 1812 account of playwright Fanny Burney’s mastectomy. With only wine cordial and a handkerchief over her face, Burney endured excruciating pain until she mercifully fainted. At the time, breast cancer was thought to be caused by various factors, including women's “unstable emotions.” Scottish surgeon John Rodman typified contemporary medical thinking, attributing the disease to women's “feeble structure” and emotional disposition – particularly those of middle- and upper-class women.

This perception of feminine sensitivity was deeply racialized: While wealthy white women were viewed as exceptionally delicate and sensitive to pain, poor women and women of color were assumed to be more resistant to suffering – a dangerous misconception that continues to affect medical treatment disparities today. Black women, in particular, still see their pain being systematically undertreated or dismissed in medical settings.

The history of gynecological medicine reveals how deeply cultural fears and moral panic about women’s sexuality have shaped medical practice. At the center of one nineteenth-century controversy was an seemingly innocuous tool: the speculum, a duck-bill-shaped instrument that revolutionized cervical examination. Before its invention, doctors relied on abdominal palpation to diagnose conditions like fibroids, cysts, tumors, and cervical erosion – a far less accurate method.

Despite its potential to save lives by enabling better diagnosis and treatment, the speculum faced fierce opposition. Critics worried it would destroy the hymen (considered a crucial marker of virginity) and feared it might provoke “hysteria” or create “sex-crazed women” through penetration. The fact that it helped diagnose sexually transmitted diseases only fueled the controversy.

The early twentieth-century fight for birth control access reveals both the desperation of women seeking reproductive autonomy and the complex, sometimes troubling history of the movement. In 1914, Margaret Sanger faced indictment for distributing “obscene material” through her newsletter The Woman Rebel – which included rudimentary contraceptive advice like douching with vinegar or ice-cold water, and taking laxatives and quinine to prevent suspected pregnancies.

While Sanger temporarily fled to England, her work inspired others like Mary Ware Dennett, who had endured three traumatic pregnancies without receiving any contraceptive guidance from her doctor. Together with Clara Stillman, Dennett founded the National Birth Control League, driven by the belief that women could never truly enjoy their bodies until freed from “forced reproduction.” She authored The Sex Side of Life, a revolutionary anatomically precise sex-education guide that encouraged young people to embrace sexual pleasure without shame, though she still reflected contemporary prejudices against masturbation and sex work.

Throughout history, menstrual pain has been simultaneously pathologized and dismissed – a paradox that exemplifies medicine’s problematic approach to women’s health. In the nineteenth and early twentieth centuries, as gynecology became increasingly professionalized, male physicians perpetuated the idea that debilitating period pain was both inevitable and evidence of women’s inherent weakness. Enter Clelia Duel Mosher, a pioneering researcher determined to challenge these assumptions.

Mosher conducted groundbreaking research to demonstrate that severe menstrual pain wasn’t universal – many women experienced minimal discomfort, and those who did suffer could find relief rather than resignation. Her rigorous methodology involved studying over 3,350 menstrual cycles across 400 women, tracking everything from cycle details and blood pressure to subjective experiences through patient diaries. This contrasted sharply with male gynecologists’ tendency to inflate abnormal cases, promoting the misleading notion that all women were incapacitated one week of every month.

The medicalization of women’s discontent in the 1950s reveals how pharmaceutical companies and doctors interpreted social issues through a lens of individual pathology. At the center of this story was the drug Miltown (meprobamate), the first widely distributed minor tranquilizer. Released in 1955 by Wallace Laboratories, it was marketed as a miracle cure for everything from arthritis and asthma to anxiety and multiple sclerosis. Within a year, it became America’s most-prescribed drug.

Marketing specifically targeted housewives, promising to fortify them for daily tasks from grocery shopping to PTA meetings to marital duties. However, the anxiety these women experienced often stemmed from oppressive gender norms rather than medical conditions. Moreover, many symptoms treated with Miltown – chronic fatigue, unexplained pain, rheumatism – were actually manifestations of autoimmune diseases like lupus, ME, and MS, which predominantly affect women and remain poorly understood even today.