Noodle & Bloom

A feminist-informed look at health innovation, with a focus on women’s health

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A little note…

*A little note from me: While I have nothing against the use of AI for editing, I want you to know that I don’t use AI for this blog because I find it washes out my voice. As such, if you find the cadence and the tone a bit weird, that tracks. I’m weird. I’ve also never been accused of being short-winded, so, enjoy the long reads… 🙂

March 9, 2026

Precision vs Generalizability – Who’s left to pick up the pieces when individual outcomes are poor?

Shameless Plug

Before I go into this month’s post, I’d love to share that I recently had an article published in Ramona Magazine – a feminist Aussie publication. If you’re not yet sick of my writing, and would like to take a peek at what’s up for discussion on the other end of the globe, take a peek!

The Noodle

One of the challenges that I see playing out in medicine generally, but especially in women’s health, is this dance between personalized care vs following generalizable, evidence-based guidelines. Now, before you come for me, please know I am a huge advocate for evidence-based care, and we know guidelines are based on rigorous study and generalizable evidence that applies to most across the board. But of course, human beings are inherently variable; we are a rich collection of diverse genetics, physiology, and socio-emotional factors. Add in the patriarchal and paternalistic patterns that permeate women’s health, and the balance gets, well… complicated.

A New York Times Article published just a few months ago in November called continuous fetal monitoring “the worst test in medicine” because it increases the rate of c-sections. While I think the article did a good job of facilitating the conversation about interventions vs benefit, I couldn’t help but roll my eyes at the pointed finger at the big, bad word in labour and delivery commentary: C-Section. If we’re jumping on the bandwagon of inflammatory statements, c-section is the most demonized surgery in medicine (IMHO). Never mind that North American parents have increasingly higher complex health conditions, parents are having children at later ages, and the United States has maternal mortality rates on par with developing countries – largely attributable to overt medical racism, even when you control for every other socio-economic factor. Now, all these also contribute to higher rates of c-sections, but are not mentioned in the article. All this said, when it comes down to it, why are we so up in arms about c-sections anyway? Yes, c-sections are major surgery with longer recovery periods, increased acute care resources, and a source of potential complications, but for many people (including myself), c-sections are also the reason we’re still here, and why our children are alive. So it makes sense to me that guidelines generally recommend trying for vaginal delivery, especially in low-risk pregnancies. However, vaginal deliveries are not inherently “low risk” because they’re “natural.” Look at the incidence of birth trauma (ranging from 20% to 45%, depending on where you look), and ask yourself, are c-sections REALLY the enemy here? Because if you’re left with urinary and fecal incontinence for the rest of your life following a 4th degree tear, it doesn’t really matter if the guidelines recommended vaginal delivery, you’re still the one left to pick up the pieces during recovery.

V-BAC (vaginal birth after cesarean) discussions are another topic I always find interesting. For some, V-BAC can be an incredibly healing and validating experience. In fact, 80% of people are able to be considered for V-BAC, and many indeed choose to go this route. But I find a lot of conversations on this topic center around why more people DON’T choose V-BAC. Anecdotally, so many of the conversations I hear around why folks may not choose Trial of Labour after Cesarean (TOLAC) centre around “patient education” and “provider attitude” While absolutely that plays a role, I never hear about how the patient might feel, who perhaps felt unsafe or unsupported in an initial labour that ultimately resulted in a medical emergency requiring surgery. For some, the opportunity to go back and hope for a different outcome can be empowering and healing, for some, it’s being asked to re-live your worst nightmare. Both perspectives are valid, but only one gets treated as such.

In the early 2020’s, the UK was having its moment for having low c-section rates compared to other G7 countries. All over the world, people spoke with reverence about the incredible work; c-section rates were dropping, largely attributable to an increased number of births being done in trusts as opposed to hospitals. However, in 2022, reports began circling indicating that while c-section rates were down, some alarming trends were beginning to emerge with respect to other types of morbidity and mortality. Some people were experiencing significant disability following difficult vaginal births that required intervention. Some babies were harmed during deliveries. Some didn’t survive. Obviously, the notion of keeping the c-section rate low at all costs was having, predictably, poor consequences. So recommendations changed, and the metric became about maternal safety as opposed to lowering c-section rates. The c-section rate in the UK has now risen to 45%.

So… when we read articles claiming that a medical device is the “worst test in medicine” because it allegedly increases c-section rates, I think we have to ask ourselves why a c-section might be considered the worst outcome? I think when we consider outcome metrics, it’s extremely weird that we measure against mode of delivery as our success indicator as opposed to things like post-partum disability, patient satisfaction, long-term pelvic floor function, mental health outcomes. Friends, when we consider c-section rate as a proxy to “good births,” I can’t help but feel like we are collecting the wrong data. And here is where I’m going to get ranty… Paternalism is a feature in modern medicine (especially women’s health), and patriarchal structures continue to govern women’s lives. Let’s face it, if you’ve ever given birth before, you know there are some pretty limiting choices available to you. Birth providers have to apply evidence-based decision making based on generalizable data, data that currently regards low c-section rates as a “gold standard.” But recommendations may not fit each and every patient, and at the end of the day, it’s the patient who has to live with those outcomes, and birth has some pretty gnarly souvenirs. If we can’t contextualize evidence based decision making to the individual in front of us, we will continue to leave people’s bodies will and truly fucked after birth.

Lived Experience

“So, and of course during all of this, I’m asking, what about hormone replacement therapy? This is affecting my life.”

This month I had the chance to sit down with one of my favourite people of all time and talk about … menopause! The topic on the minds of many, and a perfect example of women paying the price when it comes to lack of care in pursuit of our own “best interest.” For the purpose of this blog, we’ll call her Liz.

Liz started experiencing her first onset of symptoms when she was in her mid-40’s. For a little context, this would have been in the early 2010’s, long before this menopause renaissance we’re currently living in. Nobody was speaking about it, doctors weren’t providing clinical support, and influencers weren’t trying to sell you weighted vests or discount codes (a small relief I guess). Yes friends, as the kids say, Liz was raw-dogging menopause.

“It affects your mental health um just you just feel like you’re under a constant barrage, like you don’t know when it’s [heavy bleeding] going to happen. It’s a surprise. It’s that Jack in the Box thing, but you just never know. Boom. There it is.”

For Liz, she didn’t experience the emotional rollercoaster that she had heard could happen. Her experience was really characterized by physical changes and brain fog. The bleeding she experienced was frankly, wild, which required a ton of cognitive capacity to manage.

“Once this kind of all started happening, those little pre-warning triggers were not there anymore and you could just all of a sudden your period would just start and quite often with a vengeance. It’s like there’s a bucketload in your pants. I didn’t leave the house without several pads, several tampons in my bag. Once peri-menopause was kind of in its full swing, I was wearing a tampon and having two overnight pads on all the time because I didn’t know when it [bleeding] was going to start.”

When people talk about how your periods can get a bit wonky through perimenopause, they don’t really characterize the impact it has on your life. But the constant cognitive labour that goes into making sure you always have protection is a special kind of hell, especially when dealing with the impacts of brain fog.

“Every purse, every bag, every vehicle had tampons and pads. You just never knew when it was going to happen.”

And of course, with heavy bleeding comes iron deficiency. Meaning on top of the labour to manage the sheer volume and unpredictability of bleeding, you’re also exhausted, and having to think about an iron supplement. For those who’ve never partaken, iron supplements can be super hard on your stomach, so planning around that is ANOTHER layer of cognitive labour.

“I was tired all the time. I was taking extra iron because it’s a lot of blood loss. So, you know, probably aren’t iron deficient after 5 days of a period, but after 21 days of a period, you are.”

Liz approached her GPs about hormone replacement therapy on multiple occasions. The impact physical symptoms alone had on her life were incredibly challenging, especially during a period in her life where she was caring for an aging parent, teenage and young adult kids, and a new grandchild. She was constantly rebuked at the hands of the Women’s Health Initiative (WHI) study. When she’d ask about a surgical option like a hysterectomy to at the very least manage her bleeding, she was again denied because it was considered “unnecessary.” If you’re wearing multiple menstrual products every day and night, and taking medication for iron deficiency because of bleeding, I wonder how “unnecessary” surgery would seem…

Liz is not alone in being denied menopause care on the basis of the WHI Study. What absolutely boggles the mind is that an entire generation of women experienced this, all because of interim, misinterpreted findings. When early analyses were released in 2002, there were concerns about increased cancer risk. Later analyses of the data revealed that increased cancer rates were likely attributable to pre-existing medical morbidity among study participants. Friends, in the wild world of science, we call this a confound. It is a very basic tenet of large, human population based studies that confounds must be controlled (i.e.: make sure your conclusion about the impact of one thing isn’t because of another thing). So in summary, an entire generation of peri-menopausal and menopausal people missed out on effective care because data were poorly interpreted and then sensationalized. Gross.

But for argument’s sake, let’s say HRT did indeed cause increased cancer risk in general. Is it fair that an entire generation of people are unable to access it en masse? Shouldn’t the people who have to live with the symptoms of menopause, and the potential risk of cancer, get a say? And herein lies the big question – who gets to decide what’s worth the risk? I think we should absolutely be providing people evidence based tools to make decisions about their health, we should absolutely be making sure misinformation doesn’t play a role in that decision, but at the end of the day, shouldn’t the person who’s left picking up the pieces of a medical decision be the one who influences it? I think if Liz deserved to be empowered with the risks and benefits known (or believed) of both HRT and surgical solutions at the time, and be left with the decision of what risks she was okay with.

I’m happy to report that Liz, after more than a decade of her original peri-menopause symptoms, is now able to access HRT and has felt the impacts profoundly. She’s also noted a changes in her community, with a local menopause clinic having opened. It’s a different world compared to when she first experienced symptoms, with menopause becoming part of the mainstream conversation, which of course brings new challenges (like misinformation and commodification of bullshit). But having lived the spectrum of menopause care over the span of more than a decade, her hope is to see evidence-based care and access to information make its way into the hands of more people who seek it. Because at the very least, people deserve a choice about what they’re willing to live with.

Unofficial Bookclub

For this month’s bookclub, I’m going rogue, and would love to share a recent thriller that I think has a lot of insight to offer (yes, FICTION. What a gift.) Witchcraft for Wayward Girls by Grady Hendrix is an excellent novel that poses questions around consent, choice, and women’s bodies in a time where reproductive rights are a critical legislative conversation south of the border, and a bit of a cultural question here in Alberta (and I’m sure other parts of Canada), with elected officials actively promoting misinformation in the legislature.

While campy and a bit gruesome at times, to me this book shines a light on important questions for both society and medicine about choice and autonomy as it pertains to the bodies of girls and women. Since witchcraft is not yet a viable solution for our societal woes, we may have to simply consider dismantling systemic patriarchal and paternalistic structures in healthcare, and use the policy tools at our disposal to ensure women, girls, and femmes have access to appropriate care when we need it.

Until next time my friends, that’s enough from me.

Cheers,

-Kate

February 2, 2026

Where misogyny and misinformation collide…among other things

*Before I jump in, a little shameless promotion. If you like these conversations where we dig into the nuance and weird little complexities, I would love you to join me at a virtual Fireside Chat this Friday with Margie Sills-Maerov from Thought Architects. Hope to see you there!

The Noodle

It’s no secret that Women’s Health has been historically under-funded, under-researched, underserved… We are starting to see a change in the tide, at least when it comes to awareness about women’s health. Generations of women watched their Moms and Aunties pay the price for their unaddressed health needs, and boldly decided, fuck that. Menopause, historically only discussed in whispered notions of “the change,” is now a key feature in discussions of workforce management, evidence generation, and innovation development. A grassroots campaign of women sharing their experiences on social media of their IUD insertions FINALLY prompted medical societies to acknowledge that this is not a neutral experience for many, and have released statements and guidelines around pain management. Endometriosis, previously thought of as a “whiny women’s disease” has entered the mainstream. Scientific and clinical authorities now recognize it as a multisystem disease with clear etiology – though we are still a far cry from efficient and effective diagnostic pathways. Women’s health is no longer the whispered conversation, but rather a loud and emphatic discussion that permeates every generation, every workplace, and every social experience. The momentum is groundbreaking, and IMHO, positive. But as we know, all good things come at a cost. And you can’t have momentum at this scale without grifters entering the chat.

While we’ve seen tremendous cultural momentum when it comes to women’s health, there are still massive gaps in the clinical applications of care, and this experience is deeply felt by the women and femmes who are still waiting for their health needs to be met. What happens when you have massive cultural momentum combined with expansive gaps in clinical care and 51% of the population with well-articulated unmet needs? A MASSIVE opportunity. And when we see innovators, clinicians, scientists see this opportunity for what it is, it’s incredible. But you know who else sees that opportunity? Gweneth Paltrow. There is an enormous market built on the unmet health needs of women, where they are being sold bullshit. Because this women’s health opportunity is incredibly lucrative – women are economically empowered and make 75% of household discretionary spending decisions. Now, think about how fast you can earn a buck if you don’t have to research your innovation, if you’re not accountable to a governing body, and if you don’t have to care about the harm you’re doing. It is SO EASY to publish bullshit, attach it to a link, and wait for someone desperate enough to try your “solution.” The threat of misinformation has been identified as a key threat to public health, and its origins, mechanisms, and harms have been well studied. But I think we need to discuss the very sinister misogynistic underpinnings of women’s health misinformation I’m seeing today. Buckle up kids, to quote the incomparable Jessica Day, “I hope you like feminist rants.”

We are, for the first time in history, seeing a generation of youth who believe less in gender equality than the one before them. Simultaneously, we have a major global influencer country who are walking back women’s rights, funding for research (especially for equity seeking groups), healthcare spending, and peddling misinformation even better than Jenny McCarthy. We also continue to have patriarchal systems that disenfranchise women across multiple dimensions. We have created the conditions for misinformation to fuel the sales of literal garbage, with a shiny sticker that promises health improvement. These forces do not exist within a vacuum – they inform and influence each other.

So let’s go back to this notion that we have a generation of youth who do not believe in gender equality to the same degree previous generations did – and its an ideological movement being largely driven by young boys and men. Part of this theory comes from the fact young boys and men may be feeling disenfranchised by the aftermath of “me too,” without having experienced how bad things used to be. Similar to those who are anit-vax are and have never come face to face with the widespread harm of vaccine preventable illness – they rally against a system that has ultimately protected them. They’re also incredibly online, and when very normal feelings of discomfort and loneliness hit (part of the abject humiliation of being a teenager), they are welcomed into (no longer so niche) misogynist groups that make them feel like their loneliness, awkwardness, and discomfort are the fault of women (if you’re looking for a deep dive here, check out Men Who Hate Women by Laura Bates). Let’s combine this with a generation of young women who have been bombarded by a curated feed of expectations and bullshit information since birth. These women and girls have watched their Moms lose their minds while unsupported through perimenopause, and their millennial aunties burnout from hustle culture, multiple global crises, cannibalized job markets, and debilitating student debt. Let’s also consider that our Gen Zs are not the tide-pod slurping teens that a lot of people envision – they’re building lives, they’re in the workforce, and they’re influencing policy. They are also, being influenced themselves.

Influencers and gifters capitalize on misappropriating real hardships. Let’s look at the “hormonal birth control is bad for you” narrative. Grifters have grabbed onto something real. For some, hormonal birth control can have side effects that some find intolerable. Those experiences are very valid, and very real. The most obvious solution is to invest in scientific discovery and therapeutic development to ensure there is a larger diversity of options on the market. Recognize the limitations of what exists, but also the profound benefits, and work to extend those benefits to a broader portion of the population through evidence based innovation. But of course, that’s not what’s happening. Instead, we see misinformation being peddled: “Birth control is bad for you, stop taking your pills, but you should definitely start taking my supplement (link in bio ;)), and also here’s my app that you can track your fertility windows, but I won’t tell you that even when adhered to perfectly is about 20% less effective that that pill I’ve told you is poison. Also, I’m going to use your data that you’ve plugged into it to sell to a third party but STAY BLESSED GIRL!” And what do we know about these social forces and their impact on health – NOTHING happens in a vacuum. Health misinformation is coupled with misogyny, and fear-mongered to a generation of kids who don’t want to put up with generations before them did. To argue that it’s genderless, especially in this day and age, is simply naive.

Misinformation will continue to harm folks across generations, because it is so fundamentally unchecked. If you go to Goop’s website right now (not that I’d recommend, Gweneth doesn’t need the clicks), it is still fully operational, even though it peddles health products that have absolutely zero evidence backing. If you do a quick google search for “best supplement to take in menopause” you’ll get an onslaught of different options, all with different claims and details, but did you know these products are NOT regulated? If I develop a medication or device, I’m required to study it for years over progressively larger samples of people to demonstrate efficacy, safety, and generalizability. Before I can ever sell it, I must go through the incredibly rigorous process of having it certified by Health Canada (Canada) or the FDA (US). Even food products need that level of oversight, and skipping the regulatory process results in massive consequences. But supplements and wellness products are exempt from this process. And did you know the wellness industry is worth about $6.3 Trillion? By comparison, the global pharmaceutical market is worth about $1.86 Trillion. Who’s after your money now?

I think it’s no secret that misinformation harms, and there is simply so much opportunity for it to spread along the spectrum of women’s health, especially for young people who are so deeply susceptible. Obviously, IMHO, I think we need better regulation of wellness products, and who is able to sell them. But I think we also need to consider what’s driving people to these products. We need to invest in better solutions so women’s health needs are better met. We need to listen to women in clinical environments so they’re not left feeling invalidated and frustrated. We need to create the conditions in which needs are well met, and we don’t push women into the arms of clever health grifters. We’re seeing momentum… a massive grassroots push of women who are not willing to put up with being underserved anymore. But a cultural shift is only step one, we have to embrace the next step of meeting these pressing health challenges head on.

Lived Experience

I remember when I first started experiencing symptoms of adenomyosis. Of course, the most bothersome symptom being the sheer volume of bleeding, but also noting the bloating, persistent pain, exhaustion, ect. At the time, the renowned neuroscientist Dr. Nadia Chaudhri, had just passed away from ovarian cancer. She had been very public with her experience, and left a lot of people with the distinct message, “don’t ignore symptoms.” When I brought them up to my Family Doc, she immediately took me seriously. She was a young doc, probably around my age, and she was also really affected by the death of a female scientist taken too soon. While my doc immediately ordered an ultrasound and sent a referral to an OBGYN, I waited 7 months for the ultrasound, and never received that specialist appointment. I asked her about screening protocols for ovarian cancer, and while she was compassionate about my concerns, she was also openly frustrated when she told me, “honestly, they’re really shitty.”

The next time I saw her, symptoms had only gotten worse. By this time, my husband and I had decided we were not having more kids. When speaking to my doctor about the worsening of symptoms, I mentioned to that at this point, I’d rather just have a hysterectomy than put up with this any longer. Once again, she was compassionate, but told me there was no world in which I’d find a surgeon to perform it, so get that idea out of my head. We tried a new birth control. It worked for about 3 months. Then my symptoms came back, worse. She left medicine. Burnout, I think.

I was one of the lucky people from my GP’s old practice that were “adopted” by a new GP, fresh from residency. Another kind, compassionate doc who took my symptoms seriously. When we talked about my symptoms, she put in (another) referral to OBGYN, and another ultrasound. In the meantime, I was put on another birth control, coupled with tranexamic acid to help with excessive bleeding. The ultrasound (another 8 months of waiting) yielded no significant results, and when we moved across the country 2 years later, we did so having never seen an OBGYN. The tranexamic acid worked well for about 9 months before the bleeding started to get worse and worse again each month.

We had just packed up and moved our family across the country a few months before my daughter turned 5. During my meet and greet appointment with my new doctor, she said she was concerned about continuing use of tranexamic acid, especially when it wasn’t working as well anymore. Another ultrasound. This time, with “rule out adenomyosis” explicitly stated in the requisition. The radiology report came back normal, but I was referred to a women’s health GP, and then an OBGYN with a sub-specialty in uterine conditions. He saw the radiology report that reported everything as normal. He looked at the scan itself (something most GPs do not have access to). He asked about my symptoms. “You have textbook adenomyosis,” he said.

I hear a lot in the space of women’s health, where women feel dismissed by their providers. With all due respect for these experiences (which are real, valid, and true), mine has been different. I have time and time again been met with providers who are compassionate, who take me seriously, but we’re frustrated by the tools available to treat the patient in front of them, and then increasingly frustrated by a system too overwhelmed or un-prepared to support them. Time and time again I was sent for ultrasounds that came back “normal.” Time and time again I was referred to specialists who were so busy that I would never get an appointment. When I inquired about definitive treatment, my GP knew that we live in a world in which a young, otherwise healthy woman, would not be given a fertility ending surgery when I could just continue bleeding instead. When health care professionals continually show up and meet their patients with compassion and empathy, and do not have the benefit of a system that has their back, the conditions for burnout and moral injury are created.

The truth is, we ask a lot of GPs. They are the gatekeepers of the health system. They are the “make it or break it” point for their patients getting the care they need. The age old adage of needing to know a little bit about a lot of things doesn’t cut it, they need to hold an incredible amount of knowledge across an unfathomable spectrum of health concerns. We hear continued calls for better education in medical school for women’s health concerns. And yes, that. But it’s also true that all doctors are required to invest in continued education while they practice. They also need to stay up to date on emerging evidence and treatment protocols, not just in “their field,” but across all fields of medicine, because as a GP, your field is everything. That’s a tremendous responsibility. We hear a lot about physician burnout. What would burnout in this profession look like if GPs were better supported, by a system that was responsive and by therapeutics and innovations that made a difference for their patients. How might that change how GP’s respond to their patients, how seriously they take them, and what amount of compassion they can access?

Unofficial Book Club

For this month’s unofficial book club, allow me to recommend Dead Mom Walking by Rachel Matlow. I read this book a few years back, and it still resonates with me. In Dead Mom Walking, Matlow’s Mom is diagnosed with a highly treatable cancer, but rejects the treatment options offered by her oncologist in lieu of “curing it naturally.” Spoiler alert – she dies. Of cancer. That was not cured naturally. For me, what resonates the most is how she got there. As Matlow walks us through the world she lives in with her mother, it is my opinion that she’s not unintelligent, nor is she unreasonable. She’s scared, and she’s been swindled by a movement that is marked by excellent marketing tactics and zero evidence. But for me, I also see the ways in which Matlow’s mom did not get what she needed from the way we deliver medicine now. While I don’t believe in playing the blame game, I do think we need to consider how a patient’s experience lays the groundwork of trust, and if that fundamental trust isn’t there, the conditions are perfectly curated for movements that thrive on misinformation to swoop in and offer a nice sounding alternative. To me, this book illustrates the human cost of misinformation, and poses the question, “had this woman been a bit better supported in her lifetime of experiences with medicine, would she still be here today?”

Until next time my friends, that’s enough from me.

Cheers,

-Kate

January 5th, 2026

Welcome to Noodle & Bloom

The Noodle

I’m sitting in my living room, reflecting on what the past year has given me, pondering what new form of anxiety has gripped my dog this week (suddenly rattled by couches and stairs), and thinking to myself, the world could use another blog. I mean of course no one needs that, but here I am, penning (typing??) one out, while you, presumably, take this journey with me as I bravely embark to scream into the void (metaphorically of course).

In all seriousness, as the world seems to descend further and further into chaos, I’ve been stuck on this notion that we can’t seem to effectively wrap our heads around nuance – and in my world I see this so succinctly in the space of health innovation. For those who have met me, you might know that my heart rests in women’s health innovation. I’ve always been captivated by an underdog, and there is no greater underdog in the space of health innovation than women’s health. Yet we persist! I’ve never seen a field of work that so promisingly embodies “punching above their weight.” It’s no secret that women’s health has been chronically under-funded, under-resourced, with patients systemically dismissed. With the rise clinicians, scientists, and people with lived experience becoming more vocal about the challenges, and more importantly, advocating for wide-spread change, I’m seeing impressive strides in this space. But we are humbled by our inability to incorporate nuance into these conversations, at least in my opinion. People who experience negative side effects from hormonal birth control deserve to be heard – their experience is real; AND, hormonal birth control is not “bad for you” – it’s in fact is an incredible innovation that’s served as a valuable therapeutic and an important tool for reproductive autonomy. Some populations have been pushed into over-medicalized labour and delivery practices that left them stripped of a dignifying experience, AND, our fascination with natural everything in pregnancy has left some folks unable to receive needed medical care – both can be true. Women’s health research has been systemically under-funded for years, creating an evidence gap that permeates the way women and femmes experience healthcare, AND, despite these challenges we have excellent evidence on different topics that is routinely ignored amidst the rise of misinformation.

I feel we’ve become obsessed with black and white thinking, silver-bullets, and the notion that one experience is true for everyone. But in a topic as complex as health, especially women’s health, with all of the medical, scientific, societal, and economic impacts and influences that permeate literally every aspect, we need to get more comfortable with nuance and complexity. Which is what brought me here, noodling around these complex topics, and maybe seeing if there are others out there who are keen to wade around in all this messiness. This blog will largely be focused on women’s health innovation through a feminist informed lens. But even the most neurotic of us get off-topic, so you should expect that too. I hope you’ll join me in this weird and wonderful adventure!

Lived Experience

My connection to women’s health has always been a combination of scientific curiosity blended with lived experience. My earliest experience in the women’s health system came in my early 20’s, when I had multiple cervical biopsies. At the time I was a baby research assistant, fresh from Undergrad, working in a spinal surgery lab (an extremely cool gig with some excellent people). To put me at ease, the OBGYN I saw asked me about what research we had on the go. I gave her the highlights, and asked, “what about you? Any new and exciting research you’ve got on the go?” I remember her peeking over the top of my gown to tell me, “Nah – this is women’s health. Nothing really ever changes.” A phrase that left me (and still leaves me) SHOOK. You mean to tell me it doesn’t get better than this??

Throughout my career, I’ve always been so surprised at how hard I’ve had to work just to get answers about my own body – despite the enormous privilege I have as a financially stable, white, able-bodied woman with a graduate level education that LITERALLY FOCUSED ON SYSTEMS IN WOMEN’S HEALTH. I was finishing my thesis on perinatal care systems when I was pregnant with my own daughter, and was constantly bewildered by the experience of researching a system I was going through from an academic perspective, and living it as a patient.

However, I think my most illuminating journey was my pathway to diagnosis and treatment of a uterine condition called Adenomyosis. It took me 5 years, a move across the country, and honestly, luck to get my diagnosis. I recognize that this is actually well under the average timeline for diagnosis. For those of you who’ve not heard of adeno, I like to think of it as the ugly little sister of endometriosis. It involves endometrial lesions growing into the musculature of the uterus (as opposed to endo, where this tissue grows outside of the uterus). Symptoms include persistent pelvic pain (regardless of where you’re at in your cycle), and VERY heavy bleeding. For me, this developed after the birth of my daughter (which is no surprise – a key risk factor for adeno is uterine surgery, like a c-section). But I had a hard time self-advocating (which I have some thoughts about… I’ll share at another time), because since these symptoms coincided with the post-partum period, I was caught in the trap of thinking that this is normal. “Parents are always talking about how tired and sore they are, right?” For 5+ years I had zero pain-free days, periods so heavy I was chronically anemic, and would plan my work around periods because it was common to bleed through multiple period products and all over my clothes. I had several ultrasounds over the years that always came back as “normal.” I have been on virtually every type of hormonal birth control, tranexamic acid (yes – the drug they give to trauma patients to keep them from bleeding out, also helpful for periods!), and progressively stronger NSAIDs to manage, all with results that were promising up front, and usually waned after about 3-4 months. When we moved across the country and I was doing a meet and greet with my new GP, I was sent for another ultrasound and bloodwork. The ultrasound came back “normal” and the bloodwork “girl, you’re a worry.” So I was sent along to a women’s health family medicine doc, who then sent me along to an OBGYN with a sub-specialty in uterine conditions. Between the women’s health GP and the specialist, I was placed on a drug originally designed for endo, but works well for adeno too. When I finally spoke to the specialist, I was surprised to learn that my ultrasound was not in fact “normal,” as radiology reports indicated over and over again. In fact, while subtle, there were visual clues on the imaging, that combined with my symptom profile and surgical history, indicated a very “textbook” case of adenomyosis.

I’m happy to report that since my diagnosis and treatment, my condition has been super well managed. The medication, named Dienogest, is more or less progesterone therapy. And I will HAPPILY play poster child because I can tell you that this medication gave me my life back. Did you know it’s not normal to be in pain every single day? Follow along for other fun Mom hacks! But in all seriousness, its wild to me that such an easy intervention took so long to access. The brand-name version (Visanne by Bayer) came onto the Canadian market in 2011, but the generic Dienogest (by Aspen Pharmacare) only became available in 2020. Regardless, its wild to me that with the rise of Endometriosis’ profile in the mainstream hasn’t translated to more prescribers being aware of this option, and more patients knowing it exists. When you speak to women with endo or adeno, treatment options seem to be focused on IUDs, surgery, or “get pregnant.” A recent study looked at women’s health therapeutic approvals in Canada. They found that only 53% of FDA approved women’s health medications had been approved in Canada since 2003, AND that it takes on average an extra year for women’s health medications to find their way onto provincial drug plans. Now I’m no expert, but I’d say this disparity on therapeutic development, approval, and provincial drug plan inclusion might be a sticking point as to why these medications aren’t making it into patients’ bodies!

While my experience with adenomyosis was illustrative to me about this intersect of scientific disparity and what it feels like as a patient, I’m willing to bet there are thousands of stories out there that hold similar clues in some of our biggest health innovation challenges. Since I’ve now overshared my personal health information on the internet (excuse me while I go hyperventilate), I invite you to do the same. If you’ve had a healthcare experience in the space of women’s or femme health that you’d like to share in this little corner of the innovation world, I’d love to listen to what you have to say.

Unofficial Bookclub

Let me tell you about a book that fundamentally BLEW MY MIND.

Enter: Invisible Women: Data Bias in a World Designed for Men by Caroline Criado Pérez. This book explores the gender data gap across sectors of engineering, tech, economics, policy, and of course, health. When we talk about the gender data gap, it speaks to the ways in which decisions are made, products are designed, and systems developed. These are informed by data, which has historically not included women. She speaks to a lot of topics including drug development, crash test dummies, and that tech bros don’t seem to understand that the typical iPhone does not fit in women’s pants pockets, and thus is not good tech for ambient movement tracking across genders. This book, released in 2018, illustrated to me that the disparities we know and hate in health data are not unique, and that the ways in which we collect, interpret, and use data across literally every sector are subject to this monumental design flaw. What’s even more wild to me is how little things have changed since the book’s release.

That said, there are some folks out there working on this gender data gap that give me hope! CIHR released a policy in 2016 that required consideration of sex and gender data in all grant applications in order to be funded. PROGRESS. However, as a grant agency, they’re limited to a degree in how that funded research’s data are reported, whether they disaggregate and actually analyze it, and how disseminated data are interpreted (especially by clinical governance bodies). All to say, to really make a dent in this gap from a clinical perspective, EVERYONE NEEDS TO GET ON BOARD! I’m looking at you, scientific journals, Institutional Research Service Offices, and Regulatory Colleges. One federal grant agency in one country can’t be the sole source of widespread adoption.

Anyway, I highly recommend giving this book a read. I hope it gets you to a place of feeling spicy!

Until next time my friends, that’s enough from me.

Cheers,

-Kate