They Never Told You The Truth About Your Own Body — And That Was Never An Accident

The quiet, institutional war against women's hormonal health is not ignorance. It's a design.

Let's begin with a number that should make your blood boil.

More than 75% of women who need a simple, inexpensive, widely available vaginal estrogen cream — a cream that can prevent excruciating sex, chronic urinary tract infections, and in severe cases, death from sepsis — are never prescribed it. Not because it doesn't work. Not because it's experimental or controversial. But because the doctors who should be handing out those prescriptions were never properly taught to.

Sit with that.
A generic cream. Decades of supporting evidence. And still, the majority of women who need it go home without it.

This is not a story about one bad doctor or one outdated textbook. This is a story about a medical system that has, for generations, treated the female body as an inconvenient afterthought — too complicated to study thoroughly, too "sensitive" to discuss openly, and apparently too marginal to protect.

The Word They Left Out
Dr. Rachel Rubin, a urologist and sexual medicine specialist who has spent years dragging this conversation from hushed corridors into public light, recently said something that stopped me cold. For years — for decades — the word "clitoris" did not appear on standardised OB/GYN training checklists. Not on the evaluations that determined whether a doctor was competent to treat women. Not on the criteria that governed what a physician needed to know before entering a practice.

Let me be plain about what this means. Doctors were being certified as specialists in women's reproductive health without ever being formally required to demonstrate knowledge of the primary anatomy responsible for female sexual response.

We are not talking about ancient history. We are talking about a systemic educational omission that shaped an entire pipeline of practitioners — practitioners who then told women experiencing pain, dysfunction, and hormonal chaos to "relax," to "see a therapist," or, most infuriatingly, that what they were experiencing was simply "normal."

Normal. The great catch-all diagnosis for anything a woman feels that medicine cannot be bothered to investigate.

The Fear They Manufactured
Then came the hormone catastrophe.
In 2002, a major Women's Health Initiative study sent shockwaves through the medical establishment. Its headline findings linked Hormone Replacement Therapy — specifically estrogen and progestin combinations — to increased risks of breast cancer and heart disease. Overnight, millions of women were taken off their HRT prescriptions. Doctors, terrified of liability, stopped prescribing it. And a generation of women was left to "manage" menopause without support.

The problem? The study's findings were widely misinterpreted and incompletely communicated. The data applied largely to older women who began HRT many years after menopause — not to the younger, perimenopausal women for whom it was originally intended. Subsequent research, including major reanalyses published in the British Medical Journal and The Lancet, painted a far more nuanced and, in many cases, significantly more favourable picture. For most women, when introduced early and appropriately, HRT does not increase breast cancer risk beyond that of lifestyle factors like daily alcohol consumption — a comparison that receives virtually none of the same cultural panic.

And yet here we are, almost a quarter century later, and the fear has outlasted the science.

Women are still being denied prescriptions for estrogen. Women are still being told their hot flashes, brain fog, bone density loss, cardiovascular deterioration, and shattered sleep are just "part of ageing." Women are still suffering — needlessly — because a bad headline in 2002 became medical orthodoxy, and correcting it turned out to be far less newsworthy than the original scare.

The message that women received, whether explicitly or not, was this: your comfort is not worth the risk. Your suffering is acceptable. Endure.

The Hormone They Never Told You Was Yours

Here is something many women learn far too late, if they ever learn it at all: testosterone is not a male hormone.

Women produce testosterone. It is made in the ovaries and the adrenal glands. It is essential for energy, cognitive function, bone strength, muscle maintenance, mood regulation, and yes — sexual desire. And it begins declining significantly in a woman's thirties. Not at menopause. The thirties.

Women in their mid-to-late thirties are walking into their doctors' offices complaining of fatigue they cannot explain, a libido that has quietly disappeared, an inability to concentrate, delayed orgasms, a sense that something fundamental about them has changed — and they are being handed antidepressants, or told they are stressed, or assured that this is just what happens when you get older and have more responsibilities.

Some of these women are being prescribed medications whose side effects actively worsen the problem. SSRIs — among the most commonly prescribed drugs in the world — carry well-documented risks of sexual dysfunction: decreased libido, delayed or absent orgasm, emotional blunting. This is not obscure information. It is in the pharmacological literature. And yet, in the rushed twelve-minute appointment that constitutes modern primary care, this is rarely the conversation women are given.

Informed consent, the cornerstone of medical ethics, requires that patients be told what they are agreeing to. It is not informed consent if the doctor simply doesn't mention it.

The New Drugs, The Old Silence
We are now in the age of GLP-1 receptor agonists — drugs like Ozempic and Mounjaro, originally developed for diabetes and now prescribed at extraordinary scale for weight loss. Millions of women are taking them.

Early, unpublished survey data suggests that roughly 25% of women on these medications report noticeable changes in their sexual health. Of those, approximately half report a decline in libido. The other quarter report an improvement — possibly because weight loss and metabolic improvements carry their own benefits for hormonal balance.

But here is the question nobody is asking loudly enough: are these women being told this before they start? Are the doctors prescribing these drugs — drugs we are still learning about, in bodies whose full hormonal complexity medicine has historically refused to study adequately — sitting down with their patients and saying, this may affect how you experience intimacy, and here is what we know so far?

The silence that answers that question is its own kind of response.

This Is Not About Sex. This Is About Power.

I want to head off the predictable dismissal before it arrives.

Someone, somewhere, will read this and conclude that this is an article about sex — that it is about pleasure, that it is a niche concern, that more pressing health issues deserve our attention first. They will be wrong.

As a man writing this, I am acutely aware that this conversation is too often abandoned to the women it directly affects — as though the rest of us have no stake in whether the women in our lives, our families, our communities, are being treated with basic medical competence and honesty. We do. Every one of us does.

This is about the systematic failure to take women's bodies seriously. It is about a medical culture that omitted the word "clitoris" from training requirements, that manufactured and sustained a fear of hormonal therapy without updating the evidence base it claimed to stand on, that never formally studied female testosterone, and that continues to produce physicians who treat women's complaints as hysteria dressed up in modern language.

The consequences are not merely that women have less enjoyable sex lives. The consequences are that women develop severe, hospitalisation-worthy UTIs that estrogen cream could have prevented. That they lose bone density and cognitive function and cardiovascular health because menopause was described to them as a mild inconvenience. That they lose themselves — their energy, their sharpness, their sense of who they are — and are handed a prescription that makes it worse.

Sexual health is not a luxury. It is an indicator of whole-body health. Testosterone and estrogen do not only govern desire — they govern cognition, immunity, metabolic function, and mental stability. When a woman loses access to these hormones and nobody investigates why, nobody intervenes, nobody offers her information she has every right to receive — that is not oversight. That is neglect.

What Has to Change, Right Now
The case for systemic change is not complex. It is being resisted, not because the arguments are weak, but because the incentives to maintain the status quo are strong and the patients bearing the cost are women.

Medical school curricula must be updated — not as a progressive gesture, but as a baseline requirement of competence. Physicians who completed their training in an era of endemic educational gaps must have access to continuing education that addresses those gaps, without shame and without bureaucratic obstruction. HRT must be discussed with accuracy, with current evidence, and without the spectre of a misread 2002 headline hanging over every consultation. Testosterone — female testosterone — must be integrated into the standard hormonal conversation, not treated as an afterthought or a fringe subject.

And women — every woman who encounters this piece — must know that they are permitted to ask questions, to request bloodwork, to push back on a "that's normal" that their instincts tell them is not the whole truth. The system has not earned your deference.

Dr. Rubin and those like her are doing the work — publishing, teaching, advocating, training other physicians on their own time and their own resources. The fact that this advocacy is necessary at all is an indictment of a system that should have never required it.

Women were never told the full truth about their own bodies. And the longer that silence persists, the more it costs — in health, in dignity, and in lives.

It is long past time for all of us to be angry about that.

Chief Tutu Baffour Asare Brownsy Williams is an author, columnist, and founder of Brownsy Silva Company. He writes on gender, society, public health, and African affairs.