When Women Aren’t Heard – alive magazine

Despite medical advances, many women continue to feel unheard in healthcare. A 2025 national survey published by Maple, a telehealth platform, found that 74 percent of Canadian women feel that their health concerns are not taken seriously, 43 percent have experienced delays in receiving appropriate treatment, and 76 percent believe that the system is not designed with their needs in mind.

But healthcare delays and avoidance don’t make the problem go away. Prolonged wait times can lead to adverse physical and mental health outcomes, while the dismissal or downplaying of women’s concerns can leave symptoms unaddressed.

Contributing factors to women’s healthcare avoidance

In the hopes of shaping Canadian women’s healthcare to be well-informed, compassionate, and coordinated, the IWK Foundation published a groundbreaking 2025 study that highlights the experience of 27,317 female residents across the Maritimes. They found common challenges women need to overcome:

Personal barriers

Women are often caregivers for children and/or parents, which can lead to caregiver burnout and become an invisible barrier to wellness. In fact, 51 percent of respondents said they delayed care due to other responsibilities.

Over 75 percent of women admitted to delaying or avoiding care altogether, while 58 percent reported downplaying their health concerns. Knowledge gaps about which signs and symptoms warrant a doctor’s visit exacerbate this.

Cultural barriers

Just over half of surveyed women reported worrying about not being heard by their doctors, fearing they would be labelled as fussy or difficult, or face bias or dismissal. A lack of understanding of women’s health was identified as a potential barrier to family doctors providing effective care.

Systemic barriers

Access to specialized women’s health services, preventative care, and research funding differs dramatically depending on where a woman lives in Canada, with 28 percent of survey respondents reporting they couldn’t access a family doctor when they needed one. In fact, only seven percent of health research in Canada focuses specifically on women, and less than nine percent of course content at 16 medical schools includes women’s health.

These disparities can translate into tangible challenges for women navigating the healthcare system. Women experience adverse drug reactions nearly twice as often as men, in part because most pharmaceuticals currently in use were approved based on research conducted on men.

Advancing women’s health

Sarah Wilson is a naturopathic doctor, author, and founder of 10 Advanced Women’s Health clinics across BC and Ontario. Wilson and her multidisciplinary team work closely together to provide truly collaborative women’s healthcare.

Among her patients, Wilson has observed three top reasons that women avoid healthcare:

1. Unmet needs: “They’ve sought care in the past and have not been well-received. They were told everything was normal. They didn’t feel heard,” Wilson says. “If they went back, it would be the same result.” Why bother?
2. Self-sacrifice: “All we hear is about the demands on our healthcare system,” says Wilson. “I had a patient yesterday with very high blood pressure, but she said she didn’t want to go to the hospital because she didn’t want to take the spot of someone who needed it more. We’re empathetic to a fault.”
3. Symptom normalization: “It’s not that bad, why would I go to the doctor for this?” Wilson has observed that minimizing symptoms and avoiding care may also delay diagnosis and treatment. She shared a sobering story of a patient whose broken arm wasn’t healing, and when she finally sought care, doctors found ovarian cancer.

Filling knowledge gaps

For many women, being taken seriously requires effort, persistence, and self-advocacy. These strategies can help women gain clarity about their bodies and confidence about talking to their doctors.

Absence of disease

“There’s a belief that if you don’t have a disease, then you’re healthy,” says Wilson. But just because your lab results are normal doesn’t mean you’re in optimal health.

Wilson encourages women to do investigative lab work from the perspective of prevention and optimization and work with a practitioner who is skilled in assessing findings.

Body awareness

Seventy-seven percent of women in the IWK Foundation survey reported carefully considering which symptoms are worth mentioning to their doctors.

Knowing yourself and how you usually feel under various life circumstances can provide a baseline to help you know when a symptom warrants medical attention. Generally speaking, if a symptom is new, persisting or getting worse, or impacting your life, then it’s worth mentioning to your doctor.

Harmful myths

Many of us have inherited cultural misunderstandings about women’s health, which can keep us needlessly suffering in silence. The notions that menstrual pain, pain during sex, and volatile mood swings are normal parts of being a woman discourage investigation into potential underlying causes and appropriate treatment.

These gaps highlight an important question: where does our knowledge fall short, and which health issues should women be most aware of?

Vaginal health

Vaginal health remains a mystery to many women. Let’s rectify that!

Discharge

For a year or two before puberty until after menopause, it is normal and healthy for a woman to produce vaginal discharge. Discharge consists of bacteria, mucus, fluid produced by the cervix and vagina, and epithelial cells that slough from the vaginal walls.

Unless on hormonal birth control, the amount and texture of discharge changes throughout the menstrual cycle. At the beginning and end of the cycle, discharge is thick and sticky. Around midcycle (ovulation), discharge gets clearer, watery, and stretchy.

Vaginal microbiome

Vaginal bacteria help maintain an acidic pH and compete with outside pathogens (disease-causing organisms) to adhere to the vaginal mucosa. They also fend off pathogens by producing antimicrobial compounds.

Immune deficiency, hormonal changes, stress, or use of a vaginal douche or soap to clean the vulva or vagina may alter the vaginal microbiome and pH. A healthy vagina in childbearing years is slightly acidic, with a pH around 3.8 to 5, creating an environment that helps protective bacteria thrive while keeping harmful microbes in check.

Vaginal infections

Normal vaginal bacteria (microbiome), an acidic vaginal pH, and vaginal discharge make up the innate defence mechanisms that protect against vulvovaginal infections. A disruption in any of these factors may pave the way for infection.

Some of the most common vaginal infections include bacterial vaginosis, vulvovaginal candidiasis (yeast infection), and trichomoniasis (a sexually transmitted infection).

“Discharge that is yellow, grey, foul-smelling, clumpy, and cottage-cheese-like in texture is abnormal and may indicate vaginal infection,” says Wilson.

Other signs of vaginal infection include burning, itching, and vaginal odour that isn’t mitigated by basic daily hygiene.

Wilson shares that a cyclicity of symptoms, usually presenting right before or after one’s period, often points to a vaginal infection. During a period, the changes in hormones and the presence of blood in the vagina alter the pH and impacts the microbiome.

Changes at menopause: With a decrease in production of estrogen and collagen at menopause, the vaginal mucosa becomes thinner. The population of Lactobacillus bacteria in the vagina also declines, which consequently raises the pH (meaning it becomes less acidic).

Altogether, these vulvar and vaginal changes predispose postmenopausal women to vulvovaginal infections and vulvovaginal diseases, including genitourinary syndrome of menopause. These changes can negatively impact a woman’s sexual health and overall quality of life.

Symptoms of vulvovaginal disease may include discomfort, pain during sex, itchiness, and changes in vulvar colour and texture.

Hormone replacement therapy and probiotic therapy may assist with menopause-related vulvovaginal symptoms.

Vaginal and vulvar care practices

Here are some essential ways to maintain your genital health:

• Wash your vulva with your hand; avoiding sponges or flannels.
• Avoid soap, shower gel, bubble bath, and vaginal douches, which can disrupt pH.
• Wear loose-fitting cotton underwear.
• Sleep without underwear.
• Use cotton tampons and breathable sanitary pads (without plastic backing) for menstrual bleeding.

Iron deficiency

Iron is an essential element required for oxygen transport, DNA synthesis, metabolic energy, cellular respiration, and the production of red blood cells and thyroid hormone, yet one in four Canadian women aged 14 to 50 has low iron.

Symptoms

A deficiency in iron may cause anemia and affect many aspects of physical and mental-emotional well-being. Symptoms may include fatigue, brain fog, dizziness, weakness, shortness of breath, cold hands and feet, restless legs syndrome, and hair loss. Some of these effects, as well as reduced work performance, can severely limit a person’s daily functions. In fact, iron-deficiency anemia in women is the leading cause of years of life lost due to disability.

Iron deficiency in women

Iron deficiency disproportionately affects women, with heavy menstrual bleeding, uterine fibroids, pregnancy, and the postpartum period as major contributing factors.

Despite the high prevalence of iron deficiency and its impact on quality of life, iron deficiency among reproductive-age women is still underdiagnosed and undertreated. This may be due in part to women’s own normalization of their symptoms, along with a lack of screening in doctor’s offices.

Blood work

Serum ferritin correlates with iron storage, so it is an appropriate marker to screen for when it comes to iron deficiency in otherwise healthy women.

The exception lies in those with inflammatory conditions, such as autoimmune diseases and obesity. In inflammatory states, ferritin acts as an acute phase reactant protein, and a high result on blood work may give a false indication of sufficient iron status. These women may walk out of their doctor’s visit with seemingly normal blood work and undiagnosed iron deficiency.

Ask for a full iron panel, including serum iron, total iron-binding capacity, and transferrin saturation for a fuller picture. Get a baseline and monitor regularly to catch iron deficiency in its early stages.

Increasing iron status

We need to be mindful of our iron sources through diet and lifestyle, says Wilson, who suggests cooking with a cast iron pan and using iron cooking tools, which are small pieces of iron that you boil in water or soup to release bioavailable iron into the liquid.

There are two types of iron found in foods: heme iron (found in meat, fish, and poultry) and non-heme iron (found in eggs; plant-based foods; and items with added iron, such as certain cereals or pastas). Non-heme iron is less efficiently absorbed than heme iron, so vegetarians and vegans need to be especially conscious of their intake.

Optimize absorption by pairing iron with a food source of vitamin C, such as citrus fruits; red, yellow, and green peppers; broccoli; Brussels sprouts; and papaya. Talk to your healthcare practitioner about iron supplements, as too much iron can be harmful. Take iron supplements away from meals, coffee, and items that contain tannins, such as tea, which decrease the bioavailability of iron.

Carbohydrate confusion

For years, we’ve heard that “carbs are bad,” which has led quite a few women striving to “cut carbs” to lose weight.

While this may be partially true, it’s just that: a half-truth! Generally speaking, it might be more helpful to focus on carbohydrate quality and timing to promote stable energy, mood, and weight. “Not all carbohydrates have a big impact on insulin, fat storage, or blood sugar,” explains Wilson.

Quality of carbohydrates

In a 2025 study of 47,513 women published in JAMA Network Open, intakes of high-quality carbohydrates from whole grains, fruits, vegetables, and legumes as well as total dietary fibre in midlife were associated with increased odds of healthy aging and positive health status in older adulthood.

By contrast, refined carbohydrate intake (such as white bread, pasta, and cereal) was associated with lower odds of healthy aging. “Dried fruits, tropical fruits, and refined carbohydrates can increase the amount of fat storage and blood sugar, thereby increasing fatigue, brain fog, and weight gain,” says Wilson.

Timing of carbohydrates

“Protein is critical for blood sugar regulation,” says Wilson. Pair high-quality carbohydrates with a protein source for a blood glucose–blunting effect, thereby avoiding a post-meal energy slump.

Better yet, adopt the practice of food sequencing for your meals, whereby you eat fibre first (such as salad), followed by protein and/or fat (salmon), and lastly, carbohydrates (rice).

This practice has been researched for its benefits on glucose and insulin regulation. Improved glucose regulation may mitigate irritability, fatigue, and headaches, while improved insulin sensitivity may assist with weight management.

This article was originally published in the May 2026 issue of alive magazine.