First of all, let me admit, that this post has been 'triggered' by a post from a gynaecologist implying that the reason for the gender health gap is that women believe ignorant influencers on the internet.

I suppose it's good of him to admit there is one. Although if he doesn't understand the reasons for it, I doubt he'll have any success in fixing it. 

On average women live longer than men. However they spend a much bigger chunk (25% more) of their lives in ill health. I remember my Biology teacher telling me "women don't live longer, they just die more slowly."

So, assuming the reason for this isn't women's stupidity, why does it happen?

Menopause is part of the story. I know so many women of my mum's generation whose health has been compromised because of complications of osteoporosis or bladder infections. And as we know those hormonal changes can have an impact throughout the body and brain. 

But there are also fundamental health inequalities that have been affecting us all our lives. If you want to dig further into this I'd recommend a lock at Unwell Women by Elinor Cleghorn or Caroline Criado Perez's Invisible Women.

But here are the highlights.

It takes longer for women to be referred to a specialist than men - in one study of chronic pain, 3 years longer.

Women's pain is more likely to be assumed to be 'emotional'. This shows up significantly in the attitude to pain relief in procedures such as hysteroscopy compared to the attitude to pain relief in procedures such as colonoscopy.

Female hormones such as oestrogen affect the working of our whole body - our immune system, circulatory system, but our ideas about illness are based on the male body. We know for example that heart attacks present differently for women. 

Many drugs work differently on men than women, but only a women comprise only 22% of phase one drug trials - the ones where they're figuring out if it works,

Drugs such as antibiotics, anti-depressants or antihistamines are impacted by the menstrual system, both in terms of their effectiveness and side-effects, but we don't have enough information to take account of this in dosage.

Illnesses that exclusively affect the female body, such as endometriosis go undiagnosed for years - and often decades.

So what does all this mean? It's really not because we're stupid. In actual fact it means that we have to be smarter and work harder to get the same.

I'm not telling you this so that you get your knickers in a twist. I'd also prefer it if you didn't ball them up and gaffer tape them into someone's mouth - which is pretty much what I wanted to do a few days ago.

But it's ok to be angry. Please give yourself as much space as you need to be angry.

And then we need to move past anger and get to determination.

How do we work harder and smarter to get what we need?

If we don't feel we can trust that what is written in our medical records will reflect our experience, we can keep our own records.

We can be dogged and keep going back until it's easier for them to take us seriously.

We can be assertive, while remembering that getting angry or upset may get us labelled.

We can chose not to leave an appointment until we're confident that everything we have to say has been listened to - and we can go with a written list.

We can hang on to the validity of our own experience and believe in it even when others do not.

We can find reliable sources of information about our conditions - and make sure they are those that someone with the perspective of a medical doctor will respect them. (In the case of menopause I usually go to https://www.womens-health-concern.org/which is part of the British Menopause Society).

We can take responsibility for our own health and do the things we know will help keep us healthier.

We can remember that stress and trauma can have a huge impact on our physical as well as our mental health - and if our engagement with the medical profession is causing that stress and trauma then we can work to counteract it by investing in our own mental health.

We can acknowledge that all of this is hard work and nurture ourselves accordingly.

And one of the ways of doing both those things that is to find support from the those around us, especially the networks of women that we're connected to.

And of course we can learn about this problem and talk about this problem. When you're ready - there are days that I can't look at some of the books on my shelf!

And yes, we can avoid silly influencers on the internet. I'm going to be avoiding smug misogynistic gynaecologists as well. On the internet at least...