With the advent of the field of reproductive medicine, there’s increasing knowledge about the misunderstood uterus.
I figure it’s my turn to speak. I do have a right to speak for myself, right? Apparently not everyone thinks so.
Forgive me for being grumpy: I have a long history of being misunderstood. By the Greeks, for instance. To them, I was the hystera, and Hippocrates, Plato, Celsus and others wrote learned treatises about my habit of wandering about the body, causing women to behave badly (you guessed it – “hysteria”.) In their defence, these scientists may simply have been plagiarising a medical papyrus first published by ancient Egyptians (the original beard-strokers) in 1900BC.
Sadly, this would not be the only time a bunch of self-described wise, conservative men would attempt to explain women, but not by actually observing anything. It would also not be the only time a bunch of male leaders would be allowed to blow hot air from posterior orifices without anyone telling them they were wrong.
Here’s an incomplete summary of the “medical facts” told about me, growing more fantastical with each century:
1. Not only am I hyperactive, but also I can’t drive straight. My collisions with the other organs of the body cause problems such as dizziness, fatigue, muteness and sudden death.
2. I can be encouraged to move downwards by the application of bad smells to the nose (incidentally, where the idea of smelling salts to treat fainting came from). I’m very glad the other suggestion, wafting perfume up the vagina to keep me glued to the pelvis floor, did not persist past the Middle Ages.
3. If I am kept busy (ie, pregnant), then these problems can be largely avoided.
4. I emanate my own “seed” (a female equivalent of sperm), but this tends to rot and produce gases contaminating the body.
These beliefs persisted until a guy named Freud, bless his soul, came along and told everyone that mental illness wasn’t my fault, after all, but the result of men unconsciously wanting to have sex with their mothers. (Thank god for that correction.) I’d love to say it was a relief to enter the modern age of medicine, one based on systematic experimentation and careful observation, but it really wasn’t. The history of the “discovery” of my actual form is littered with (surprise) sexism, racism and yet more mansplaining.
For example, when German physiologist Johannes Müller happened to discover the origins of female sexual organs in animals (he was doing experiments on frogs at the time), he named these after himself, but didn’t do much more – he found frogs, fish and birds more interesting. It’s only in the past 20 years that scientists have admitted they still don’t know much about how the “Müllerian ducts” actually become woman bits, and started investing time and research funding in finding out.
Some doctors did take an interest in my anatomy, of course. The “father of modern gynaecology” was a 19th-century American physician called Dr J Marion Sims. He invented tools – such as the speculum – which are still used today, and he perfected life-saving operations to help women deal with childbirth injuries. But he did this by experimenting, without anaesthetic or consent, on enslaved black women. Although this fact is undisputed, some people in the medical establishment still want his statues up and his name on buildings – because, as they write in eminent medical publication the BMJ, he was just an unfairly maligned product of his times and the end justified the means. Yes, we have heard that one before, haven’t we?
Medical textbooks today still mostly describe me in simplistic terms. I’m apparently usually “pear shaped”, I have either three or four parts, depending on who you read (a fundus, corpus, isthmus and cervix – or, translated from the Greek, the roofy bit, body bit, bridge bit and horny bit). Much is made of my ability to stretch up to contain a baby. I go from the size of a pear to a grapefruit to a papaya to a watermelon. I mean, what is this weird Fallopian tube Uterus obsession with describing me as a fruit?
Happily, with the advent of the field of reproductive medicine, there’s increasing knowledge about my layers, and their function. Did I mention I’m supremely complex, layered and multi-functional? I have three main layers – the perimetrium (tough protective outer layer), the myometrium (middle muscular layer, which does all the work in labour) and the endometrium (inner lining, which builds up monthly and then sheds if it’s not needed – otherwise known as a period).
I also have different states, depending on what is needed of me, changing through your life from pre-pubertal, to ready-for-kids-if-needed, to over-it-I’m-menopausal. But (surprise!) research into common conditions such as endometriosis, that disrupt the lives of so many women, is still in its infancy.
You’re still some way from understanding the complex interplay of nerve signals, hormones and blood flow that help me function. What is known, though, is that the nerves that control me are from the parasympathetic and sympathetic systems, hardwired into the most primal impulses of the brain. (Maybe those Greeks were partially right.) And hormones such as oxytocin – stimulated by warm, social interactions and feelings of security – are essential for preparing me for the big job of labour. But it’s still such an early conversation, led by a new generation of female researchers.
I’m feeling hopeful these days. I’m hoping the bad old days of men planting their flags and names all over my body and claiming control over my function, using dubious “moral” arguments, is finally over. Sure, there are setbacks. But with your help, maybe I’ll finally be understood. And maybe hysteria – a state of understanding me – will finally be seen as a good thing.
It was lovely to get to know you. I am your uterus.
