Opinion: Thailand needs to change its attitude towards reproductive health/education

I am 16 and on hormone medications. 

It began in the summer of August 2020 when my grandma asked me when was the last time my period came. I remember answering her that it had not come since December of the previous year.

As a teenager, I was not aware of the implications of leaving my condition untreated. I simply believed that being period-free was a blessing – which as I have realized, could not be further from the truth. 

I was lucky that my mother and grandmother were not unaware like I was. 

They took me to see a gynecologist, who after giving me a blood test and ultrasound, diagnosed me with Polycystic Ovary Syndrome (PCOS). 

PCOS is a disorder caused by an imbalance of sex hormones. The most common symptom leading up to it is losing one’s period. Acne and weight also fall under this category; however, because these symptoms are more generalizable to an array of disorders, it becomes harder to correctly attribute their cause to PCOS.

This misdiagnosis is reflected in our daily lives. We often see Thais going to a dermatologist when they have acne or a nutritionist when they gain weight, but no one ever thinks of going to a gyno. This lack of awareness that a disorder may be the underlying causes to my the varied symptoms could misinforms patients leading to frustration and anguish.

The reason for why most Thais do not take their child to the gynecologist is partly cultural. In the past, gynecologists were referred to as “mhor tamyaes”, women whose primary role was to give birth. I think that associating modern doctors with this antiquated description paints an incomplete picture of their role in taking care of a womnn’s vaginal health. 

This misconception is also very dangerous. It is quite concerning that we reduce gynecologists to doctors whom we only go see if we are pregnant or just had sex. 

For example, if I had not seen a gyno and not given hormone medications, I would have been at major risk of type 2 diabetes, infertility, cardiovascular disease, obesity, sleep apnea, non-alcoholic fatty liver disease, depression, and even endometrial cancer – all implications of undiagnosed PCOS. 

Although the stats are shocking – 1 in 10 women worldwide suffer from PCOS – lessons on menstrual disorders have not been implemented in Thai schools. I  know girls who, despite experiencing over 12 months of irregular periods, still refuse to go see a gyno. 

This poses the question: if menstrual disorders were to be taught in schools, would girls care to learn about it, especially when their long-term implications have not yet surfaced?

Our generation’s lack of awareness is not even due to any fault of our own, it is the refusal to teach us, the lack of access to information and education.

As we become more informed, here are the changes I hope we can all make:

One, for all young girls to receive education about their vaginas, especially in recognizing early signs of PCOS.

Two, for all gynecologist visits to be normalized, same as visiting a dermatologist or any other types of doctors.

Three, for all Thai schools to cultivate – not condemn – conversations on menstruation and reproductive health.

Before trying to reform the education system or declutter deep-rooted cultural stigmas, let us first raise the respect we have for ourselves by genuinely caring for these issues and taking them seriously.

By Manyasiri Chotbunwong (Pear)

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