Imagine teenage boys started bleeding at thirteen. Not once, not an injury they recover from, but every month, for decades. Picture classrooms of boys doubled over with cramps strong enough to make some of them sick. Boys sitting exams while exhausted, bloated, foggy and in pain. The panic of leaking through school trousers. The quiet monthly arithmetic of whether they have enough supplies hidden in a bag. The fear of standing up and finding blood on the chair.

Now imagine telling them to get on with it, because it's just part of life.

For girls, that conversation has been normalised for generations. Before most young women even understand their own bodies, they have already been taught to tolerate discomfort quietly, and not always mild discomfort. For some, periods are an inconvenience. For others, they are debilitating: pain radiating through the back and legs, nausea, migraines, heavy bleeding, hormonal crashes, a fatigue so complete it becomes hard to think, let alone perform. And still millions of women go to school, sit through meetings, raise children and run companies while behaving as though nothing is happening at all, because somewhere along the way they learned that functioning through pain was simply expected of them.

For decades, women were excluded from clinical trials. The default patient was a man. Women were the variation.

In recent years, a particular kind of video has gone round: men trying a device that simulates period cramps, filmed by the women in their lives. The machines are real, a form of nerve stimulation, and the footage follows a pattern. The confidence goes first. The men double over, ask to stop, plead at settings the women beside them sit through while carrying on a conversation. What tends to stay with them afterwards is not the pain but the recalibration, the sudden understanding of what the women around them had been quietly absorbing all along. Nobody had explained it any better than before. For once, it had simply been made visible.

The default patient was never only male. She was also white, and the further a woman sits from that template, the longer she waits to be believed.

That is the heart of the problem. So much of women's suffering stays invisible because it has been normalised for so long that no one thinks to question it. And the consequences of that reach far beyond a monthly period.

Women's health has, for most of medical history, been approached through endurance rather than understanding. The question was rarely how do we reduce this suffering. More often it was how does she keep going despite it. That is not an accident of attitude. It is built into the structure of medicine itself. For decades, women were excluded from clinical trials, on the reasoning that fluctuating hormones complicated the data, which means much of what we know about how the body responds to illness and medication was learned from male bodies and applied to everyone. The default patient was a man. Women were the variation.

The results of that follow a woman through her whole life. Period pain dismissed as hormones. Endometriosis, which affects roughly one in ten women, still taking an average of almost nine years to diagnose in the UK. Heart attacks missed or mistaken, with women in the UK around fifty per cent more likely than men to be misdiagnosed when one strikes, because the symptoms they present with don't match the male template doctors were trained on. Pain minimised, mood changes waved away, PMDD misunderstood, perimenopause overlooked, menopause treated as an inconvenience rather than the major physiological transition it is. Women are expected to absorb enormous hormonal and physical change while continuing to perform inside systems largely designed around male biology, and because they become so practised at coping, coping is mistaken for being well.

Coping is not the same as being well.

And the failure is not shared equally. For much of the twentieth century, medicine taught that endometriosis was a condition of affluent white women and rare in Black women, a belief since shown to be wrong but one that shaped how a generation of doctors was trained. Its residue remains. Black women wait longer for diagnosis, have their pain dismissed more readily, and carry the sharpest disparities of all: in endometrial cancer, Black women die at roughly twice the rate of white women, a gap that holds in both the UK and the US despite their different health systems. The default patient was never only male. She was also white, and the further a woman sits from that template, the longer she waits to be believed.

But coping is not the same as being well. Women's health was never fully built around women's lived experience. It was built around women continuing to function, and there is a great deal of distance between those two things.

Perhaps that is why so many women feel exhausted long before anyone listens properly. What looks like weakness is really the accumulated weight of carrying levels of discomfort that no one ever expected men to normalise in the same way. And perhaps the real shift begins the moment women stop minimising what they feel simply because they have survived it for so long, and start expecting medicine to be as interested in their comfort as it has always been in their endurance.