Women’s pain and discomfort have a history of being neglected in health care. Here are two ways that are starting to change.

Two major improvements in women’s health have recently hit the news: non-invasive alternatives to the pap smear – long considered an “inconvenient but necessary” screening tool for cancer of the uterus – and new pain management guidelines for IUD insertion, the most effective form of contraception that many women do. they said pain when placed in the uterus to prevent pregnancy.

Women suffering disproportionately in health care settings is nothing new. Research suggests that they suffer even more than men, but women’s discomfort is largely overlooked and often overlooked. Women in distress are more likely than men to receive prescriptions for sedatives rather than pain medications, and one study found that women who underwent coronary bypass surgery were and half as likely to be prescribed painkillers as men who had the same procedure.

Why has women’s pain been dismissed for so long?

The pain and discomfort of women in health care settings has long been overlooked and largely misunderstood because women’s bodies and health were poorly understood – since the third century BCE, the philosopher Aristotle, who when he believed that women’s bodies are different from men’s. genitalia “turned outward.” As a result, the way women have traditionally been treated as patients often reflects old prejudices.

“The origin of the word hysterectomy pointed to the belief that ‘hysteria,’ a mental illness of uncontrollable emotions, was specific to women and rooted in the womb,” Beth Darnall, a pain psychologist doctor at Stanford University, he tells Yahoo Life.

The tendency to emotionalize women’s pain is still happening today. The Washington Post reported on a study that found “middle-aged women with chest pain and other heart disease symptoms are twice as likely to be diagnosed with heart disease.” mentally compared to men with similar symptoms.”

David Thomas, special advisor to the director of the Office of Research on Women’s Health, tells Yahoo Life: “Women are more often prescribed antidepressants for pain compared to men, where pain is considered caused by emotions. And unfortunately, the disobedience of women in clinical settings goes far beyond women reporting pain. ”

Dr. Kristen MacKenzie, an assistant professor of medicine at Stanford University, explains that popular culture has historically believed that certain aspects of femininity—such as menstruation, childbirth, and menopause— they are inherently uncomfortable and women have been “dealing with them” for centuries. .

“This creates the impression that if you’re complaining about it, the problem is your pain tolerance and not the physical condition,” MacKenzie tells Yahoo Life.

Medicine also has a long history of excluding women from studies to better understand their health. For example, under a 1977 policy (later repealed in 1993) the Food and Drug Administration barred women of childbearing age from participating in early drug trials—even if they were pregnant— childbirth or with men who have had vasectomies; the goal was to prevent unborn babies from receiving experimental drugs, but the result was a lack of information on how the drugs affect women.

“Historically, women’s health care has received little attention, research and funding, and that has affected women’s health outcomes today – including how pain is measured, investigated and treated. how,” Irene Aninye, chief scientific officer at the Society for Women’s Health Research (SWHR). ), tells Yahoo Life. “For a long time, women were not considered much different from young men when it came to their health” – meaning that their pain was considered a “small change” in pain. of men – “so the conclusions found for men were considered applicable to women. too. Now we know that these things are false. There are important sex and gender differences when it comes to health and the pain.”

How things change

In some ways, little has changed in women’s health care. The speculum has not been significantly improved in 170 years and the forceps commonly used for inserting IUDs and cervical examinations, for example, were invented 135 years ago by a surgeon Frenchman Samuel Pozzi, said to be the father of modern gynecology – and inspired by French surgeon Samuel Pozzi. American Civil War era bulletproof vest.

But experts say they are seeing an improvement in taking women’s symptoms and pain seriously.

“There’s a greater awareness of bias in general, including gender bias, and the cultural movement toward equality,” says Darnall. “For example, the National Institutes of Health require researchers to include sex as a biological variable in studies, to ensure that we collect evidence from women and understand how to best meet their needs.”

She adds: “Having more representation of female doctors can also make a difference. Last year, 55 percent of medical students were women.”

Aninye says conditions that specifically affect women (such as endometriosis and menopause) as well as diseases that affect women disproportionately (such as migraines, which affect women twice as often as men , and autoimmune diseases, and 80% of cases are found in women) receive more attention. But he says: “There is still a lot of work to be done to make these topics more prominent.”

Another problem, they say, is that pain is only human. Thomas said another area of ​​research the NIH is focusing on is finding “objective measures of pain” to remove bias from treatment and diagnosis.

“Hopefully, objective measures of pain, not just things [like] a scale of 0-10, can confirm that people are in pain, what kind of pain they have and suggest possible treatments,” Thomas says. “Although the patient’s voice is often ignored or dismissed, our hope is that hard scientific information will not be ignored.”

What can women do to be heard?

Experts offer these tips for discussing pain or discomfort – or bringing up other health problems with medical professionals.

• Find a doctor you trust. Seek health care and treatment advice from someone you trust who will be sympathetic and understanding of your concerns. Dr. Paula Castaño, assistant professor of reproductive health at Columbia University, says: “Patients need to find a doctor they trust – it may be based on their previous experiences with that doctor or following trusted recommendations.

• Ask questions. MacKenzie says it’s best to bring a list of specific questions to medical candidates, and tell your client in advance that you’d like to go through that list with them. “Many patients have anxiety about a lost diagnosis, and they need to feel empowered to bring that to their provider in order to get a definitive diagnosis or referral,” she says. to a young doctor,” he says. And if you’re considering treatment, ask your doctor about any pain you may be experiencing and how to manage it.

• Bring a lawyer. Castaño says: “Since medical visits can be scary or stressful, I also encourage patients to bring a trusted friend or family member to help ask questions and advocate for them.

• Take a breather. If your concerns are ignored, persist. “Feeling dismissed can be confusing,” says Darnall. “It’s best to stay calm and repeat your main question or concern. Ask for more information so you understand the treatment plan and options.” yours.”

• Get a second opinion. If your current provider isn’t answering your questions or giving you the information you need, find one who will listen to your concerns. Aninye says: “As a patient, you have the right to get as much information as you need to be comfortable when making health care decisions. “Unfortunately, it is common for many women to visit several [providers] before they get a proper diagnosis or confirm an effective treatment plan for their condition. ”

• Share your story. MacKenzie says women who share their experiences on social media are raising awareness in the general public and among medical providers, and are already leading to change. She says: “Women deserve to talk to their providers without the expectation that they will suffer just because women have experienced these symptoms in front of them. Aninye agrees: “Sharing first-hand accounts can lead to powerful relationships and become real agents of change in health care, research and policy. Women should share their life stories where they feel comfortable. Speaking up can improve awareness of women’s lives and even influencing research and financial decisions.”