Tuesday, May 10, 2016

Doctors underestimate women's pain

woman in a hospital

“On a Wednesday morning, as I prepared to go to work, I heard a cry in the silence, I ran into the bathroom and saw my wife bent in pain, out of breath.

See her in that state really scared me to death. Rachel is not one of those people who complain about nothing. So, when I saw her in that state, crying like a little girl, I immediately called the ambulance.

I don’t know how long it took the ambulance to arrive because the pain and panic distort our perception of time, but when I heard the siren I felt relieved. I didn’t know that our adventure had just begun.

One of the technicians asked my wife the classic question: ‘If you were to quantify, from 1 to 10 how strong is your pain?’

‘Eleven’, stammered Rachel.

During the ride on the ambulance, I suffered almost as much as my wife, but I had confidence that everything would be son over when just arrived at the medical center. The trip took 10 minutes to get to the hospital, the stretcher was placed in a long row, and Rachel became officially a patient.

After a while I went to a nurse and asked her to see my wife because I had never seen her complaining that way.

‘You'll have to wait your turn, it's just a bit of pain, hold on honey’, I said as I stroked her head.

At that time we didn’t know that one of her ovaries was dying, literally. My wife had an ovarian cyst, a fairly common problem, but in her case had grown too much going to twist a fallopian tube. This condition is defined: ovarian torsion, and is very painful and requires immediate surgery.

However, the attention needed by my wife was late in coming. Two hours later came a doctor, asked her a couple of quick questions, a brief examination and then disappeared. Half an hour later a nurse put a drip for the pain and brought her into the room to perform a CT scan. It was the routine treatment for kidney stones.

When the painkiller began to take effect Rachel lost consciousness, but still had on her face a grimace of pain. Three hours after the CT scan, the doctor saw the results and his eyes widened. He confirmed that my wife had a large mass in the abdomen but do not know what it was. It was only then that everybody went serious and took over the ovarian torsion.

Rachel was operated and all went well, but later she wondered what would happen if she came alone to the hospital, where doctors and nurses seemed to tell everyone: ‘Don’t worry, women cries for nothing. They are all like that!’”.

This story, more or less synthesized, was directly lived by journalist Joe Fassler, who indignantly published it in The Atlantic. And I share it with you because I too had the experience of seeing in the eyes of some doctors the look that minimizes the symptoms and makes you feel halfway between hysterical and hypochondriac. And I'm not the only one. Many women were treated the same way.

Women are more likely to suffer from diseases that cause pain, but receive a more conservative treatment

A study by researchers at the University of Maryland revealed an alarming fact: in the United States men wait an average of 49 minutes to receive an analgesic for acute abdominal pain. Women are waiting an average of 65 minutes to receive the same treatment for the same reason, because often their pain is classified as “emotional”, “psychogenic” or even “unreal”.

Another study conducted at the University of Pennsylvania found that women are between 13% and 25% less likely to receive treatment with opiates to relieve pain, while men are prescribed this treatment more quickly and frequently .

However, it is curious that researchers of the University of Florida found that women are at greater risk of developing diseases that cause intense pain. Women are twice as likely to suffer from multiple sclerosis, two to three times more likely to develop rheumatoid arthritis, and four times more likely to suffer from chronic fatigue syndrome than men. Moreover, the autoimmune disease, which often include debilitating pain, affects women three times more than men.

Yet, even so many doctors and nurses minimize their pain, apparently we must continue to bring upon us the historical weight of hysteria. In fact, female hysteria was a common diagnosis until the mid-nineteenth century, at that time it was estimated that one in four women suffered from hysteria.

This diagnosis was applied to a wide range of symptoms, insomnia, fainting, fluid retention, irritability, headaches and muscle spasms. And the funny thing is that, at that time, the only treatment was the stimulation of the female genitalia. Obviously, at the base there was the idea that women were exaggerating the pain or even invented it.

The medical community is aware of this “gender curse”, but continues thinking that women are too sensitive

The worst thing is that this “gender curse” is a well known phenomenon in the medical community. In fact, exists something known as “Yentl Syndrome”, whereby the usually heart attacks occur differently in men than women, which is why many doctors focus on classic signs of men and many women are not diagnosed in time, with the corresponding deadly consequences that this entails.

Statistics indicate that women who suffer from heart disease often receive less aggressive treatment than men, even if their illness is usually at an advanced stage. Women are half as likely to undergo cardiac catheterization and are less likely to see themselves recommended a bypass surgery or a procedure to unblock clogged arteries.

What's more, it was also found that women are more likely to receive a diagnosis of conditions such as fibromyalgia and chronic fatigue syndrome, of which, however, have not yet been adequately identified the causes and there is no definitive diagnostic test. This means that women are more likely to receive a diagnosis of disorders that have a large psychological component.

Obviously, in a society that is moving towards gender equality, these stereotypes are inconceivable. And worst of all is that these preconceptions by which women would be “sensible” and “whiner” in medical terms can mean the difference between life and death, or at least, significantly affecting the quality of a person's life.

Unfortunately, according to Leslie Jamison, an American essayist who has thoroughly studied this phenomenon and has shaped his “Grand Unified Theory of Female Pain”, “women receive an initial treatment less aggressive than men, until they prove that their pain it's important”.

Obviously, not all health care workers have these stereotypes. But if you're one of them, you'd do well to make a concience exam.

Fillingim, R. B. et. Al. (2009) Sex, Gender, and Pain: A Review of Recent Clinical and Experimental Findings. Journal of Pain; 10(5): 447–485.
Chen, E. H. et. Al. (2008) Gender disparity in analgesic treatment of emergency department patients with acute abdominal pain. Acad Emerg Med; 15(5):414-418. 
Hoffmann, D. E. & Tarzian, A. J. (2001) The girl who cried pain: a bias against women in the treatment of pain. J Law Med Ethics; 29(1): 13-27.
Healy, B. (1991) The Yentl syndrome. The New England Journal of Medicine; 325(4): 274-276.


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Doctors underestimate women's pain
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Jennifer Delgado Suárez

Psicologist by profession and passion, dedicated to to string words together. Discover my Books


Psychology as you never heard about...

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