Do doctors take women's pain less seriously?

mahamageehad

Most of us have joked about man-flu at some stage and how women just "get on with it". We've also all heard the whole "a kick in the balls is as bad as labour" line. The idea of comparing a woman's pain to that of a man for the sake of comparison was always a bit silly to me. What I never considered though was that there may be bias within the medical system itself. I came across a really thought-provoking article by The Atlantic recently on the topic. The article is a tough read, but what really struck me was all the women commenting on it that they had experienced similar. I was wondering if any of you had ever felt like that?

I won't copypasta the entire article here as it's very long. Basically the lady is question presented at the ER with a case of ovarian torsion. For those that don't know what that is, it's when the ovary and sometimes fallopian tube get twisted. It's very rare, but incredibly painful and dangerous. Here's some interesting excerpts:

“My wife,” I said. “I’ve never seen her like this. Something’s wrong, you have to see her.”

“She’ll have to wait her turn,” she said. Other nurses’ reactions ranged from dismissive to condescending. “You’re just feeling a little pain, honey,” one of them told Rachel, all but patting her head.

Women are “more likely to be treated less aggressively in their initial encounters with the health-care system until they ‘prove that they are as sick as male patients,’” the study concludes—a phenomenon referred to in the medical community as “Yentl Syndrome.”

The article links to a study that appears to back up this point.

I've never experienced this in any serious sense. I get bad monthly cramps but I grit my teeth and get on with it. Sometimes I feel like my boyfriend can be a bit dismissive of that pain, but as I also tend to push it aside and not treat it like a big deal I can't blame him for that. I did, however, see this firsthand when my sister was younger. I had to collect her from school where she was complaining of severe abdominal pain. I drove her to the closest A&E fearing it was her appendix. They sent her home almost dismissively calling it period pain. She was 16. For 24 hours she was in a lot of pain until my dad drove her back. After some test they told us it was a burst cyst on her ovary and that the worst was over.

So ladies, do you feel that the medical system tends to downplay your pain?

I can only speak from my own experiences which have all been good.

She hardly noticed when the [first] attending physician came and visited her bed; I almost missed him, too. He never touched her body. He asked a few quick questions, and then left. His visit was so brief it didn’t register that he was the person overseeing Rachel’s care.

Around 10:45, someone came with an inverted vial and began to strap a tourniquet around Rachel’s trembling arm. We didn’t know it, but the doctor had prescribed the standard pain-management treatment for patients with kidney stones: hydromorphone for the pain, followed by a CT scan.

[Later] When [the second attending physician] pulled up Rachel’s file, her eyes widened. “What is this mess?” she said. Her pupils flicked as she scanned the page, the screen reflected in her eyes. “Oh my god,” she murmured, as though I wasn’t standing there to hear. “He never did an exam.”

My doctor has caught two serious conditions I have over the past year and had them dealt with immediately. The above strikes me as utter incompetence.

Emergency-room patients are supposed to be immediately assessed and treated according to the urgency of their condition. Most hospitals use the Emergency Severity Index, a five-level system that categorizes patients on a scale from “resuscitate” (treat immediately) to “non-urgent” (treat within two to 24 hours).

I knew which end of the spectrum we were on. Rachel was nearly crucified with pain, her arms gripping the metal rails blanched-knuckle tight. I flagged down the first nurse I could.

“My wife,” I said. “I’ve never seen her like this. Something’s wrong, you have to see her.” “She’ll have to wait her turn,” she said

My last experience of an ER was taking my son to one when he was in terrible pain. This ER had a proper triage system and he was diagnosed with peritonitis and operated on with a couple of hours. I can't believe a modern-day ER doesn't have a triage system in operation.

The Yentl Syndrome is more related to medical research than medical treatment.

So I think, for the most part, it depends more on the doctor you see and the hospital you go to on the day.

What strikes me as another major factor is this:

Still, in the throes of debilitating pain, she tried to bite her lip, wait her turn, be good for the doctors.

Does the medical system downplay our pain or do we?

mahamageehad

Deleted User wrote: »

I can only speak from my own experiences which have all been good.

My doctor has caught two serious conditions I have over the past year and had them dealt with immediately. The above strikes me as utter incompetence.

My last experience of an ER was taking my son to one when he was in terrible pain. This ER had a proper triage system and he was diagnosed with peritonitis and operated on with a couple of hours. I can't believe a modern-day ER doesn't have a triage system in operation.

The Yentl Syndrome is more related to medical research than medical treatment.

So I think, for the most part, it depends more on the doctor you see and the hospital you go to on the day.

What strikes me as another major factor is this:

Does the medical system downplay our pain or do we?

I agree it sounds like utter incompetence, but unfortunately that's always a risk. Look at the report on Savita Halappanavar, there were plenty of mistakes made.

Good to hear that you haven't had that experience. I was wondering how much the article was influenced by the American healthcare system. I was also completely baffled at a modern A&E without triage.

I've done come preliminary googling on Yentl syndrome and I don't understand what you mean by that it's related to research rather than treatment? This link seems to indicate that if can be seen at the diagnostic level resulting in different treatments for men and women (with women being undertreated) but it's from a site called heart sisters so it could be biased.

sullivlo

[Deleted User] wrote: »

I can only speak from my own experiences which have all been good.

My doctor has caught two serious conditions I have over the past year and had them dealt with immediately. The above strikes me as utter incompetence.

My last experience of an ER was taking my son to one when he was in terrible pain. This ER had a proper triage system and he was diagnosed with peritonitis and operated on with a couple of hours. I can't believe a modern-day ER doesn't have a triage system in operation.

The Yentl Syndrome is more related to medical research than medical treatment.

So I think, for the most part, it depends more on the doctor you see and the hospital you go to on the day.

What strikes me as another major factor is this:

Does the medical system downplay our pain or do we?

I think it could be that we downplay our pain. But also the opinions of others can impact it too.

I've been on a chair in a&e, vomiting, on a drip and bleeding back into it, and passing out onto the person next to me. I was afraid to make a fuss. And a (male) visitor to the person next to me asked if I was just hungover...

I was admitted to hospital a few hours later with an obstructed bowel, not a hangover, but because I wasn't complaining and moaning about it nobody really paid attention.

Even the doctors dismissed it as "women's pains" (think I was mid cycle) until they scanned me!

mahamageehad

I know that not every woman suffers from cramps etc, but for those that do, is it possible that it raises our pain threshold? I mean, I would get cramps on occasion that'd knock the breath out of me. Then it's gone and I get on with it. But in general, pain would have to be severe and sustained before I'd worry or do something about it. In that respect I think we downplay pain, but maybe we've got a different scale for comparison?

Some of the rest could be societal pressure. I mean, no-one likes to make a fuss and I think women are more cautious than men in that respect.

rainbow kirby

I reckon that's a distinct possibility - I have a relatively high pain threshold as a result of years of martial arts and running (and yes, some pretty grim periods) and I got through 9 hours of back labour on gas and air when I was having my son.

mahamageehad

mahamageehad wrote: »

I agree it sounds like utter incompetence, but unfortunately that's always a risk. Look at the report on Savita Halappanavar, there were plenty of mistakes made.

Good to hear that you haven't had that experience. I was wondering how much the article was influenced by the American healthcare system. I was also completely baffled at a modern A&E without triage.

I've done come preliminary googling on Yentl syndrome and I don't understand what you mean by that it's related to research rather than treatment? This link seems to indicate that if can be seen at the diagnostic level resulting in different treatments for men and women (with women being undertreated) but it's from a site called heart sisters so it could be biased.

No it's correct, I just mean that this is a result of the fact that nearly all of the research into cardiovascular disease has been carried out on men which has led to this situation of misdiagnosis for women.

https://myheartsisters.org/2011/10/28/the-sad-reality-of-womens-heart-disease-hits-home/

Diagnostics that have been designed, researched and recommended for male patients have not turned out to be as accurate in appropriately identifying cardiovascular disease in many women.

mahamageehad wrote: »

I would get cramps on occasion that'd knock the breath out of me. Then it's gone and I get on with it. But in general, pain would have to be severe and sustained before I'd worry or do something about it. In that respect I think we downplay pain, but maybe we've got a different scale for comparison?

I think that's a great point. When you go through pain regularly, it must affect our tolerance levels, no?

mahamageehad wrote: »

I mean, no-one likes to make a fuss and I think women are more cautious than men in that respect.

This is exactly it. Any time there's a discussion about gender pay gaps, the point is made that men are statistically more likely to demand a pay rise than women are. The same possibly applies to this and other issues, we tend to make less of a fuss.

emo72

Brought my daughter to A+E with severe abdominal pain. They said she was constipated. She was sent home with laxatives. It was ovarian cysts. In and out of GPs and Hospital until it was diagnosed. Can't believe they would leave a young child in such pain, go home and suck it up was the"treatment".

So, no. I have no faith in treatment for young women, and also there is hardly any gynaecologist who will treat kids of 13 or 14. I'm fuming seeing this thread, brings it all back.

Neyite

My brother in law got better pain relief and for longer with his keyhole appendix removal than I did for my emergency C-section. He got about 2 weeks of Difene. I got 4 days worth. He was horrified that I only got paracetamol when I was discharged.

And when buying that paracetamol over the counter, the male pharmacist would only let me buy a single pack.

El_Duderino 09

mahamageehad wrote:

We've also all heard the whole "a kick in the balls is as bad as labour" line. The idea of comparing a woman's pain to that of a man for the sake of comparison was always a bit silly to me.

The idea that kick in the balls is comparable to childbirth is a crazy comparison for comparison's​ sake. But the sensation if getting hit in the balls is a different kind of pain. It's wrapped up on fear and causes the entire body to tense up. So balls pain is severe as he takes in a pain-fear-tension-pain-fear-tension cycle. Not similar to bits of your flest tearing asunder so not similar to childbirth.

sullivlo wrote:

Even the doctors dismissed it as "women's pains" (think I was mid cycle) until they scanned me!

I often wonder ​how much of it is down to the fact that "women's pains" are both non harmful and not really treatable by a doctor. When a doctor says 'its only woman's pains' i wonder if they mean 'I can't do anything for it and it's not harmful so it's not really that important to me as a doctor'. Not a commentary on the level of pain as such.

sullivlo

El_Duderino 09 wrote: »

I often wonder ​how much of it is down to the fact that "women's pains" are both non harmful and not really treatable by a doctor. When a doctor says 'its only woman's pains' i wonder if they mean 'I can't do anything for it and it's not harmful so it's not really that important to me as a doctor'. Not a commentary on the level of pain as such.

Eh.

The OP links something that was referred to as "womens pains" which turned out to be ovarian torsion. Which is both harmful and treatable.

Endometreosis - harmful in that it can cause infertility; treatable, in a sense, with hormones and surgery.

PCOS - harmful in that it can cause infertility; treatable, in a sense, with hormones and surgery.

Ovarian cysts - harmful in that they can burst and cause internal bleeding; treatable with hormones and surgery.

Fibroids are another thing that can cause extreme pain, bleeding and can also be fatal.

Ill informed opinion, methinks.

Bog standard period pain is something that women have to put up with. I take some paracetamol or ibuprofen and suck it up. As I mentioned previously, I have a stomach issue, and the first few times I went to my GP it was dismissed as ovulation pains. I've had ovulation pains - this was nothing like it. I've also had ovarian cysts - this wasn't similar pain.

But even horrible period pain can be treated, or horrible periods. There are medications to reduce bloodflow in order to make periods lighter. There are better medications out there for dealing with cramps - buscopan to reduce spasming, ponstan to reduce pain.

Lots of ways to "treat" womens pains.

rgace

I would suspect as men visit the doctor less often than women it is taken more seriously when they do.

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Carlos Orange

Neyite wrote: »

And when buying that paracetamol over the counter, the male pharmacist would only let me buy a single pack.

Whatever about anything else you can't blame a pharmacist for the fact it is illegal to sell more than one packet of paracetamol at a time. Their gender is kinda irrelevant.

[actually now I'm not really sure how the law applies to pharmacists, they may be able to supply 2 packets after interview]

Neyite

psinno wrote: »

Whatever about anything else you can't blame a pharmacist for the fact it is illegal to sell more than one packet of paracetamol at a time. Their gender is kinda irrelevant.

[actually now I'm not really sure how the law applies to pharmacists, they may be able to supply 2 packets after interview]

Most places will put them a second box through in a separate transaction once they know you are going to be housebound for 6 weeks and unable to drive to the chemist to get more.

He made it quite clear to me that he had concluded I didn't need more than 24 paracetamol for that 6 weeks.

XxMCRxBabyxX

Neyite wrote: »

My brother in law got better pain relief and for longer with his keyhole appendix removal than I did for my emergency C-section. He got about 2 weeks of Difene. I got 4 days worth. He was horrified that I only got paracetamol when I was discharged.

And when buying that paracetamol over the counter, the male pharmacist would only let me buy a single pack.

My boyfriend got better pain relief after he had his wisdom teeth taken out than I got after brain surgery! I can't remember what it was but it was one of the extra strong ones and they wouldn't sign off on it for me when leaving the hospital while he was given a week's dose!

In my experience I actually think men are more likely to take pain relief. With my problems I regularly carry around pain relief but I rarely take it. You'll only know that I'm in major pain if you do see me take one! With the above situations, my boyfriend took his pain relief like clockwork whereas I would only take them if I really, really needed them.

I agree that I think women's pain may be taken less seriously sometimes because we can control it better and are more likely to downplay it. Though personally I haven't had much experience of any doctor not taking my pain seriously.