Do Doctors Treat Women’s Pain Less Seriously Than Men? There is recent evidence showing women treated differently for similar symptoms.
The Yentl Syndrome
Sometimes movies can have an impact in ways nobody who wrote or worked on the movie could possibly imagine.
In the 1983 film “Yentl”, Barbara Streisand’s character plays the role of a male in order to receive the education she wants. Dr. Bernadine Healy used the phrase “Yentl Syndrome” in an academic paper eight years after the film was released. She used it to describe how many women died because they were misdiagnosed because their symptoms were different than men.
Today the term Yentl Syndrome is widely used as a description of how women are more likely to be treated less aggressively than men. This is primarily because medical research has focused on the symptoms of male heart attacks, and many women have different symptoms.
The term Yentl Syndrome has also been used in a wider context of how because women experience pain differently than men, many healthcare providers do not take the pain of a woman as seriously as they do a man.
Prove You Are As Sick as a Male Patient
In initial encounters with the health-care system, women are more likely to be treated less aggressively than men until they “prove that they are as sick as male patients”, according to a study entitled “The Girl Who Cried Pain,”. A contributing factor is that most emergency rooms in the United States do not have an attending OB-GYN.
Women were less likely to receive aggressive treatment when diagnosed, and were more likely to have their pain characterized as “emotional” or “psychogenic” and therefore “not real” according to the study.
These misplaced characterizations can lead to treatment for mental health issues that might not even exist in the patient. Then the situation is further complicated because antidepressants are absorbed differently in women and may have different levels of effectiveness.
Women Wait Longer, Get Less Pain Medication
In one study of almost 1,000 people who visited an emergency room, men and women reported similar pain scores. But that was where the similarities ended. Women were 13 to 25 percent less likely than men to receive an opioid pain medicine. Also, women waited an average of 11 minutes longer to receive their pain medication than men.
Another study looked at the medical records of 30 male and 30 female patients who had recently undergone coronary artery bypass graft surgery. The results noted that male patients were given pain medication more frequently than the female patients, while the women were more likely to be given sedatives and not pain medicine. The study reviewed all available literature and it indicated health care professionals hold stereotypical views of women as more emotional and more likely to exaggerate complaints of pain than men.
Women “Tend to Complain And Exaggerate”
Do women complain and exaggerate more? Nobody has studied that question, but it is true that health care providers hold that belief across the board. The University Of Maryland School Of Nursing found many reasons health care providers may be biased in the way they treat men versus women for pain when it studied the issue.
It noted that health care professionals thought that men typically complained less than women, so when they did complain they thought it must be real. Others found that some health care providers believed that women should be able to tolerate pain more since they can handle childbirth. And they found the one bias common across many studies, which is many health care providers thought women were not very accurate when reporting pain.
Drugs Impact Women’s Bodies Differently
Not all drugs impact women and men’s bodies the same and most of the reasons are because there are many biological differences. Women have hormonal cycles, smaller organs and higher body fat composition than men. Each of those differences plays a role in how drugs impact women.
There are also differences in the genes of a male and female that can make differences in the way the sexes metabolize drugs. For example, men metabolize caffeine more quickly, while women metabolize some antibiotics and anxiety medications more quickly. Women are less responsive to anesthesia and ibuprofen as an example. In other cases, women are at more risk for adverse and even lethal side effects.
More Women Suffer Chronic Pain
Not getting the right pain medication can have an overwhelming impact on the lives of women who are not prescribed the correct pain medication. Women face a substantially greater risk of developing pain conditions than men according to a review published in the Journal of Pain in 2009.
Women are also twice as likely to have multiple sclerosis, two to three times more likely to develop rheumatoid arthritis and four times more likely to have chronic fatigue syndrome than men. As a whole, autoimmune diseases, which often include debilitating pain, strike women three times more frequently than men. Hormonal, genetic and even environmental factors might influence some of these diseases.
Women’s Reports of Pain “More Likely To Be Dismissed”
The Institute of Medicine in 2011 published a report on the public health impact of chronic pain, called “Relieving Pain in America.” According to the report, not only did women appear to suffer more from pain, but when women reported pain it was more likely to be dismissed.
Because pain is subjective and self-reported, diagnosis and treatment depend on the assumption that the person reporting symptoms is beyond doubt. When the personal biases of health care providers cloud their assessment of their patients pain, it can lead to serious issues.
Women Get Less Pain Medication
The routine attribution of abdominal pain from conditions like appendicitis or gastrointestinal disease to gynecological problems can also delay or complicate the diagnostic process.
A 2008 study published in the journal Academic Emergency Medicine, designed to gauge gender disparities among emergency room patients complaining of abdominal pain, found that even after adjusting for race, class and triage assessment, women were still 13 to 25 percent less likely than men to receive high-strength “opioid” pain medication. Those who did get opioid pain relievers waited an average of 16 minutes longer to receive them.
Women are more likely to receive diagnoses of many of the types of conditions that are difficult to diagnose and hard to treat like fibromyalgia, which affects about six million patients in the United States. It is nine times more likely to be diagnosed in women than in men.
Women in Pain Report Significant Gender Bias
More than 90 percent of women with chronic pain feel the healthcare system discriminates against them and believe physicians do not treat them the same as men regarding pain, according to a 2014 survey. It was published in Diseases & Conditions, Fibromyalgia.
Steve Passik, PhD, a psychologist and Vice President of Research and Advocacy for Millennium Health said the study was a wake-up call for health care professionals who take care of women in pain.
“When there’s a stigma to be a chronic pain patient and when there’s a stigma for taking controlled substances for pain, the last thing anyone needs is an additional unseen bias to make it worse. And the idea that women have a struggle that’s differentially worse is something that needs to come to light,” he said.
Gender Bias Noted
When asked in a 2014 survey published by Diseases & Conditions, Fibromyalgia if the healthcare system (doctors, pharmacists, insurers, etc.) discriminates against female patients, nearly one out of four women (24%) said “usually or “always.” Sixty-seven percent said “sometimes” and only 9% said there was no discrimination.
Other feelings of gender bias uncovered in the survey included results that noted 65% felt doctors take their pain less seriously because they are female, 84% felt they have been treated differently by doctors because of their sex and 49% felt doctors were less inclined to prescribe an opioid pain medication to them because they were female.
Regarding care by female physicians, 55% feel more comfortable being treated by a female doctor and 49% felt female doctors understood their pain better than male doctors.
Chronic Pain May Be Impacted by Childhood Trauma
Many chronic pain experts believe there is a link between childhood trauma and chronic pain conditions developed later in life. And more women than men typically report having traumatic experiences as children that range from emotional abuse to bullying to sexual abuse.
Being exposed to trauma for females typically can lead to a development of chronic pain, according to Beth Darnall, PhD, a pain psychologist and author of Less Pain, Fewer Pills.
She noted that early life trauma can lead to the body triggering biochemical changes that can turn on different genes. Females who already have a genetic predisposition may be more likely to have those adult issues with chronic pain, she said.
Does Pot Work? (Apparently…)
When the pain becomes intense, women begin to try alternative therapies. In a 2014 survey published by Diseases & Conditions, Fibromyalgia, respondents noted that they had tried many different nontraditional therapies such as acupuncture and hypnosis.
Unfortunately, these alternative treatments were successful in only about a third of the time they were used, with one notable exception.
Medical marijuana had an astounding 80% success rate among those who have tried it.