Have you left an appointment with your doctor with the feeling that he or she hadn’t been listening to you when you complained of pain? If you’re a woman, that feeling may not be all in your head. Unfortunately, studies show that doctors of both genders have a tendency to ignore or minimize women’s pain. This makes the process of diagnosis and effective pain treatment more difficult and time-consuming for women.
In 2001, the Journal of Law, Medicine, & Ethics published an important study on this topic–“The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain,” which laid out several troubling findings, including that doctors were less likely to aggressively treat women’s pain when they made a diagnosis, and women were told more often than men that their pain was “not real,” or that it was “emotional” or “psychogenic.” The study also found that doctors often, and falsely, believe that the experience or capacity for childbirth gives women a “natural capacity to endure pain.” Not true.
Another study, this one published in Academic Emergency Medicine in 2008, found that women who go to emergency rooms complaining of pain wait an average of 16 minutes longer than men to receive pain medication. The study also found that women are 13-25% less likely to be given strong opioid drugs for their pain.
A Common Experience for Women
Complicating the situation further, chronic conditions like fibromyalgia and chronic fatigue syndrome, which are often diagnosed through a process of elimination of easier-to-pin-down diseases, disproportionately affect women and frequently are characterized by pain. Because these conditions remain poorly understood by the medical establishment, the women who have them often find that they aren’t treated as trustworthy sources when they talk about their pain.
If this has happened to you, you are not alone. Articles about doctors’ ignoring or minimizing women’s experiences of pain about—this one in the Atlantic narrates the story of a woman who suffered in the ER for more than 12 hours before a doctor looked at her CT scans and she was rushed to emergency surgery. A New York Times article ends with the writer’s account of her own difficulties in the diagnosis and treatment of a rare lung condition. “I’d been sick since birth, but long diagnostic journeys are occupational hazards of living with conditions doctors don’t often see. Still, my journey was unnecessarily protracted by my doctors’ dismissal of my symptoms as those of a neurotic young woman.” A writer of a Vice article also described her travails:
“I first realized a doctor wasn’t taking my pain seriously when I visited a new primary care doctor because an ovarian cyst had burst. Previous doctors had prescribed me the type of painkiller you might flush down the toilet after the pain had subsided, but my new doctor (who could never have experienced a burst ovarian cyst) gave me a cringey smile when I asked for medication. ‘I don’t really love to prescribe painkillers for this kind of thing,’ he said. ‘Have you ever tried meditation for managing pain?’”
It’s clear that the medical profession needs to take steps to bring the treatment of women on par with that of men. Maybe changes could be made to curricula at medical schools, and/or continuing education for doctors, and certainly conditions that disproportionately affect women, like fibromyalgia and chronic fatigue syndrome, merit further study, so they can be more reliably diagnosed and better understood.
What Can Patients Look For?
But as a female patient, how can you know if your doctor is listening? An “Ask the Expert” feature in Practical Pain Management offers form advice for doctors, which we can turn around for the patient’s perspective.
When you tell your doctor you’re experiencing pain, does he/she ask some or all of the following questions?
Do also pay attention to how your doctor behaves with you. Does he/she make eye contact? Are they taking notes of the things you say, and asking follow-up questions that show you they’re listening? Does your doctor seem rushed or distracted?
If you’re getting a lot of “No’s” here, if your doctor doesn’t appear to be listening to you, and doesn’t ask any of the above questions (or similar ones) about your pain when you bring it up, it may be time to look around for a new doctor, someone who does listen to you. Your health is worth it.