Four years ago, Deborah J. Cohan went to her primary-care doctor with excruciating pain throughout her midsection. “I wasn't able to stand up straight. Eating and going to the bathroom were uncomfortable,” Cohan, who lives in South Carolina, tells Health. She had a hunch it was gynecological, but her doctor dismissed the idea. Declaring it to be back pain, she prescribed Cohan muscle relaxants.
They didn’t work. Neither did over-the-counter pain relief, ice, heat, chiropractic care, or stretching.
A few days later, Cohan’s pain was so bad, she went to the ER. But instead of getting help, she only encountered more pushback.
The doctor on duty confidently announced that Cohan had uterine fibroids. When she pointed out that she didn’t have a uterus anymore—it had been removed in that same hospital the year before—“the doctor was adamant I was mistaken,” she remembers.
Not until Cohan’s ob-gyn came onto the scene was the right diagnosis finally made. Cohan’s ovaries had twisted and fallen from their normal position—a condition called ovarian torsion. It’s considered a medical emergency and, if left untreated, can be fatal.
After immediate surgery to remove both her ovaries, Cohan recuperated quickly. Still, “this experience confirmed what I’ve long believed,” she says. “Women need to embrace, trust, own, and protect their own bodies.”
In other words, doctors won’t always do that for you. In fact, your doctor might even try to gaslight you.
"Gaslighting" happens when one person tries to convince another to second-guess their instincts and doubt their perception that something is real. Medical gaslighting happens when health-care professionals downplay or blow off symptoms you know you're feeling and instead try to convince you they're caused by something else—or even that you're imagining them.
A disconnect—or disrespect?
As the #MeToo movement continues to bring allegations of sexual harassment and sexual assault into the daylight, it’s illuminating another unsettling gender-based offense: how women’s health issues often go ignored, undertreated, or misdiagnosed by doctors.
“It’s a true phenomenon,” G. Thomas Ruiz, MD, lead ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, California, tells Health. “Gender bias is a harsh opinion as to why [it happens], but there’s some pretty good research to support that.”
Granted, some gynecological disorders, like endometriosis, are notoriously tricky to diagnose. But it’s not just women’s health issues that doctors tend to downplay.
For instance, women with heart disease are prescribed less medicine and offered surgery less often than men. Women are also less likely to get treatment for conditions ranging from strokes to knee pain, researchers reported in Critical Care Nurse. Go to the ER with severe stomach pain? You’ll wait 65 minutes to get help vs. the 49 minutes it takes for men to be offered pain relief, according to a study in Academic Emergency Medicine.
“Because of the ubiquity of the message—that pain is a normal part of womanhood or girlhood—we have a systemic, societal problem where we all, doctors included, aren't good at sorting out the normal from the abnormal for women's health,” Erin Jackson, a healthcare attorney and founder of Inspire Santé, a pelvic pain nonprofit organization, tells Health. “Women's veracious complaints of symptoms or illness may be labeled as whiny, and we don't trust women to be the experts in their bodies' experiences and autonomy.”
'Being told that I was fine was terrifying'
Jackson knows this firsthand. For 10 years, she was told by physicians that her “stabbing, burning, and tingling” pelvic pain was nothing to worry about. Despite severe cramps, vulvar swelling, and aches in her lower back, “I was told nothing was wrong or encouraged to seek psychiatric care,” she says. “Being told I was fine was terrifying.”
Desperate for answers, Jackson consulted with a “double digit” number of doctors. Many insisted she was perfectly healthy, assured her that her pain was "just bad periods,” or urged her to better manage her stress.
“I've never felt so scared as when I was in the ER and felt that, because the doctor wasn't listening to me, the doctor couldn't help me—but there was nowhere else to go,” Jackson says.
After finally finding a doctor who didn’t think her pain was all in her head and referred her to a pelvic floor physical therapist, she’s since become pain-free. But through her nonprofit, “I've heard from women whose experiences are so similar to my own that I could've written the story,” says Jackson.
Many, she says, are repeatedly told by their doctors that painful periods and sex are simply “normal.” “If you don’t speak up for yourself or how much pain you’re in, [your issue] may go overlooked,” Yvonne Bohn, MD, ob-gyn at Providence Saint John’s Health Center in Santa Monica, California, tells Health.
A new ad for Orilissa, the first ever FDA-approved drug for endometriosis pain, even plays on that theme. “Any pain?” a doctor asks a female patient who’s come in for a checkup. “Kinda,” the woman shrugs apologetically. It’s not until her inner voice comes to life and shouts at her, “Speak up!” that she finally does.
Get the care you need
Think you’re being gaslighted by your doctor? Here’s what to do.
Find a provider you bond with. “You shouldn’t be looking for someone you want to have drinks with. That isn’t the goal,” Dr. Bohn clarifies. “But you do want someone who is honest and direct” and truly listens to you when you speak.
Prioritize your concerns. “As physicians, we’re under a lot of pressure,” admits Dr. Bohn. “We have too many patients and not enough time.” If you come to an appointment with a list of 15 questions, your doctor may struggle to get to them all. Instead, focus on a few of your most urgent concerns. Many doctors can now weigh in on less important issues by email.
Advocate for yourself. “If you don’t believe the first opinion you get, get a second,” Dr. Ruiz advises. In some cases, you may need to insist on a consult with a women’s health professional.
And don’t necessarily steer clear of male doctors. “I know as many insensitive female ob-gyns as male ob-gyns,” acknowledges Dr. Ruiz. “Find a physician who listens to you and takes your complaints seriously.”
Mind & Body – Health.com