A few years ago I went in to see a doctor about some recurring pain I had been experiencing. When I described my symptoms he smirked at me. It’s because you are old, he said. Taken aback, and also feeling mildly bruised as I was only in my early 30s I responded that I’d had the pain for quite some time and didn’t think my age had anything to do with it. It’s because you haven’t gotten pregnant, he said. Get pregnant and the pain will go away. I explained some of the symptoms I was having and he said that they didn’t make sense and therefore weren’t possible. He began to ask me questions rapid fire about when I had the symptoms. When did they start? For how long? When did I experience them? I became more and more flustered. I didn’t have exact dates. It was hard to remember. Had it been a year? Less? Longer? I ended up leaving that day and once outside promptly burst into tears. The whole experience was horrifying.
From that point I have never once gone in to see a doctor without a notebook; armed with evidence. I track everything. Does it make me appear defensive? Probably. But I got tired of doctors telling me that the experiences I was having weren’t real because they had not encountered the symptoms before, were unable to understand them, or were just too lazy to investigate. In the situation I just described ultimately it was discovered that I had a fibroid the size of a baseball in my uterus. It took a doctor finally taking the time to listen to discover it. I had a simple surgery to remove it, and the pain was gone.
Over the years I’ve heard stories from numerous women who have told me about similar situations where they felt as if they weren’t being listened to by their doctor or that their concerns were being dismissed. It’s the same thing again and again and again. We all have either had the experience ourselves or we know of somebody who has. It happens all too frequently for women and part of the reason why we built Caia is because we think it’s gone on for far too long. Enough is enough.
There seems to be a societal trend that wants to make us all the same. But the reality is that when it comes to our body women are different. We have different reproductive organs. We have different levels of hormones that are produced by our reproductive organs and other organs in the body. Our entire physiology is different. And this matters. It impacts the way we metabolize drugs. It impacts the type of symptoms that we present with. It even impacts they way in which we experience pain.
Take heart disease. Women have different ways of having a heart attack than men. So when they take a traditional test, they may often get a reading that would suggest that everything is "normal". Why? Because these tests were based on men's bodies. While women may present with chest pain similar to men, they are more likely to also showcase symptoms such as:
In fact, it is common that a woman might even present with no chest pain at all, even though the symptoms above will be present. As a result, the female patients will often be told that they just have reflux or anxiety. Because so many doctors are trained to identify and treat symptoms in men, it means that frequently they are less likely to properly diagnose female patients. In fact, a 2019 survey showed that over half of women think gender discrimination by doctors is a serious problem, compared to 36% of men.
So what do you do if you’ve gone into your doctor and you feel as if they’re not listening to your concerns, misdiagnosing you, or brushing aside your pain? We have six suggestions to help.
Be firm. Let the doctor know that something isn’t right and you think that it is important to explore what that is because nobody knows your body better than you.
Encourage curiosity and collaboration. Ask your doctor if they could recommend an additional test that you might be able to take to narrow down what could be going on.
Be direct and ask open-ended questions to get them to share why they think the diagnosis they have made is the right one. Or, why they may or may not be suggesting a course of treatment for you. If you feel that you are not being heard tell them.
Ask your doctor whether they have ever encountered your symptoms previously. If not, see if they might be able to give you a recommendation for a specialist who has.
Ultimately, nothing speaks louder than data. If you can keep a log of any symptoms that you are experiencing: dates, frequency, levels of pain, or any other physical symptoms that occur it will go a long way in helping a doctor to diagnose you and pay attention. Think about this data as a story. This is when it started. Here is what I was doing when it happened. This is how it felt. And here is how often it happens.
If your doctor is recommending a drug for you be sure to check and see whether or not they know if there have been any clinical trials for that drug done on women. It may be that the drug or even the dosage needs to be tweaked. Unfortunately, because it’s only been since 1993 that the FDA mandated women be included in clinical trials there are still many unknowns out there and many drugs have only been tested on the male body. Research increasingly shows that men and women may respond differently even to the same drug - for some drugs a doctor may need to lower the dose for their female patients. Take many insomnia drugs, where the active ingredient Zolpidem is eliminated from the body more slowly in women, so the drug can stay in their systems longer than it does in men. As of 2017, all clinical trials supported by the NIH must now report all results by sex in a database that is publicly available. There is progress being made!
The next time you head in to chat to your doctor bring this list with you and step through our tips one by one. Jot down a few notes before you go. We know how hard it can be to remember in the moment. By having a "cheat sheet" you can ensure that you talk about what you want to talk about.
If all else fails it might be time to get another doctor. You know your body better than anyone else. It can be scary at times to push back when a doctor isn't listening but your body deserves it, and your health depends on it. If you need support, please don't hesitate to reach out to a Caia practitioner.