Unraveling Misdiagnosis and Underdiagnosis in Women’s Healthcare

Unraveling Misdiagnosis and Underdiagnosis in Women’s Healthcare

Katherine Monico


The United States healthcare system has failed half of its population. Women’s healthcare has been neglected since the standardization of medicine due to gender bias in medical research and healthcare providers. This paper will encompass the background of this problem, contributing factors to why women are continuously mis-and underdiagnosed, the consequences of these diagnoses, and solutions for the healthcare system. The woeful neglect of women’s healthcare is a multifaceted issue that is rooted in historical, societal, and systemic factors. Despite progress, disparities continue to persist in the diagnosis, treatment, and research of health conditions affecting women.


Understanding the Problem

The exploration of the standardization of medicine reveals why women are treated so poorly in their healthcare. In 1965, fewer than 10% of medical students were women[1]. Women were the minority in a male-dominated profession. So, the women who chose to work in the field during this time faced internal and institutional challenges. As men have been spearheading the medical industry for decades, medical standards have mainly been modeled after white men. History has proven that doctors envisioned female bodies as smaller versions of the male body[2]. This led to a huge lack of gender-specific research. Additionally, it wasn’t until 1993 that the National Institute of Health mandated the inclusion of women in clinical trials[3]. 

Medical gaslighting is a term that describes when healthcare professionals invalidate or ignore the concerns of their patients. One study that was conducted in 2018 worked to review literature on the gendered norms about men and women with pain and gender bias in the treatment of pain. It was revealed through 77 different articles from high-income countries that many people reflect ideologies that women are used to internal pain and pain with no external causes was “a natural characteristic of women’s bodies”[4]. Women are often perceived as being too emotional or fabricating their pain. 

Furthermore, women are not treated as autonomous beings in healthcare. A synthesis of literature showcased that there are still 18 states in which healthcare providers can require a husband’s permission before their wives can receive a tubal ligation[5]. Most autonomy issues are seen concerning reproductive health. In childbirth, the fetal-focused framework often prioritizes the child above the woman giving birth as reducing fetal harm is the sole focus of giving birth. This pressures women to make certain decisions regarding their birthing plan or their choice in the matter of complications. However, those arrangements are often not expressed because healthcare professionals write off the woman as hysterical due to the immense pain of childbirth. 


Contributing Factors

Through research, the contributing factors to the prevalence of the misdiagnosis and underdiagnosis of women can be identified. The first is the reference to “atypical” symptoms. The symptoms that women experience from various diseases such as heart disease and autoimmune diseases[6] often differ from the symptoms of the standard, hence white men. These symptoms are then classified as “atypical” and thus not properly identified and treated.

Since the medical industry has been primarily a male-dominated field and based on historical context, there has been much stigmatization around the discussion of reproductive issues. In many cultures, menstruating women were deemed as ‘unclean’, thus the societal taboo of sexual and reproductive health creates a sense of discomfort and shame[7]. This societal construct led to a lack of education in schools and an overall lack of understanding of these health issues. Therefore, when women present with gender-specific problems, there is not much research or knowledge to lead healthcare professionals to an accurate diagnosis and treatment. 

Identity poses an additional factor to this problem. Race, ethnicity, socioeconomic status, and age are all examples. Samantha Muka is an assistant professor of science, technology, and society in the Humanities Department at Stevens Institute of Technology. She taught two classes, History of Medicine, and Technology and Medicine, in which she dove into the historical context of the standardization of medicine. In an interview, she touched on these contributing factors to the misdiagnosis and underdiagnosis in women’s healthcare. “And then there’s age, which is something I’ve talked about a little bit. But an older woman and a very young woman are much less likely to be believed about their pain, for the same reason that you’re talking about, which is young women don’t know what they are talking about because they are just stupid and young and old women are whiny and weak”[8]. Muka detailed how age contributes to the treatment of women in healthcare by providing insight into how healthcare professionals view women. Muka additionally mentions that women of Latina or African-American descent are often treated worse than Caucasian women just due to their minority status. Women are often referred to as “emotional medical mysteries” which only inhibits additional research. The makeup of a woman’s identity continues to hurt them in the healthcare field. 


Consequences of Misdiagnosis and Underdiagnosis

Consequences of misdiagnosis and underdiagnosis relate to physical and mental health,  quality of life, and economic burden. As women are consistently characterized as hysterical and dramatic with their pain, there is true suffering that is being felt. One of the most common examples of this can be seen with birth control. IUD insertions are incredibly painful. Women often pass out or become sick because of the pain. However, physicians will refuse to give any sort of numbing agent or anesthesia with it. On the other hand, if men want to seek out birth control by undergoing a vasectomy, they are often given painkillers without even requesting them. Additionally, women often feel the consequences of the healthcare system on their mental health as well. It is a consistent and draining battle to fight for the basic right to have proper healthcare treatment. This calls into question the quality of life that women have between both physical and mental health concerns.  

Furthermore, there is an economic burden for most women who need to seek out multiple forms of treatment to receive a proper diagnosis even if they are not classified as a lower class status. Not even women in the highest class status can escape the biases of the healthcare system. For example, Serena Williams, the number one ranked professional female tennis player, almost died after childbirth because her physicians chose to overlook her healthcare concerns. After giving birth to her daughter through a c-section, she was experiencing trouble breathing and immediately knew that she was having another pulmonary embolism as she had experienced those in the past. Williams immediately requested a CT scan and a blood thinner, but her nurse claimed her medication was confusing her. A following ultrasound revealed nothing until a CT was finally ordered where blood clots in her lungs were revealed. She was treated with a heparin drip after that[9]. According to the CDC, there are around 1,000 women in the United States who die each year due to pregnancy complications[10]. Poverty, access to care, culture, communication, and decision-making all contribute to these disparities.  


Solutions and Strategies

One potential strategy to resolve the issue of misdiagnosis and underdiagnosis in women’s healthcare is to improve data collection and research[11]. This may include increasing funding for research focused on women’s health and ensuring that medical clinical trials include adequate representation of women. This would work to provide a better understanding of how diseases manifest and how treatments affect women. Another strategy would be to promote gender-sensitive healthcare. This could include implementing training programs for healthcare providers to recognize and address unconscious biases in diagnosis and treatment. Lastly, empowering women in healthcare decision-making. By educating women about the importance of preventive care, screening tests, and treatment choices, there will be a better overall understanding of women’s rights and options in healthcare. 



Resources

  1. Walling, Anne et al. “The Only Woman in the Room: Oral Histories of Senior Women Physicians in a Midwestern City.” Women's health reports (New Rochelle, N.Y.) vol. 1,1 279-286. 24 Aug. 2020, doi:10.1089/whr.2020.0041

  2. Ocrcadmin. “Understanding the Importance of Women’s Health Research.” Orlando Clinical Research Center, 19 Jan. 2022. 

  3. NIDA. "The Importance of Including Women in Research ." National Institute on Drug Abuse, 13 Apr. 2021,Accessed 27 Apr. 2024.

  4. Samulowitz, Anke et al. “"Brave Men" and "Emotional Women": A Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain.” Pain research & management vol. 2018 6358624. 25 Feb. 2018, doi:10.1155/2018/6358624

  5. Osamor, Pauline E, and Christine Grady. “Women's autonomy in health care decision-making in developing countries: a synthesis of the literature.” International journal of women's health vol. 8 191-202. 7 Jun. 2016, doi:10.2147/IJWH.S105483

  6. Rabbitt, Meghan. “These Are the Most Commonly Misdiagnosed Conditions in Women.” Inside the Epidemic of Misdiagnosed Women, 9 Apr. 2020. 

  7. Glicksman, Eve. “Stigma’s Toll on Sexual and Reproductive Health.” Hopkins Bloomberg Public Health Magazine, 17 Oct. 2022. 

  8. Muka, Samantha. Personal Interview. 11 April 2024. 

  9. Howell, Elizabeth. “‘For Serena Williams, Childbirth Was a Harrowing Ordeal. She’s Not Alone’ - Maya Salam.” Mount Sinai Health System, 11 Jan. 2018. 

  10. Hoyert DL. Maternal mortality rates in the United States, 2021. NCHS Health E-Stats. 2023.DOI: https://dx.doi.org/10.15620/cdc:124678

  11. https://grc.studentorg.berkeley.edu/how-healthcare-fails-half-the-population-an-investigation-of-gaps-in-womens-healthcare/#:~:text=Women%27s%20health%20has%20been%20neglected,widespread%20gender%2Dspecific%20treatment%20knowledge

Comments

Post a Comment

Popular posts from this blog

Molecules, Models, and Magic: The Exciting World of Computational Chemistry

Vrinda Modi I often spend time in a little cubicle in McLean in the freezing corporate cold wrapped in a blanket in the Hoboken summers sipping on free coffee from the office above. It almost always tastes like chalk, but the routine is so embedded in me. Hence, this is the perfect opportunity to talk a little more about my research in computational chemistry here at Stevens and the advances I expect in the next few years. This field excites me because it bridges my interest in chemistry with modern computing techniques, a powerful tool for advancing our understanding of chemical reactions and molecular interactions. This means we are a dry lab – running simulations on computers. No chemicals, no PPE, just models and algorithms. But why does computational chemistry exist in the first place, especially when chemistry is so rooted in physical matter? The answer is efficiency. Modeling molecules on a computer saves us from ordering chemicals, waiting for deliveries (a delay in chemistry t...
Read more

Scaling the Potential of Vertical Farming Going into 2025 and Beyond

Image
  Matthew P Kearney Scaling the Potential of Vertical Farming Going into 2025 and Beyond      Vertical farming may seem like something out of a futuristic movie, but they are very real in today’s agricultural industry. Vertical farming may promote a stronger relationship between urbanization and sustainable crop production. Based on recent innovations across agriculture and technology, vertical farming has the potential to revolutionize our current farming system. Through the development of vertical farming-based production lines, cities and otherwise unfarmable areas can be provided with fresh, local, and pesticide-free produce. Vertical farming and other adaptations of agriculture are not new ideas, but instead a historic and human process.      These technologies are ready to meaningfully address global food security through the technological and computational advancements in agriculture. Vertical farming has a promising future, which becomes a case...
Read more

Knot Your Average Problem: How do Tongue Ties Impact Oral Myofunctional Health?

Image
  Hadia Hussain      Knot Your Average Problem: How do Tongue Ties Impact Oral Myofunctional Health? Sitting in the nursery of the dental office where I worked, I reviewed Baby V’s medical history and reports from the Emergency Department at Jersey City Medical Center. I found it odd that, despite multiple visits and clear signs of malnutrition, no physician had been able to diagnose the cause. Baby V, at a low weight of 12 pounds was struggling with difficulty nursing and bottle feeding, excessive gassiness, colic, clicking sounds when feeding, milk dribbling out of the mouth, and mouth breathing—but doctors had dismissed these signs, labeling him as "healthy."  It didn’t make sense as his low weight raised serious concerns.  According to Pediatric specialists Jenny Olson, DNP, and Sarha DeVrieze, ARNP, at the UnityPoint Clinic, a 9-month-old baby boy should weigh anywhere in between the range of 17 to 25 pounds. Baby V's situation was clearly a ...
Read more