A fundamental flaw exists in the healthcare system, and it’s having dire consequences for women.
This is the fact that pain in women is more poorly understood, and thus mistreated, compared to pain in men – due to systemic gaps and biases.
It’s known as the gender pain gap. And it is widening – a recent report, commissioned by Nurofen, shows that in 2023 11 per cent more women than men feel their pain has been ignored or dismissed, compared to 7 per cent in 2022.
The report surveyed more than 5,000 people, with a near 50:50 split between men and women. It found that it takes UK women longer than men to receive a medical diagnosis for the same types of pain.
Fewer than half (47 per cent) of women surveyed received a diagnosis within 11 months, compared to two-thirds (66 per cent) of men.
Additionally, more women than men (14 per cent vs 9 per cent) still did not have a diagnosis for their pain after 12 months or longer. And a third of women felt the delay in diagnosis was because they were not listened to, or taken seriously by their healthcare professionals, or worse still completely dismissed.
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Similarly, in a recent survey of over 110,000 women in the Government’s call for evidence (2021) for the Women’s Health Strategy – 50 per cent of women felt their pain was ignored and/or dismissed.
This dismissal was often coupled with being told that certain symptoms should be accepted as inherent to being a woman and therefore did not require treatment. This was particularly prevalent in relation to menstrual health.
Dr Marieke Bigg, sociologist and author of This Won’t Hurt: How Medicine Fails Women says: "Healthcare professionals continually misattributes women’s symptoms to stress or ‘hormones’, while men are more likely to be sent for a physical check – even when complaining of the same type of pain. Over time, this has led to women’s pain being overlooked, resulting in a gender pain gap. Women are waiting longer to get a diagnosis for their pain, and do not feel empowered to push for the support they need. This is unacceptable.”
Why female pain is often dismissed
Often, we hear that women are told their pain ‘is normal for a woman’.
However, the issue here is that ‘normal’ makes the woman feel it is acceptable to have and feel the pain and that there is nothing wrong. Furthermore, she then believes that there is nothing to be done about it, or scope to improve it.
But in fact, instead of normal, healthcare professionals mean one or more of the following – ‘this pain is common’, ‘we expect this to happen’, or ‘we know this does happen and you are not alone’. But this is often not communicated, with ‘normal’ being the default.
This is damaging to the patient’s confidence and empowerment, so advocacy is broken – affecting the remainder of, and any further, consultations.
Women live longer than men, but a greater proportion of their life is spent in ill health, therefore they have a lower healthy life expectancy.
It is likely that the gender pain gap is a factor in this, especially as more women than men suffer from chronic conditions.
The problem with medical research
The gender pain gap is obviously complex and multifactorial, but its existence is not surprising, given that it was only in 1993 that the FDA finally permitted women to participate in clinical trials. Up until that point, medical observation and intervention at a clinical standard was not carried out in females, therefore leading to a massive gap in the knowledge and understanding of healthcare in women.
This includes what is expected versus pathological, and what symptoms are caused by disease – whether gynaecological or not.
This has resulted in a ‘male as default’ in medicine, research and clinical trials, which means less is known about pain conditions that predominantly affect women, or about how conditions affect men and women differently.
And the past and current women’s health research funding is disproportionately low given that approx. 50 per cent of the population is female. Frustratingly, research findings are still rarely disaggregated by sex, thus missing the chance to significantly increase our knowledge and understanding across many fields of science and healthcare in regard to women.
The gender pain gap is not just studies and statistics – it’s blighting women’s lives.
Take Chloe, someone involved in the Gender Pain Gap report, who had periods so painful she would ‘collapse, faint and throw up’. It became daily pain and on seeking medical help, was misdiagnosed as a urinary tract infection or dismissed as ‘seeking attention’.
As is common for many in this situation, Chloe felt alone, dismissed and started to question her own mind. She was finally diagnosed, 7 years on, with Stage 2 endometriosis affecting her womb and pelvis.
Women are still struggling to have their pain taken seriously and properly treated in a healthcare system that continues to underserve and overlook them, exacerbating health inequality – as women accept more pain, and avoid seeking advice for it, or treating it. This has a significant impact – due to pain affecting quality of life, but also the financial, emotional and work-related consequences that go with it.
This is unfair and unnecessary – and it must stop.
About our expert, Dr Marike Bigg
Marike is a science writer and holder of a PhD in sociology from the University of Cambridge. In her book, This Won't Hurt: How Medicine Fails Women, she lays out her argument that, from research to diagnosis to treatment medicine is not gender neutral.
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