Yes, of course, women are different from men. But I’m not referring to obvious, observable gender differences. Nor to sexual identity or gender fluidity. No, I’m talking about how women and men experience disease in very different ways, and the implications for health care.
Let’s start with scleroderma, and systemic sclerosis, in particular. The vast majority of individuals who have this disease are women. Indeed, the vast majority who live with autoimmune diseases of all kinds are women. Why? Recent studies suggest that the male sex hormone, testosterone, helps to protect the body from turning on itself. Women have about one-tenth as much testosterone as men. But that’s still just a strong theory. The fact remains that women account for the preponderance of patients with autoimmune diseases—which often present with ambiguous symptoms that are all too often misdiagnosed or dismissed as being the result of stress, anxiety, or worrying too much.
Women also experience different diseases differently than men. Heart disease is the greatest killer of women, yet the “classic” symptoms of a heart attack—crushing chest pain, radiating pain down the left arm—are atypical for women. More likely, we might feel nauseated, dizzy, upper back or neck pain, light-headed or fatigued, short of breath.
But because protocols for treating heart attacks are based on male symptoms, women experiencing heart failure often go undiagnosed and are sent home. Women also dismiss their own symptoms until it’s too late, or receive treatments that are less successful for women than for men. All of these factors combine to increase the mortality risk for women with cardiovascular disease.
Then there’s the issue of how women experience pain differently from men. We tend to have more intense pain and to verbalize our pain more readily and frequently than men—and be dismissed for complaining too much. With pain as one of the body’s most significant signals that something is awry, the fact that women are not taken as seriously as men has major consequences for appropriate medical care. This is relevant for both diagnosis and treatment of autoimmune disease and heart disease, along with a host of other medical conditions.
How women experience disease differently from men can no longer be ignored, and we need to be educated health care consumers to properly advocate for ourselves. In recent months, I’ve become much more aware of the issue thanks to one of my clients, Terry Hush at Roji Health Intelligence, and a significant series of blogs that she wrote and I edited. You can read the entire collection in this eBook. (And no, I don’t get any kick-back for promoting this work; it’s free, it’s really important, and that’s why I’m sharing the link.)
Here’s to the power of knowing.
Image: Ryoji Iwata