I became a sick woman 10 years ago. In October 2010, the cause of the strange pain that had plagued me for many years was finally revealed, and I was diagnosed with systemic lupus erythematosus (SLE), the most common form of lupus, a chronic autoimmune disease. .. 90 percent of the estimated 3.5 million people who have it are women. Like many other autoimmune and chronic diseases that affect women imbalance, such as polysclerosis, Graves’ disease, myasthenia gravis, rheumatoid arthritis, and endometriosis, SLE is incurable. The cause is not fully understood.
For years after being diagnosed, I learned to live with a mysterious and unpredictable illness, so I dug up my medical history to get an answer. Like many Russian nested dolls, unwell women emerged from the medical chronicles. Their medical history often followed a similar pattern: childhood illness, years of pain and mysterious symptoms, and repeated misdiagnosis. These women were part of my history. However, observations of their disability and symptoms in clinical studies have told only a small part of their story. The notes about their case gave clues about their bodies, but did not say anything about the meaning of living within them.
I tried to imagine how it feels like an unwell woman suffering from an illness that resists medical understanding at these various points in history. I felt an intimate kinship. We shared the same essential biology. What has changed over time is that medicine understands it, not the female body.
Since ancient Greece, ghosts of suspicion and discrimination have been plagued by medical treatises on women’s health. The author of Hippocrates Corpus, a basic paper on Western medical practice, talked about “inexperience and ignorance” in women’s body and illness problems. In the 17th century, hysteria emerged as an explanation for the various symptoms and illnesses of women.Derived from ancient Greek hysteriaHysteria, which means uterus, was initially thought to be derived from the reproductive organs, which have been the cause of many women’s illnesses since the Hippocratic era.
In the 19th century, especially when the cause of the disease could not be immediately identified, female hysteria “moved to the center of the stage” and “became a clear theme in numerous medical texts,” said British medical historian Roy. Porter writes in “Hysteria Beyond Freud.” .. As cultural critic Elaine Showalter showed in her influential history, The Female Malady, prominent doctors and psychiatrists at the time were aware of the perception of women who create symptoms of hysteria for attention and empathy. Associated with trends.
Prejudice against women’s body, mind and life casts a long shadow on modern clinical and biomedical knowledge. Graves’ disease, an autoimmune thyroid disease that affects 70-80% of women more than men, was first described in 1835 as “female nervousness” and in 1956 an autoimmune causal relationship. Was still labeled as psychosomatic after the discovery of. Graves’ disease, an autoimmune neuromuscular disease first named in 1877, was misdiagnosed as mentally ill and was rejected as a psychosomatic disorder in the 20th century. Multiple sclerosis has been known to be more common in women since the 1940s, but this prevalence has long been obscured by the assumption that women’s neuropathy and movement disorders are neuropathy or hysteria. Was there.
In 1955, Johns Hopkins’ chronic disease expert found that in the last decade, several women who were finally diagnosed with lupus after a doctor misdiagnosed chronic physical pain were treated with electroshock therapy, insulin. He revealed that he had tolerated unnecessary psychiatric and surgical interventions such as coma and hysterectomy. As a symptomatism of emotional instability. Ulcerative colitis is a chronic bowel disease that affects women’s reproductive and sexual function in ways that are not well understood and has historically been attributed to psychological distress. The recommended treatment for female patients in the 1950s was prefrontal lobotomy.
Widespread awareness of the “gender pain gap” emerged only a generation ago as a result of a groundbreaking study in 2001.
Until near the end of the 20th century, clinical trials and biomedical research relied heavily on male subjects and male laboratory animal models. US law in 1993 required the proper inclusion of women and minority members in projects funded by the National Institutes of Health. This, for example, spurred the first large-scale study of the preventive effects of aspirin on women’s cardiovascular disease. In previous exams, only men were enrolled.
Widespread awareness of the “gender pain gap” emerged only a generation ago as a result of a groundbreaking 2001 study, “Girls Who Cry Pain: Prejudice against Women in the Treatment of Pain.” Utilizing clinical data and social research collected since the 1970s, authors Diane Hoffman and Anita Talzian, scholars of medical ethics and medical law at the University of Maryland, found that women are more sedative than referenced A diagnostic test after self-reporting chronic pain revealed that they were more likely to be prescribed antidepressants. They considered this disparity to be “unreliable because it is more emotionally based” on women’s pain.
More recently, a Swedish team analyzed gender and pain studies published in the United States, United Kingdom, and Europe since 2001, and women’s pain is more often “psychologically” compared to men’s pain. It’s not taken very seriously. “
A 2019 and 2020 report by two related Toronto-based teams analyzed studies on the treatment of heart disease and depression and found that women had fewer referrals and procedures than men. Women also tended to explain poor communication with doctors. The report can change the dynamics by developing specific “patient-centric” regimens in the treatment of women, including clinician training on “active listening” and “questioning”. It was suggested that few practical studies were found on initiating such practices.
One of the bright spots is that the ranks of female doctors are rising. Women self-report better results of diagnosis and treatment when treated by a female doctor. According to a 2018 report by the National Academy of Sciences, female patients are more likely to survive a heart attack if their doctor is a woman. Men still outnumber women among active US physicians, but in 2019 women accounted for 36.6% of the field, up 8 points from 2007.
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Last year, the Covid-19 pandemic demonstrated the importance of integrating gender differences into medical research. Studies have shown that women, especially women over the age of 55, are more likely to be affected by long-term post-viral symptoms such as shortness of breath, malaise, and brain fog. Women also appear to suffer more side effects after vaccination, including life-threatening ones, but the extent and severity of possible risks are not yet understood.
Today, researchers have recognized that the exact reason for gender differences in the incidence of my disease, SLE, was prevalent in women over a century ago, but it remains largely a mystery. Further research is urgently needed to understand how and why complex chronic and immune illnesses and conditions affect far more women, but women also experience their own experiences of pain and illness. Must be more appreciated as an accurate reporter. Many of the answers are in the female body, which has been written by the female body for centuries.
— This essay is based on Craighorn’s new book, “Women in Sickness: Misdiagnosis and Myths in the Artificial World” (Dutton).
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Medical failure with painful women
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