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Gender-Bias in treatment of pain

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  • Gender-Bias in treatment of pain

    Turns out we women don't get a fair deal most of the time when it comes to having our pain treated. I think some lawsuits would change that, but where to start?

    FOR IMMEDIATE RELEASE Contact: Carlota Gutierrez

    February 6, 2004 (916) 445-6671

    [email protected]

    Legislature Examines Gender Bias in Pain Management

    Women’s pain often discredited

    (Sacramento, CA) During a legislative hearing, chaired by Senator Liz Figueroa (D-Fremont), examining how chronic and debilitating pain afflicts men and women differently, legislators were shocked to learn the severity of gender bias on the part of practitioners surrounding the treatment of pain.

    In collaboration with the Senate Health and Human Services Committee and as chair of the Legislative Women’s Caucus, Figueroa led the informational hearing with the goal of educating the public on the significant inequities towards the diagnosing and treatment of pain suffered by women as compared to men.

    “Across the board, chronic pain in this country is largely under-treated, but women pain patients face an additional barrier to proper treatment and diagnosis,” said Figueroa. “Pain has long been considered a troublesome female complaint rather than a legitimate symptom that something is physically wrong. Social and cultural barriers continue to discredit a woman’s pain as emotional, psychogenic and therefore not real, and in response physicians are more likely to prescribe women sedatives to ‘calm their nerves’ rather than actually treat the pain.”

    The research and medical world has long been a male dominated environment, which has fostered a well-entrenched, little recognized inequity in the world of pain management. While studies show biological and psychological differences in how males and females perceive and respond to pain, these differences hardly account for the discrepancies in physician ordered treatment of pain.

    Leading advocate for pain patients Cynthia Toussaint, who suffers with the Reflex Sympathetic Dystrophy, has seen a growing awareness towards women in pain, however, a gulf of inequities still exist. During the years prior to her diagnosis, physicians told Cynthia she was “suffering stage fright” and one doctor even suggested suicide. “All of this abuse was framed by a constant reminder that I was only a woman anyway—it didn’t matter.“ testified Toussaint. “This is a healthcare crisis, and sanctioned torture, that has been ignored for far too long…we must educate our health practitioners and medical students to simply believe a woman when she reports she is in pain.”

    Renowned professor Diane Hoffmann, Associate Dean at the University of Maryland School of Law, acknowledges there is no solid objective measure for pain and patients’ descriptions are subjective. Yet her 2001 study, published in the Journal of Law, Medicine and Ethics, and titled ‘The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain’ found that women’s pain is taken less seriously and women receive less treatment than men do.

    In addition, women are often viewed as less accurate reporters of their pain. This perception has been debunked by a National Academy of Sciences study showing a patient’s subjective description of their pain is an accurate indication of the degree of pain they are experiencing.

    Dr. Scott Fishman, Chief of the Division of Pain Management at the U.C. Davis Medical Center, attributes the gender discrepancy to a larger problem; the unwillingness of physicians to prescribe needed pain medication due to fears of patient addiction. “When someone has cancer it is worth the risk of prescribing radiation and chemotherapy, essentially poison,” testified Fishman. “But, when someone is in pain it is somehow not worth the risk of prescribing needed pain medication.”

    Some in the medical community attribute the problem to biases on the part of the health insurance industry. “Insurance companies are more willing to pay for expensive and often unnecessary procedures rather than pay for a physician to spend the necessary amount of time with the patient to properly diagnose the problem,” testified Dr. Steven Richeimer, Director of the USC Pain Management Department. “When the patient is a woman, it’s that much easier for the insurance company to deny proper treatment.”

    Chronic pain refers to a host of debilitating conditions that afflict nearly 50 million Americans and 45% of all Americans seek care for persistent pain at some point in their lives. These illnesses include common medical problems such as arthritis and migraine headaches as well as other conditions such as Reflex Sympathetic Dystrophy, Interstitial Cystitis, Ehlers Danlos Syndrome and Lupus that go largely under-diagnosed.

    “It is absolutely necessary that we continue to examine this issue and find solutions. Pain is a human condition and generally treatable. Women, and men, are suffering needlessly and that is intolerable,“ concluded Figueroa.


  • #2
    I've noticed this throughout my journey with chronic pain disorders.

    Remember that story I told about how, when my husband was hospitalized with what turned out to be a minor heart problem, he commented to a nurse that he "kinda had a little headache"? As soon as he said that, someone was in the room giving him IV MORPHINE. For a HEADACHE. We were both like, "Sh*t, what happened to TYELENOL????"

    But we were really angry for another reason -- my husband had literally carried me, crying and screaming in pain, to the ER at that same hospital at an earlier date when I was forced into withdrawal by a doctor who did not believe in pain control. I was in withdrawal, but I was also in horrible pain from my IC and fibro. Of course, when I was literally crying in pain, they left me like that for hours and only then decided to give me a prescription to fill on the way home... no acute pain treatment at all in the ER.

    So I cry in pain and don't get treated; my husband makes an offhand comment about a small headache and got enough morphine to knock him out for 12 hours.

    The gender bias also comes out sometimes at appointments -- if I go alone but want to talk about something, even my FEMALE pain doc doesn't really take it that seriously. However, if I bring my husband and he raises the same issue about it, something is done immediately.

    It sickens and saddens me that in this day and age, when women are lawyers, doctors, scientists, senators, and the like, that they are still not taken seriously and are still called hysterical or told it's in their head....

    *Diagnosed with severe IC in 2004
    *Also diagnosed with PFD, fibromyalgia, chronic myofascial pain, IBS, migraines, allergies/asthma, dermatographism
    *Kept trying a million different treatments for all these things until I found what works, and I am doing okay these days with the help of a cocktail of medications and the InterStim, which was first placed in 2007. [I have had 2 revisions - one in 2010 when my battery died and had to be replaced, and one complete replacement (lead and generator) in 2012 after a fall on my stairs caused my lead to move.]
    *Current meds include Atarax (50mg at night), Lyrica (150mg twice a day), Xanax (0.5mg at night and as needed), Zanaflex (4mg at night), hydrocodone (10/325, every 6 hours as needed), Advair, Nasonex, Singulair (10mg at night), oral contraceptives, home instills containing Elmiron and Marcaine (as often as I need to do them).

    **I am not a medical authority nor do I offer definitive medical advice. I strongly encourage you to discuss your medical treatment with your personal medical care provider. Only they can, and should, give medical recommendations to you.


    • #3
      I know someone(friends husband) who has a lifetime supply of vicodin for TMJ!!!! Funny because so many IC patients have to beg for pain medicine and usually get little to nothing for their pain! Crazy and unfair!


      • #4
        I begged three different doctors for a hydro for fifteen months, funny because the day I brought my fiance, business suit and all, to my appointment, I was scheduled for the hydro the following week. I guess I never really thought about it, but my ex-husband got my gall bladder removed late on a Friday afternoon one Memorial day weekend. All the doctor wanted to do was give me was demerol, even though he knew I was breastfeeding. My ex came home to find me and my 8 month old daughter high as kites, and the next day I was having the surgery.
        I was born with one ureta not attached to it's kidney, I've been poked and prodded for so long. I never had "private" parts. I had constant infections and took low dose preventive antibiotics into my teens.

        DX with IC July 1993 after seeing 3 different Uro's and finally switching Primary care doctors and affiliated hospitals.

        I have 2 beautiful daughters, the oldest has been in heaven since she was 14 when she was hit by a car The youngest is 20 now. She has had one UTI. She went into complete panic that she would end up like me. Now she has some idea of what the pain is like. Poor kid has been forced to know where every bathroom in Disney World is.


        • #5
          This is HAPPENING TO ME NOW!!!!! My doctor just wants me doped up on sedatives and is pulling me OFF the pain meds that gave me my life back!!!!!


          I'm printing this up. Total BS.

          Hugs and Wishes for Pain FREE days!!,

 ~reducing plastic waste one bag at a time~

          Facebook: Kara Kaiser
          Twitter: Love4Earth

          Me and my Guccigirl... she helps me through those painful hours!


          • #6
            I know I too have already posted about this, but both my husband and I have noted the unbelievable discrepancy in the way I get treated by physicians, depending on whether he is with me or not. I HATE that I have to resort to these little games, but there have been times when my husband isn't available, I have had to ask my father to come with me, or one time my brother-in-law.

            I remember appointments when the dr. talked to my husband instead of me, as if I weren't even there, when I am the patient. I've really had to hold myself back; more than once I wanted to stand up and say, "Should I leave the room so you two can talk, penis to penis?" My husband is as angry about the situation as I am. Between us we have two brothers and a sister who are medical doctors, and we've asked them if there's a gender bias in medicine. Guess which two said no?

            What got me about that press release, is the California legilature acting like this is a shocking new discovery... grr.

            Well, I am lucky to be settled with a woman doctor who understands and trusts me, but I cringe whenever I read about someone else on the board who is still going through this problem, not getting appropriate treatment for pain. I understand; it took me nine years to get my IC diagnosis, and during that time I was called a liar, hysterical, a drug seeker, attention seeker, and "probably mentally ill," -- all of these are exact terms used by physicians that I saw during my journey to diagnosis.

            Oh, I could go on and on about this, but it's unproductive. We all get it, here. We need to get the point across in the medical community.
            Je vous souhaite de la joie, de la bonne santée, et tout ce qu'il y a de bon dans la vie.
            Wishing you happiness and good health, and all the best out of life.

            Peace, Carolyn

            Laura (11), Susannah (12 1/2) and Maman (that's me!), North Wildwood NJ, September 2007

            On the Beach with IC


            • #7
              So true...

              COming home from vacation on Monday I was talking to my husband, my sister and her boyfriend about this very things. Her boyfriend has chronic renal disease and has only one working kidney (donated from his Mom) He and I can very much relate on many aspects, especially with all the potty breaks we need! Anyways, after a few days of seeing how real and constant my pain is, he was amazed that I have had such a hard time getting the painrelief I have know (which is not doing much anymore...) He has had many instances where he was in the hospital and complained of some pain and was given morphine right away!
              IC; PFD; possible Fibromyalgia; IBS;

              Symptoms: Frequency, Urgency, pelvic and bladder pain, bladder and pelvic spasms, difficulty starting urination, weak stream, incontinence, vaginal and urethral pain

              I've Tried:
              three Hydrodistentions, various Rescue Installments; 6 DSMO treatments; Pyridium Plus; Proced; Detrol (patch); Elavil; Uricet K; Elmiron; Nortiptyline; Ultram; Allegra; Ditropan; Ditropan ER; Vesicare; regular Lidocain; Neurontin; Lyrica; and few more I can't remember!
              Currently using:
              Valium; Vicadin; Proced DS; Claritin; Buffered Lidocain; Cymbalta; Baclofen; Prazosin @ night (also on Prednisone and Adderall for my joint pain and severe fatigue)
              Heating pads; frozen water bottles; A&D ointment; Poise pads; IC dieter since 8/06; yoga; imagery & relaxation CD, Mindfullness, self healing CD's; hot baths; seat cushion; prayer
              I am 28 yrs old, dx'ed in '06, still trying to get my health undercontrol!!