When They Don’t Have Time for Your Pain

Doctors are supposed to treat all patients equally, but sadly, sometimes they don’t. In fact, if you are a woman, you may actually receive worse treatment for your pain than if you are a man. If being in pain isn’t hard enough— add a doctor who won’t listen, and you can end up depressed, frustrated, and distrustful of the entire medical profession. 

What kind of inconsistencies are happening exactly? Let’s take a closer look. 

  • In a study of almost 1000 patients published in the Academic Emergency Medicine journal, it took women with abdominal pain in an urban emergency department 16 minutes longer than men to be treated. Women were also not as likely to be prescribed opiates. The study concluded that “gender bias is a possible explanation for oligoanalgesia in women who present to the ED with acute abdominal pain.” (Oligoanalegesia is just a fancy term for when pain is undertreated.) 
  • A 2022 article in The Washington Post looked at studies that explored the inferior medical treatment received by women experiencing pain compared to men. This included enduring a longer wait time to be seen for a potential heart attack, or being told they have a mental illness when they had heart disease symptoms. “Among middle-aged women,” that study said, “31.3% received a mental health condition as the most certain diagnosis, compared with 15.6% of their male counterparts.” 

And then there are personal accounts of women struggling for years to receive a proper diagnosis.

Broad City actress Ilana Glazer spoke of her battle to be taken seriously by doctors for pelvic pain. She went undiagnosed for two decades! “I remember being 15 years old and my mom and I sitting there and this doctor telling me that my problem was too problematic for him, and just feeling laughed at and so angry,” she said.  

Essayist Carli Cutchin had to wait 11 years to be told she had a compressed pelvic nerve. The reason? Medical professionals simply didn’t believe that her pain existed.  

Cartoonist Aubrey Hirsch created a comic about being told her ear pain was not significant enough to be problematic. However, when the male doctor looked closer, he discovered it was a ruptured eardrum with an infection. “Why didn’t you say you were in this much pain?” the doctor asked her at the end of the session, even though she had!

A few years ago, when Hillary Koplinka was feeling tired and achy, she was told to participate in yoga by her male doctor for what turned out to be Hashimoto’s disease! 

Maybe you’ve heard stories like these from your female friends and family?

So what can you do? Although the onus shouldn’t be on the patient to get her doctor to listen, there are steps you can take to advocate for yourself.

Zocdoc suggests being thorough in keeping notes about “when, where and how” your pain occurs so you can describe it. Having another person validate your story is also important, be they a friend or relative. It can also help to parrot back the information the doctor shares during the visit. 

Finally, don’t stop until you find a doctor with whom you are comfortable. 

 And if you are having pelvic floor dysfunction pain and live in New York or nearby, consider Revitalize Physical Therapy. You will receive top notch medical care from providers who know what you are going through! We will never dismiss your pain because we recognize that having the right team who takes you and your pain seriously can make all the difference.

Could a Simple Swab Test Predict Pelvic Organ Prolapse?

 

Pelvic organ prolapse is one of many pelvic floor disorders we are able to treat here at Revitalize Physical Therapy. Never heard of it? I’m not surprised! It doesn’t get the coverage it should. Data on how many women are dealing with it also appears to vary. It affects approximately 3% of women in America, according to WebMD; however, the University of Chicago Medical Center says that as many as a third of women can have it by age 80. No small amount!

 

Pelvic organ prolapse is the medical term for what happens when organs, such as the bladder, small intestine, rectum, vagina or uterus, fall either into or out of the vaginal canal or the anus. This can happen due to issues, including pregnancy, delivery, pelvic organ cancers, and constipation. Any woman at any age can be affected potentially, but it’s most prevalent in midlife and among younger senior citizens.

 

Pelvic organ prolapse goes by different names, so you may hear your medical provider use a word like rectocele for a prolapse of the rectum, or cyctocele, when the bladder moves into the vagina. (Cyctocele is in fact the most common form of pelvic organ prolapse.) Pelvic organ prolapse can result in urinary frequency, incomplete emptying of the rectum, or painful sex, to name a few.  

 

So now that you’ve heard about pelvic organ prolapse, your next question might be: How can I avoid it? Fair enough! Some risk factors can be averted and others can’t. You can’t help things like, say, a history of this in your family or having had a baby, but you can make sure you are eating sufficient fiber (25-30 grams/day), and drinking enough water (8 cups/day) to try to avoid constipation. Furthermore, both urination and defecation should be completely passive processes. No straining is required, and if you must strain or push excessively to pass bowel movements, speak to your friendly neighborhood pelvic floor PT! Finally, don’t start smoking or give it up if you are already in the habit (which is a good idea anyway).

 

If you suspect that you have pelvic organ prolapse, the issue may be diagnosed by an ultrasound of your pelvis or other tests involving the bladder or urination. Physical therapy, a pessary and, when all else fails, surgery are used to treat pelvic organ prolapse. (It is worth noting, though, that surgery has a high chance of not working.)

 

Happily, science may be coming along to help further: Researchers at UT Southwestern Medical Center have found a potentially noninvasive way to screen for pelvic organ prolapse. They have discovered a vaginal swab test that may identify women who are prone to developing pelvic organ prolapse. The study appears in a medical journal called Aging Medicine. This test found that certain proteins were higher in the vaginal secretions of postmenopausal women who were diagnosed with pelvic organ prolapse. 

 

If we know which women are likely to have pelvic organ prolapse, a doctor or pelvic floor therapist can initiate a preventative plan rather than one that treats them when they already are showing symptoms. When it comes to prophylactic treatment, I like to say that an ounce of prevention is worth more than a pound of cure!

 

The article doesn’t specify when the swab test will be available, but I hope it will come and soon. And you can rest assured that as soon as I have any more updates, I will keep you posted, dear readers. In closing, the sooner we know what’s going on with our pelvic floor health, the better. 

 

RESOURCES/FURTHER READING:

 

https://www.utsouthwestern.edu/newsroom/articles/year-2023/july-pelvic-floor-disorders.html

 

https://www.totalurologycare.com/services/pelvic-organ-prolapse?gclid=Cj0KCQjwtamlBhD3ARIsAARoaEypktyKARrFGB9toCH_X7KJD2u1nmb3wLQZTDxeCXhzkr6Ji2WUY8kaAptfEALw_wcB

 

https://nyulangone.org/conditions/pelvic-organ-prolapse/diagnosis?cid=sem_google&googadcamp=Virtual_Urgent_Care_Performance_Max&googadgroup=Performance_Max&googkeyword=&googmatchtype=&insitesid=1367&gad=1&gclid=Cj0KCQjwtamlBhD3ARIsAARoaEw2MHvExjQ5YaXD_OT05Fv35GhbOr1sSjuD3EFS1uVz4aS8OVrC6qUaAg3KEALw_wcB

 

https://www.webmd.com/women/pelvic-organ-prolapse

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166938/

 

https://www.uchicagomedicine.org/conditions-services/obgyn/urogynecology/pelvic-organ-prolapse