Women’s health is so undervalued. Im so sorry you went through this for so long, and I’m hoping you have found relief after diagnosis and treatment. If men ever suffered from endometriosis, a cure would have been found decades ago without any hesitation about coverage from insurance.
I disagree. It’s not because of gender bias. As Abigail points, 85% of gynaecologists are female. Women have more reproductive issues and illnesses than men. This makes diagnosis more difficult.
Also consider that the art of medicine, being able to listen to a patient, take the time to ask the right questions to elicit a proper history, then perform an adequate, directed physical examination, and put all that data together to formulate a differential diagnosis, has all but disappeared from medical education. Nowadays if a disease does not reveal itself via blood tests, CT or MRI scan, the diagnosis may well be missed.
I don't really blame the practitioners overall, but rather the system. That said, bias against women does exist. I've had women doctors apologize for not being able to figure out what was going with me, but they don't blame me for it.
My experience with male doctors is totally different in that they blame the patient rather than admit ignorance.
Male doc #1: Said my abdominal pain was depression.
Male doc #2: Said my bladder pain was caused by "fear of pregnancy."
Male doc #3: Said I wouldn't be able tell the difference between between gynecologic pain and bladder pain.
Male doc #4: I had a two week long severe sore throat and illness two years ago.
I suspected I had mono. Doc prescribed antibiotics and refused to test for mono after I requested it. Went to another male PA, he tried to insist I had strep despite negative swabs, but agreed to test for mono after I begged for it. Turns out I was right and had mono and got a proper prescription to help.
I’ve had only male doctor I can remember who listened to me and was a true partner in my health care. In my experience, most other male doctors I’ve seen have been dismissive and downright condescending. So yeah, I too now see exclusively female doctors.
Even female doctors have sometimes had their souls sucked out by medical school. Thinking in particular of the female doctor who didn't refer me to a rheumatologist for my symptoms (ended up being fibromyalgia) until AFTER I had cussed at her nurse on the phone for offering me pain pills (at the doctor's direction) instead of some path to diagnosis.
I have found that Nurse Practitioners are usually far better than the doctors they practice under. Most of them are female, which helps.
The NPs I work with are great & always ask us docs for help w/ anything complicated (outside of pt's earshot).
BUT: There is the right time/place for NPs. NPs have far less knowledge/experience (500 hrs clinical training vs >20,000). This often leads to patient deaths.
If you have a straightforward medical problem, then by all means, NP is fine. However, if you have an emergency, in the ER, request a physician in the ED. If you have something somewhat complicated, see a physician.
If you have something very complicated, do not see a private practice doc or NP. You need to go to an Academic Medical Center with a teaching program (residency or fellowship). They will spend a lot of time with you, they are not financially incentivized at all & they will get to the bottom of what is going on. They will figure it out & they will help you.
I'm a female physician and I work in a practice with both male & female doctors. Our styles are totally different. I would say that most women doctors are better listeners & spend more time listening to the patient. Studies back this up. We are more likely to admit if we are wrong & not ashamed to admit we don't know everything. I'm not bashing male doctors at all and they are excellent, skilled, knowledgable and great doctors. The style is just different.
I should also mention that the male doctors I work with are kind, not at all sexist, and do their best to be understanding of women's needs. They offered me great support during my pregnancies, maternity leaves, breastfeeding and pumping, etc.
You’re being kind saying it’s style differences. One can be taught to listen and ask questions better in order to do their job. And can learn not to blame a patient. Thank you for lending to the convo, truly. May you’re great style rub off on your peers!
Women doctors are better listeners and are more concerned with fixing the patient than treating them. I am a senior man so it’s not coming from any bias against men.
I had an ob/gyn tell me during a high risk pregnancy that he “couldn’t treat a problem that exists only in my head”. The very next day, I went to the ER and was admitted for 7 days of IV antibiotics. He never apologized.
Almost all of my current doctors are female. Younger male doctors (Gen X e.g.) are much less arrogant, in my opinion, than the older ones were.
Let's take this as being true. Let's say it's an awful experience. Let's say it happens with some regularity.
But let's also take into account all the people who get antibiotics for infections they don't have. Let's consider the people who got opioids for pain that they didn't need and then went on to become addicted and maybe die. Let's consider that American healthcare is the most expensive in the world, in no small part because of all the unnecessary tests and treatments that we do.
Even giving full weight to the ugly cases where patients' concerns are incorrectly dismissed, America has more of a problem with too much medicine than too little.
This will sound old-fashioned, but listen: women's bodies -- at least the reproductive part -- are perceived as more complicated (they are) and mysterious (they shouldn't be) than the male counterpart.
Then again, look at how far beyond usual doctor training is (still) on nutrition, diet, weight, and how it's all related to metabolism, diabetes, and inflammation. Only in the last few years or so have I seen any conventionally trained medical types start to really wake up to it. COVID certainly played a role -- a friend whose sister is a nurse in NYC said the first year of COVID in the ER was, "really old people" and "really big people." No healthy 30 or 50-year-olds. Focused work on the vulnerable was hysterically (sorry) rejected for two+ years.
"a friend whose sister is a nurse in NYC said the first year of COVID in the ER was, "really old people" and "really big people." No healthy 30 or 50-year-olds. "
You're right! And that's how I knew, right away, that it was a lab leak. When Fauci & company were censoring the lab leak theory, saying it was a natural virus, I knew that they were lying to the public. I knew it was a man-made virus.
Because COVID overwhelmingly targets the elderly & the obese. No natural virus does that. There is no other virus that targets obese people. When I saw that, I knew this was un-natural.
My wife has been through some weird medical things over the past few years (early 30s). We’ve also had 2 kids in that time, so we’ve been to a lot of doctors m, PAs, and PTs across several different disciplines. The only negative experiences have been with an ER doc (well, and the impatient a-hole that gave her a misplaced epidural in June, nearly killing her and our daughter, but that’s a different story).
I suspect that some of the issues with unsympathetic drs is where they went to school, but I mostly think it’s an ER issue. Emergency medicine is a joke (though there are good practitioners), and a lot of the reason why is that many family practices won’t see anyone when they actually have problems. Thus the ER doc that is at the end of a 24 or 48 hour shift isn’t in the mood to actually do any work. It’s just a bad setup.
I’ve found DOs to be way better listeners than MDs too. Also, where we live, the corporate, for profit hospital is awful. We are lucky to be with the smaller, non-profit hospital on our insurance, and they are way better, actually wanting to help.
Anyway, long post to say that the medical system sucks, and it doesn’t have to.
Medicine is not an art. You just need to follow the guidance produced by the Supreme Federal Democracy Government or you will have your license taken away. Trust the science!!!
In the last two years, the medical care was extremely politicized. The treatment options for COVID were prescribed by the government, and those who did not follow, lost licenses and were ostracized. These is a connection, unfortunately. I do see a reason for his sarcasm.
Not the way it was expressed. This was a heartfelt first person report by a woman barely out of her teens. Comments should address her story and concerns. Somethings are too important to be simplified to partisanship. Otherwise I enjoy your comments.
Some of those responses don't even sound like they were generated by a medical school educated mind. I have had both good and bad experiences with both make and female doctors. There likely are some sex differences, but those have not been what made the salient difference in my personal experience.
When will medical school teach that a dismissal of a patient because standard tests can't diagnose opens a new universe of possibilities to explore? It seems this learned in practice not school.
Due to the ACA (Obamacare). In order for Obamacare to pass Congress, Obama had to get Congress to sign off. Therefore, lobbyists who pay congress had to sign off. Lobbyists who work for Big Pharma, Big Insurance & Big Hospital Chains.
Obamacare caused many bad things. 1) Much increased paperwork, bureaucracy, excessive clicking on computers that wastes time, less time spent with patients & more time spent on endless clicking 2) Hiring lots of administrators to do all this paperwork which increases health care costs 3) Private practices are forced to sell to Big Hospital Chain monopolies which increases costs, forces docs to see more patients in less time 4) Patient satisfaction scoring, which increases patient morbidity & mortality & opioid crisis
I have found that female doctors relate to women’s issues especially gynecological ones very differently than male doctors. Particularly when first making a diagnosis. Specialists are a whole different story but if you need to have a referral, you have to get past that first hurdle.
"Dismisal" of a patient is not an appropriate outcome.
But it is important to realize that most physicians regularly see lots of patients who say or think that they have some serious physical illness that they do not actually have.
A responsible physician has to consider non-obvious medical diagnoses, but psychosomatic illness, hypochondria, malingering and factitious disorders, and plain old idiopathic illness (medical speak for we don't know what's going on) are always on the list.
It's not about doctors seeing patients who think they are sick but aren't. It's about pervasive gender bias in healthcare research and medical practice. Google it. If you don't have the energy to do that, here's a couple of links: https://www.nejm.org/doi/full/10.1056/NEJMp2201180
I have high respect for medical profession and doctors ~ I come from two generations of doctors, my grandfather and both my parents were doctors. Granted they were “old type” doctors with different ethics. I could never imagine my mother saying “ it is all in your head” to a patient. She was an excellent diagnostician, and people seeked her advice when nobody else had an answer. She could really think “out of the box” and never relied as much on tests as they do now, but on her knowledge and research.
I don’t think male doctors are prejudiced. I hope not. However, this is what happened to me a few years go. Come to your own conclusion. I almost never have headaches. Until one day my head was throbbing, and a sharp pain in the side of my head returned every 30 seconds. I went to an urgent care. Two very thoughtful and attentive doctors talked to me and prescribed a strong painkiller. It didn’t do a thing. The next day I called my family doctor, and she recommended I go to an ER immediately. I went to a hospital a few blocks from me. I live in NYC, and it is a good teaching hospital. A very respectably-looking male attending doctor in his 50s with a flock of medical students around him told me that he did not believe me I had a severe headache because I looked good and because my pupils looked normal. I could not believe it. He also pointed to the medication they had given me in the urgent care and said I was lying that I had never had headache since I had the painkiller. When I showed him the date on the bottle, which was the day before, he shut up but did not apologize. I am sure he wanted to catch me in a lie. They gave me MRI, which did not show any abnormalities. Because I insisted I continued to have pain, they finally gave me an IV, and the pain went completely away. When my family doctor called in the evening to check on me, she said she thought I was having a stroke. I don’t know what this episode was, as I am sure ER doctors see all kind of walk-ins. But when I look back, I think “you look good and cannot have that much pain” was a chauvinistic remark and still feel insulted by it.
There are physiological S/S of pain. Tachycardia, Hypertension, vomiting and when you ask the pt what is there pain level they tell its a 10/10 while the text on their phone. So looking at a pt's behavior can help confirm pain or not.
Of course. I am not an idiot. Taking vitals is important as is asking simple questions. But they do not always paint the whole picture. Empathy and an ability to listen to the patient may help when the situation is not as straightforward as in a medical textbook. This is used to be at the heart of the medical profession. And that’s the whole point of this discussion. Do you think telling a patient you look good and your pupils are not enlarged so I do not believe you experience any pain is appropriate? And in front of a group of students. That’s what they will learn.
What you experienced is appalling medical malpractice. That this kind of thing is still a commonplace experience for women, and particularly women of color, makes me seethe.
For medical malpractice (or negligence) one has to satisfy 3 conditions:
1) there has to be an injury or bad outcome
2) the 'proximate cause' of such injury has to be something the practitioner did (or failed to do)
3) it must be proven that the practitioner deviated from the standard of care, defined as what a similar practitioner would do in the same circumstance and which is demonstrated to be the "standard of care" by commonly accepted practice or - even better - by consensus guidelines for managing that particular condition set by the standard-setting organization for that medical specialty.
In the above case as told by Just an observer, these definitions were not met, ergo no "appalling medical malpractice." Just because someone was not treated empathetically, or the interaction felt rude or disrespectful or the patient felt their medical symptom(s) were not taken seriously, does not constitute malpractice.
I had a good female neurology resident. Her organization quit taking my insurance, so I got an experienced male neurologist, who kept me on steroids too long, resulting in neuropathy in both legs that adversely affected my gait. I know I can't generalize from this experience, but I certainly would never hesitate to see a woman physician.
True that. I saw a female NP in the instacare for symptoms of a UTI (blood, burning, etc). She had all my history with cancer treatment. Tests came back negative and she legit sighed like I was making shit up. Told me that possibly I didn’t know what a UTI felt like (I do!). Went to my male radiologist the next day for a follow up and he immediately realized I was probably having inflammation from my cancer treatment and expressed his frustration that she hadn’t prescribed me the pain meds for UTI since they would still help. He prescribed them and told me to just let him know if I needed more. Sure enough, symptoms ended when treatment ended. Some medical professionals are really good at thinking outside the box, some seem very intent on moving bodies through their schedules and if your tests are negative their brains shut down.
The NPs I work with are great & always ask us docs for help w/ anything complicated (outside of pt's earshot).
BUT: There is the right time/place for NPs. NPs have far less knowledge/experience (500 hrs clinical training vs >20,000). This often leads to patient deaths.
If you have a straightforward medical problem, then by all means, NP is fine. However, if you have an emergency, in the ER, request a physician in the ED. If you have something somewhat complicated, see a physician.
If you have something very complicated, do not see a private practice doc or NP. You need to go to an Academic Medical Center with a teaching program (residency or fellowship). They will spend a lot of time with you, they are not financially incentivized at all & they will get to the bottom of what is going on. They will figure it out & they will help you.
Yep, learned my lesson there. I have other NPs and PAs that I love but they only work during the weeks so any weekend need is always a toss up. I agree that an academic medical center is the best, that is where are my cancer drs are and my oncologist did more to research my possible treatment than the MD Anderson dr I saw. But that is probably due to ego associated with working at a top medical center than anything else 🤷♀️.
Dr. Martin, thank you for your comment. I am forwarding the article to a friend who is currently beginning his second year in medical school and intends to focus on family medicine with an interest in serving in more rural areas. He has already discovered the value of “listening” as an essential component of building trust between physician and patient where this trust is absolutely required in order to elicit from the patient a full and accurate understanding of not only their physical state but the environment in which they are living and in which any plan for “healing” must take place. I personally want to support him in his efforts to develop his appreciation for and perseverance in developing a similar skill along with solid medical knowledge and experience. Your words of wisdom reinforce this.
Your disagreeing doesn't make it untrue. Most pharmaceutical tests are still only done on men as default. The drugs are then released to the market as safe without ever being tested on women.
And don't even get me started on the massive gaslighting when women reported the Covid vaccine was impacting their periods. The Science (TM) told them the were imagining things. Move along.
The propaganda goal of having a COVID vaccine that objectively neither prevented infection or reduced the frequency of infection was more important than the truth.
That does not apply to endometriosis. Sounds like a lot of incompetence, in this case.
Medical incompetence should not be underrated. I visited several urologists about having a 25yo vasectomy reversed. Several told me that extracting viable sperm without reversing the whole thing was impossible. Then I saw a competent specialist (a woman) who promptly did what was deemed impossible by a bunch of men.
> Most pharmaceutical tests are still only done on men as default. The drugs are then released to the market as safe without ever being tested on women.
Your links are to the FDA guidelines. They're not evidence the pharmaceutical companies and medical industry are actually following them. And after everything we've been reading here, you want me to believe everything the FDA says???? Seriously???
If you have any sources to share, please do so -- if there are still studies being done on pharmaceuticals with such extremely biased test groups, that's a massive cause for concern.
We have not moved "way beyond that". Medicine has had centuries to establish biases against women. That doesn't get erased in a couple of generations, and it doesn't get erased because the government puts out some guidelines and recommendations and commitments.
That’s just not true Terence. 85% of gynaecologists are not women and pharmaceutical companies did not deem women important enough to use them for research. The only thing that works is to be your own advocate. Much easier to do in Canada because of our healthcare system, which allows us to see multiple doctors. Still, in the end women have to campaign on behalf of ourselves to get concrete answers
Aw, diagnosis is so hard, even women can't do it. I call BS. The structure of medicine is still strongly male-dominated, and research dollars go to what will be profitable. If men paid as much attention to the complexities of women's reproductive issues as they pay to the production of erections, we'd have solved endometriosis by now. And that is the definition of gender bias.
It's the system and the insurers. Doctors won't perform what insurers won't reimburse them for. So even if 85% of OBGYNs are women, who makes the decisions at the insurer level on what treatments will be paid for?
I dunno, Kevin. I’ve read a lot about medical history. I give a lot of credit and gratitude to the men of the Victorian era and early 20th century for their truly world-changing discoveries...but the field was ruled by and exclusive to men. Since most of us have some degree of gender bias, it is not illogical to conclude that it had its effects on these men as well. Clinicians aren’t always as clinical as they should be. It’s not even confined to the field of gynecology; studies have indicated that heart disease is often missed or misdiagnosed in women because they present with atypical symptoms vis-à-vis the guidelines--which were created based on presentation in men. Thus it’s not wildly implausible to think that if women had had a larger role in the development of the modern medical model, women’s health issues might not have so often been diagnosed and dismissed as hysteria.
I initially agreed with your premise that women are more likely to go to the doctor when something is wrong, but reassessed. Anecdotally, I have to be dragged kicking and screaming to the doctor’s office. My husband OTOH is super diligent about check-ups and is much more likely to see his doctor for a simple complaint. And generally, I would think that young moms, who are harried with jobs and child care and ferrying kids to after-school lessons and practices, may be less likely to go to the doctor simply due to lack of time.
I am not dismissive of anecdotes but in this case I think your situation is non-standard.
I’m pretty sure that, for evolutionary reasons, women are less sensitive to pain, which points in the direction of your argument. Also, men certainly get injured more but that’s not really relevant. It makes sense to me that women on average are more cautious and conscientious about health issues but maybe I’m wrong there. But there’s certainly plenty of money and prestige available in the women’s health sphere. Also there’s the thing about how companies charge more for women’s stuff which is an incentive maybe?
But I agree that women should focus more on cooking and cleaning instead of coming up with schemes where they get to meet handsome doctors.
😂😂🙏🙏
(sorry once I get going with the misogyny jokes it’s hard to stop)
All excellent points, including the desire to meet handsome doctors. 😉 I haven’t seen any studies on whether women are more likely to visit the doctor’s office than men, but now I’m intrigued.
(And I know we are atypical, as evidenced by the day that I was out in the garage, drinking beer and smoking cigarettes with the plumber, while the hubs was in the kitchen rolling out dough for homemade ravioli. 🤣)
I would maybe agree with you if there wasn’t a substantial rewards system in place that handsomely compensates medical advances regardless of the gender you are solving the problem for. And I believe women are more likely to seek medical attention (because guys are stubborn and irresponsible and stuff) so you actually probably get rewarded more for addressing/solving women’s medical issues, both financially and in terms of prestige.
I think a lot about our medical model. It’s so advanced and yet so broken. I don’t think socialized medicine is necessarily the answer, but the more advanced the technology becomes, the more expensive the care.
I know a doctor who has MS but manages it with lifestyle and is symptom-free. She lectures in medical schools about the importance of educating patients to exercise choice to avoid preventable diseases. We need a lot more of that, in my humble lay person’s opinion.
She manages it with a whole-food plant-based diet, good sleep hygiene and exercise. Look up Saray Stancic. She’s not running her wellness practice anymore, but her story is out there. She also made a documentary called Code Blue about the need to address wellness and disease prevention in medical education.
Part of the trouble here is that if a doctor tells a patient to live a healthy lifestyle and does not order a bunch of expensive tests or prescribe a controlled substance, many patients will complain that they are being ignored.
You are probably up your own arse on this: the pattern of behaviour goes back to Galen and before. It might have magnified and exacerbated the problem; but it goes back to when you could, with justice, argue there was a patriarchy.
Joe Biden has healed our nation’s soul and united our allies and he has cured most diseases and he has empathy and he returned the classified documents and is cooperating unlike Trump.
Agree. The men above are way off base here. And, even ignorant. Women are very often misdiagnosed and dismissed as emotional about health issues. It’s a statistical fact in the overall misdiagnosis of 40000-80000 people a year.
“Women are more likely to wait longer for a health diagnosis and to be told it’s ‘all in their heads’. That can be lethal: diagnostic errors cause 40,000-80,000 deaths in the US alone.”
Heart attack is the number one killer of women but often dismissed at the crucial beginning stages of heart disease because of psychology and emotion and the intricacies of women’s bodies (as the child bearers of all humanity) in those diagnoses.
How the hell would we women know? Personally, I only know what it is like to be treated as a woman. I don't have personal experience being treated as a man. I can observe stories men tell me, but then, men can also observe stories women tell them. The notion that men can or can't tell whether women are experiencing bias is as reasonable or absurd as the notion that women can or can't tell that men are similarly treated. Though I do believe that doctors are less likely to take women's pain seriously, because men tend to be more reluctant to go to the doctor, so when they go, there is more likely something wrong with them. But, that said, I find it weird that people would expect doctors to be able to help them most of the time. Because they don't.
Thank you for putting it so well. The lack of critical thinking on this point is frustrating. Bias can’t be determined from personal experience. This issue was addressed humorously in a Curb Your Enthusiasm episode, where Larry David feels slighted by a waitress and determines that it’s because he’s bald. To him that’s how it seems. Not necessarily true though.
The difference is that the women here aren't telling the men they are wrong about their own experiences as men, but some of the men are doing just that to the women that are describing their own experiences. I think area of agreement is that the system sucks for all.
I am a female doctor. I can’t countenance your attitude towards my male colleagues - mostly intelligent, conscientious and honest. Female doctors do not have a monopoly over these qualities.
I seem to recall that you "liked" my May 8 comment on Stanley Goldfarb's The Free Press article "How America's Obsession with DEI Is Sabotaging Our Medical Schools". In my comment I tried to analyze DEI ideology by conjuring up my inner (fake) "Woke" persona to see what it had to say.
Anyway, I was curious what it was about my post that inspired you to give it a like (yours is the only like I got for it). Since this is a bit off-topic, if you choose to reply perhaps you might do so to the original article at "https://www.thefp.com/p/how-americas-obsession-with-dei-is".
Some things men, without direct experience, should observe- contemplate - and then speak. Some of the usual commenters here- and I enjoy many of them- are quite defensive and demonstrating they are not listening and are as entrenched in their mindsets as those they oppose.
As a man, I probably shouldn't weigh in, but ... A large part of the problem in diagnosing women's heart attacks is that the symptoms are different between the sexes. A similar situation exists in men's breast cancers.
And while it is well-established that there HAS been gender bias, that is gradually shifting/changing as more and more women are becoming doctors. When you consider that our institutions of higher education are 60/40 women to men, and the rate of older doctors (mostly men) leaving the profession is spiking, we will have a preponderance of female doctors in the not-too-distant future. Yes, there will still be some male doctor/female patient bias but now we'll also have significant female doctor/male patient bias to "balance" it.
Let's face it - doctors are human. Like all people, some good, some bad; some caring and some just in it for the money. As best I can tell, neither sex has a monopoly on either type.
Of course you should weigh in, and of course, we do agree, but the reality of the now- and of the past- is that it is clear that many women face this issue, and it is life threatening and life altering, that it shouldn't have taken this woman that long to be diagnosed and treated because of the reality of the now by all those close to her and the medical profession.
Women have a 5-6 year life expectancy over men. I have no doubt that there is bias in healthcare but I highly doubt it is as simplistic as “doctors only care about men”. The majority of PhDs and MDs in science and medicine go to women these days and it is very unlikely this hasn’t decreased the bias. I highly doubt women doctors and PhDs leave school and then suddenly assume women are usually “hysterical” when they come in for treatment. There are certainly structural issues in healthcare and western society in general but it presents negatively in both genders in ways not always seen.
For instance, Men are less likely to go to the doctor until something is seriously wrong. They also overwhelmingly perform the most dangerous jobs and experience the most stress induced suicides. I already previously mentioned the longevity disparity and that is truly an advantage that even money can’t buy.
Lastly, Endometriosis is also a disease that is very hard to diagnose. I’ll bet men and women suffering from similar maladies (such as MS) experience similar journeys to get a proper diagnosis. I just don’t think it’s at all accurate or constructive to read this and lazily assume it’s caused by the “patriarchy” rather than really searching for ways to make things better while being willing to accept answers or solutions that contrast with your own preferred narrative.
No one is implying anything about patriarchy. We are merely asking you to look at some facts so that changes could be made. The article very clearly demonstrates that women are dismissed- dismissed- much of the time at first blush as being emotional about their health concerns, as did her own parents.
That is real and is most likely a legacy issue in medicine overall. Endometriosis has been around a very, very long time- my best friend suffered with it and was diagnosed in 1979- but it is also still continually missed, along with heart and stroke diagnoses. Women's bodies are more complex, yes, but the perspective and lens all doctors use to diagnose must continually improve.
There have been implications, for example - if men suffered from endometriosis there’d be a cure by now.
You yourself state that “men are way off base” and “ignorant” indicating this is a gender bias issue and there could be no other explanations. I’m fact, you chastise men for having an opinion that differs from you and state that they just need to listen because they can’t possibly understand how women are treated. This ignorant if not disingenuous. If men can’t understand what women experience then women can’t know what men experience and then we should even talk at all. I believe people can put themselves in other people’s shoes and think it’s a necessary starting point to having discussions that improve things. Additionally, I think many women would be surprised by men experiencing similar treatment they believed was unique to women.
Lastly, I believe we need to be careful in believing that your experience or that of a close friend or relative is what everyone of that same race, gender, religion etc receives. I have personally been dismissed about medical issues by both male and female doctors and have had those same issues correctly diagnosed by doctors of both genders. My mother was dismissed out of hand by her female doctor and it was a make doctor who then listened to her and found the cause of a chronic problem.
There is no doubt we can do better for diagnosing and treating primarily female health issues. However, I think a significant portion of the disparities can be blamed on 1) doctors being imperfect (insurance coverage incentives to see as many patients as possible, arrogance, time constraints, etc ) and needing better diagnostic tools, protocols and training in general. Abigail’s experience is heart wrenching but if you think there are thousands of uncounted men with undiagnosed medical issues causing them exhaustion, pain and low quality of life then you need to expand your willingness to accept differing ideas. Most men just suffer through those issues without ever going for treatment. This is not to minimize women’s medical issues but rather to preach caution about lazily assigning blame for a complex issue around a poorly understood disease.
Try this for bias. I have pelvic congestion syndrome which is essentially varicose veins in the pelvis. It's very painful. It's treated with a relatively minor surgery by an Interventional Radiologist. There is a lot of data to support the surgery's effectiveness. Men can have the same problem, but it's called a varicocele. It's very painful. It's treated with the exact same surgery. My insurance (UHC), won't cover the surgery for my condition but it's covered for men. Their reasoning is that it's "experimental" for women, but not for men for the exact same problem.
My insurance will however cover me taking GnRH agonists (aka puberty blockers) because they have shown a modest reduction in pain. The side effects listed are rather horrendous so it's only offered as a short term solution, but apparently they are fine for kids with healthy bodies experiencing Gender Dysphoria.
"doctors being imperfect (insurance coverage incentives to see as many patients as possible"
I actually like seeing fewer patients & spending more time with them. Many docs do.
But thanks to Obamacare (ACA), private practices were forced to sell off to Big Hospital Chain monopolies & so now most docs are Employed by Hospitals. Also thanks to Obama, there are more & more Bureaucrats in Hospital Chains who tell doctors what to do. They dictate that we see more & more patients. They cut doctors salaries to enrich themselves & pay more to Administrators. They simply won't allow you to spend more time with patients. They treat us as assembly line machines.
My SIL was diagnosed with endometriosis in the early 80’s after being married for 10 years and no pregnancy despite constant trying. According to the Mayo Clinic, a lot of women with this condition have no symptoms and are discovered when they come in with fertility problems. She had the excision surgery, which cured the endometriosis, but still couldn’t get pregnant, so they did IVF, but that didn’t work either. Ultimately they just reconciled themselves to being childless. Her husband didn’t want to adopt. He didn’t want a child that “wasn’t really his”.
I don't think it is about the patriarchy. It's more about the understanding that women are biologically different than men so studies on men do not always translate to women in terms of outcomes. Traditionally no one (public or private) wanted to do studies on women because they would have to account for their monthly cycles and hormone fluctuations.
If that were true, wouldn’t there be a cure for prostate cancer? And the author specifically states that the majority of gynecologists are women. I also suffered from endometriosis for 30 years before I had surgery. There is no diagnostic tool other than surgery.
This is a nasty condition and I am glad the author received care as a young woman.
Similar to how birth control is free. Such hyperbolic statements undermine your argument. Endometriosis is awful. After surgery, it comes back unless you agree to medical menopause. But it is not easily diagnosable. It took my female GYN years before she determined surgery was appropriate. This is not a female v. Male issue.
But the little pink pill is not. And birth control has only been free since Obama. Before that we all paid for it monthly. I happen to disagree with you, it absolutely is a gender issue, but just as I’m sure you’re not changing my mind, I don’t think I will change yours.
As a woman in my 70s, I’ve never felt that my health was undervalued.
Whether my doctor was male or female, and I have had the good fortune of having both male and female doctors who have really appreciated my health and helped me.
You’re very fortunate. That hasn’t been my experience over the years particularly with reproductive and menopausal health. My mother has been brushed off as well as my daughter. We should all be as lucky as you and I’m saying that sincerely.
The author's attempt at claiming "sexism" is self-beclowning. Her issue was not understood to be related to being female until it was diagnosed, which in her telling is when the "sexism" ended.
Meanwhile, she wraps herself in the cloak of "being female" when telling her story (instead of telling it honestly as a more general tale of doctors being skeptical of hard-to-diagnose symptoms) precisely because she understands that society is actually very sexist in women's favor, and so framing her story this way gets her more attention.
Wraps herself in the “cloak of being female “ are you joking? Let me explain this: every single month a woman with endometriosis suffers excruciating pain that can literally have you pass out on your front lawn from the pain. Every month. Do you believe if women had been writing medical journals they would have come up with the word “hysterectomy? Even that is patronizing. Like we are just so hysterical that we can’t stand a little pain. You have blood flowing through your rectum every month, no where no escape, building up with more blood every month, forming masses of endometrial tissue that pulsate with pain every month because the blood cannot flow out.
I don't get the sense the author claims sexism. Some commentators here have done so. But I don't see this some "gender wars" piece; simply telling her own story, and the specific issues she went through with this disease, which is easily misdiagnosed and only applies to women.
75% of RN, NP, PA, and MDs are female! Its not true that "womens health is so undervalued". Women account for roughly 82% of NP, 95% of RN, and mid to low 70% for PA. Women Docs make up 54% of total MD.
Additionally, to tell women the medicine "undervalues" is a self fulfilling prophecy.
Your point? Are you a woman? If not then move along. If you are and haven’t experienced any issues with doctors not taking your health concerns or pain seriously, then you’re lucky but your experience is not the norm.
Why does a solution depend on men? The author points out that most OB/GYN specialists are women.
I would suggest that medical studies fail to include women because most people, including prospective subjects, are almost as leery of experimenting on women as they are about experimenting on children.
If men suffered from endometriosis, it would never have been researched, would never be present in any medical textbook, the men who had it would receive no treatment and would be laughed out of the ER if they came in asking to be treated for their mysterious pain, and anyone who claimed it was real would be excluded from polite society.
THANK YOU, thank you thank you!!! for shedding light on this horrible disease! I didn’t even need to read past the first few paragraphs to know you were talking about endometriosis.
I have endo and it went undiagnosed for 15 years. My symptoms manifested in so many ways - but my worst symptom of all has been infertility.
I always knew endometriosis was a potential reason for my infertility struggle. An obgyn in my teens once mentioned it to me after I came in for a visit after passing out in the shower from my period pain. She told me you only get diagnosed with it if you are struggling to get pregnant, but you’ll only officially get diagnosed after you have surgery to see if you even have it. (It never dawned on me that it would be the reason behind so many of my other health issues.)
I spent tens of thousands of dollars over the years on failed fertility treatments after doctors I saw were adamant that IVF was a workaround for endo. They told me excision surgery to remove lesions was likely not worth it and they may not even find anything when they’re in there. They could not have been more wrong.
After my third miscarriage and failed embryo transfer, the IVF doctor suggest another round with a new protocol and I told them I was done throwing good money after bad and called Dr. Seckin (founder of the endometriosis foundation) and scheduled an appointment for surgery consultation. I was under the knife 6 weeks later and they found over 50 lesions of deep infiltrating endo everywhere, also on my appendix, bowels, bladder - all over. I have never been more relieved to be diagnosed with a disease.
I immediately felt better after my recovery, as if I had been given a new body. I didn’t even need Tylenol during my periods. But best of all, 10 months after surgery I naturally conceived my daughter, who turns 1 next month. She is truly a miracle and my biggest blessing in life, and I know I would not have been able to have her if I hadn’t took matters into my own hands and elected to have excision surgery.
It is appalling to me that in an era where we are so concerned about women’s reproductive rights, doctors are SO uneducated about this disease and how it manifests. I’m hopeful in my lifetime we will have more answers and a better treatment for women who are suffering.
MK, thank you for sharing your story and I appreciate your last paragraph. “It is appalling to me that in an era where we are so concerned about women’s reproductive rights, doctors are SO uneducated about this disease and how it manifests.”
I am wondering if where we live impacts healthcare options and outcomes? Are there better doctors in cities?
Are women better served with women doctors with women issues?
It seems exploratory surgery is the efficient way to confirm or eliminate an endometrial diagnosis.
My internal medicine doctor’s mantra is “the devil is in the details”.
Abigail, thank you for sharing your story and ultimate resolution for your pain and suffering.
Going forward, medical care has to provide better care and diagnosis options.
I wonder. I lived in New York City for 10 years and at the time I worked for large companies with good insurance. I would say my healthcare options were probably some of the best available to us in this country. My surgeon Dr Seckin (male) and Dr Goldstein (female) are some of the best at what they do. It is not lost on me how fortunate I was to be able to have that access to care.
On the flip side, I also was a patient at one of “the best” fertility clinics in New York City and my not-yet-officially-diagnosed disease was largely dismissed as not a real issue. All I needed was excision surgery, not more IVF and hormones like the reproductive endocrinologists suggested. They saw dollar signs and a 30 year old newlywed desperate to be a mother.
And yes, at this point exploratory surgery is the only true way to diagnose endometriosis. A scary prospect for a teenage girl who’s only had a few years of “painful cramps” to electively go under the knife. My biggest fear was “what if they don’t find anything, then what?” It turns out my ibs, anxiety, exhaustion etc was all endo related, but only developed in the years after I started my period. Hindsight is 20/20.
I hope with more awareness and funding we might find ways to diagnose in a less invasive way, and earlier. And a treatment (other than birth control!) and excision surgery would be considered a huge victory over the disease.
I was a married lawyer in my 30’s in New Orleans during the 80’s and had multiple miscarriages, which is an emotionally devastating experience. I went to the “famous fertility doctor” there at the time (all the other female lawyers and professionals who had fertility problems went to him, including one of my law partners) and that man messed me up so bad that I stopped having periods. When my husband got transferred and we moved to a smaller town, I went to a plain old OBGYN (male) and he took me off all the meds the other guy had prescribed, told me to not get pregnant for 6 months to clear out my system, and then start over. Long story short, turns out my problem was not producing enough progesterone during the pregnancy and when it fell off the charts, I would start bleeding and eventually miscarry. The small town OBGYN simply put me on progesterone pills for the majority of my pregnancy and I went on to have a healthy full term baby girl. She turned 37 on August 8th, and I love her to pieces.
A beautiful ending! I am glad you found a doctor who listened and truly helped you. I guess it doesn’t matter where you are, you just need to be lucky enough to find a good one who cares.
Yes! It also helps to have a doctor who, when your body is doing things the “books” say it can’t do, the doctor puts the books back on the shelf and treats YOUR body. In my case, the new doctor suspected a progesterone problem, so I went in for weekly blood tests of my progesterone levels. When they dropped he gave me a one week prescription and then next week, repeat. After 16 weeks the placenta is supposed to take over and make the progesterone and keep it elevated to stop bleeding and maintain the pregnancy. Mine just kept disappearing way past 16 weeks (which is about when my miscarriages had happened). What the doctor told me was, and I quote, “All the books on that shelf (in his office) say that after 16 weeks this cannot happen, and yet here you are facing me and it is happening. Therefore, we are going to to treat you and your body, which is not following the rules. I always treat the patient in my office, not the one in the book.”
That’s amazing and so incredibly lucky you were able to connect with a doctor like that. If only that were more common! I had to fight to be taken seriously during my fertility journey (as I’m sure you can understand from your struggle). Each IVF appointment felt like I was part of a flock of sheep being herded from room to room. Ultrasound. Bloodwork. More bloodwork. Another ultrasound. Follow drug protocol by the book. Rinse, Repeat... No thinking outside the box. Truly sad.
If you are able, God-willing, to conceive a second child in the next year or two, it would also be beneficial in terms of endometriosis. Pregnancy and breast-feeding are very helpful, because you don't have periods, so the endometriosis does not progress. It is also a good idea, so there will be fewer chances of having secondary infertility.
Yes that’s the intent! I have never felt better than during the 9 months I was pregnant (well minus being 9 months pregnant in august in the south 🫠) The endo will come back, but I have said it over and over that I would gladly walk into that OR to have that surgery every time if it meant having my daughter here (or future children)
I really appreciate you sharing your story. Several emotions rushed back to me as I remembered some similar experiences that I also went through. It saddens me to think that many doctors still have little knowledge about this disorder and many more women continue to go undiagnosed. It is even worse that this is a cause for infertility that could possibly be prevented if women were diagnosed sooner. I hope that many others read your story and gather knowledge to help them make the best decisions on their health care journey.
I feel everyone’s pain. I was going to college in the 70’s and was taking a course in public health and the topic of infertility came up tied to endometriosis. I thought to myself, this will be me in the future. I had very painful periods (not many pain killers in the late 60’s) and suffered every period. I started experiencing cysts that ruptured (talk about pain!). Had surgery to remove a large cyst in my late 20’s, that is when they discovered bad case of endometriosis. The doctor prescribed birth control pills, continue to take without a period for a couple of years then stopped when I was trying to get pregnant. Another procedure (cyst again), and put on Lupron (hormone blocker) for 3months. Got pregnant after the end of the third month! Had another son 2years later. Thank the Lord! However symptoms started again and started birth control pills up until I reached 60! Thank God for menopause! Symptom Free!!
You do understand that the hoopla over "reproductive rights" is code for abortion, right? I think your story, Abigail's and the countless others pretty conclusively establish that.
Yes, I do. I wish there was more hoopla over endometriosis. Maybe we’d come closer to finding better treatment for the 10% of women who suffer through it 🙂
Let me ask, Lynne, what healthcare other than abortion that Planned Parenthood puts on the table?
It's not a gotcha question. It is a question that I, as a male, am unable adequately to answer. Doesn't the mania around that organization become a major factor in the misinformation to which the general public is treated?
I am stunned that, here, thirteen months, after the Dobbs decision was released hat more states haven't acted to clear abortion into statute law. I find that inexplicable.
According to their website (Planned Parenthood Gulf Coast), they offer the following services:
Abortion, Annual wellness visit, Birth Control, Breast cancer screening, Cervical cancer screening, HIV and Rapid HIV testing, HPV testing and vaccine, Morning After pill, Pregnancy options counseling, pregnancy testing, PrEP/nPEP (HIV prevention), Primary care, STI testing, Trans care (hormones), Urinary tract infection treatment, and Vasectomy (so LK, they can treat you too 😉)
I'll go with what a friend of mine said after the twin-engine airplane that he was piloting smacked into a house when both engines failed on take-off. He woke up in the ER just as he was being prepped to have his second leg amputated. "No, that's mine" he said.
I understand where he was coming from, and I generally think it is wise medical treatment to keep what you have as long as you can have it.
I haven't been to PP in many years, but through my 20's, I and many friends who didn't have health insurance used it for normal well woman exams, birth control, and emergency treatment for even bladder infections and such. Years ago you couldn't get treatment for a yeast infection OTC which is ridiculous, so people went to PP to get an affordable RX.
It's really sad that all the attention is put on the abortion provision when in fact, they're the only women's health care that a lot of poor women have.
Well Ann and Jane have weighed in on the what else part of your question. As for why some states have not cleared abortion into statutory law that is simple - those states represent their citizenry who do not believe abortion is justified. Personally I find that refreshing. You do understand that Congress could enact such legislation, right Of course that would mean doing their job and debating meaningful legislation so it is not likely to happen. The Supreme Court did not say abortion could never be lawful nor did it say it was an issue relegated to the states. It just said Roe was improperly decided. I agree with that opinion and commend those brave justices as it is a legislative matter, whether state or federal.
Thanks for the non-reactive answers...I think what my preamble suggests is that little is said by disinterested third parties as to what Planned Parenthood actually does, and that lack of untainted information drives discussions into worm holes from with little useful emerges. Your remarks seem to validate my impression.
I will address your thoughts on Dobbs sometime over the weekend. I agree on some levels and urge your reconsideration on others. It is the others that I will address in another posting. I need to reread the opinions first so that I am sure of my ground.
Thank you, Anne and Lyne, for your measured responses instead of the immediate turn to the emotional backmail screes that usually attend this topic.
I rarely find myself on the fence but I do on this issue so you should not read anything about how I feel about abortion into my comment. I really was addressing the methodology of using "reproductive rights" instead of saying what is really meant - abortion. The two are hardly synonymous, although one is a subcategory of the other. As for the larger issue, personally I do think there might be an argument to be made for a privacy claim under the penumbra clause but I do not think Roe did that. Roe was, IMO (and that of the Dobbs court), a judicial usurpation of legislative authority. Frankly I begin to think the worst problem the nation faces is a Congress that fails and refuses to do its job on any matter of significance.
No. I was not reading anything about your position on abortion. I was indicting my appreciation of your the discussion from the side of a reasoned opinion as opposed to an emotional one.
Let me give you a heads-up regarding my reply to you: The Ninth and Tenth Amendments which were very much a part of Alito's opinion. They move the topic into constitutional areas that are frequently bypassed due to the emotional hard points.
It's not only women who are dismissed by the medical profession. If a man doesn't fit the drs. definition of what is wrong, they too are dismissed. Take this drug and if you still have a problem come back. Having undergone 2 botched surgeries, I will never trust another dr. In my 84 yrs. I've met only 1 Dr. who knew what he was doing, a dermatologist, the rest were guessing.
In my many years as a Disability Benefits attorney, I witnessed a stunning number of undiagnosed and misdiagnosed patients—men and women, and by male and female doctors. Well-intentioned or not, it became clear that too many doctors were unwilling or unable to take the time and effort to carefully listen to and evaluate their patients’ signs and symptoms, and they would dismiss, in varying degrees of concern (or lack thereof), the seriousness of the problem presented to them. Diseases such as MS and lupus—and yes, endometriosis—frequently would take years to be properly diagnosed and treated. And then to further slap my clients in the face, some Social Security Administration Administrative Law Judges hearing these clients’ cases would decide that, ok, “yes you deserve disability benefits, but only as of when the diagnosis (of whatever) was made”—even though the medical records corroborated my clients’ testimony that he/she was having severe symptoms and functional limitations, impairing the ability to sustain work, for years prior thereto. This resulted in the tragic and unjust loss to these clients of thousands of desperately-needed dollars and the unwarranted delay of Medicare insurance.
The so-called "invisible diseases" are extremely difficult to get taken seriously. I was finally diagnosed with fibromyalgia in 2004, but I had been having weird and inexplicable (and therefore scary) symptoms for several years before that. The depressing thing is that I could have been diagnosed back in grad school, when the student clinic doctor ruled out several other diseases with lab tests and mumbled vaguely about the possibility of fibromyalgia...but didn't refer me to a rheumatologist.
True that. Your frustrating experience has been repeated innumerable times, predominantly by women. Fibromyalgia is still considered by many doctors—and some judges— to be a “wastebasket” diagnosis, not to be taken seriously as an “organic” problem. Granted, like many syndromes, there are still no verifiably “objective” tests for the diagnosis, but an experienced, attentive practitioner—usually a rheumatologist, but sometimes an informed PCP— can make a medically sound diagnosis based on signs and symptoms. This then reassures the patient that the pain, fatigue, etc. is not “all in your head,” and thus begin a treatment management program.
Unfortunately, since they aren't sure yet what causes fibro, treatment is basically "throw stuff at the wall until something sticks."
Personally, I discovered something that helped completely by accident. I had already been taking Lexapro for depression before my fibro diagnosis. But it tended to make me sleepy. I had read that Wellbutrin could counteract that, AND that the Lexapro+Wellbutrin combination was better overall. So I requested to try it.
It did mitigate the sleepiness. But the unexpected thing it did was mitigate the fibro pain! And I got an unexpected confirmation of that when my doctor accidentally sent in a mail order prescription for the XL instead of the SR formulation: fibro flattened me again on XL, and was relieved when I went back on SR.
I agree that, as with many other “syndromes,” we are stuck with the trial-and-error approach. FM, because—as you noted—the etiology remains unclear, and also because there is such a broad and varied constellation of symptoms reported by patients, often similar to symptoms characteristic of other syndromes and diseases; e.g., degenerative disc disease, will continue to be a problem in which the patient’s self-help is particularly critical.
Years ago I found some terrific books for FM sufferers: “The Fibromyalgia Advocate” by Devin Starlanyl, MD; and “The Fibromyalgia Survivor” by Mark Pellegrino, MD. These are now pretty old, and I know Pellegrino and others have written more recently.
Good for you for finding medications, even if accidentally, which have given you some relief.
There are a few common characteristics seen in most people with fibromyalgia:
- inexplicable pain, generally near but not IN the joints
- intestinal issues resembling IBS
- "fibro fog" (decrease in ability to focus and think clearly)
- lack of energy, even with plenty of sleep
- atypical responses to medications
Some list insomnia, but since that is often a product of unrelieved pain, I don't.
There are many theories (some of them pretty out there!), but the current theory that seems most reasonable to me is a semi-latent viral infection of the vagus nerve.
Yeah... My wife has fibro and Endo (detected leproscopically) and doctors were very bad at detecting either. Treatment involved years and years of trying many drugs for insomnia and pain.
I do think it's in a sense a mixed bag of conditions (although very much real). It's crazy but she used CBTI to very easily solve the insomnia after maybe 15 years on relying on multiple drugs to fall and stay asleep
For anyone in the UK who might be affected by such, or knows someone who is, these folk have been very helpful to me and dozens of others I know in navigating this thicket: https://www.benefitsandwork.co.uk
I actually like seeing fewer patients & spending more time with each patient. Many docs do.
But thanks to Obamacare (ACA), private practices were forced to sell off to Big Hospital Chain monopolies & so now most docs are Employed by Hospitals. Also thanks to Obama, there are more & more Bureaucrats in Hospital Chains who tell doctors what to do. They dictate that we see more & more patients. They cut doctors salaries to enrich themselves & pay more to hospital Administrators. They simply won't allow you to spend time with patients. They treat us as assembly line machines. Thankfully, I'm at a private practice and I'm allowed 30 minutes per pt, but there are many places where Docs are only allowed 5-10 minutes per patient!! Not by choice. Not something docs want. It is due to Hospital Chain Stockholders, administrators & business people seeking profits at the expense of patients.
My PCP, who has been a doc for 30 years, probably, just up and bailed. No forwarding practice info, done. During COVID he'd call me back at 7 or 8pm. I also noticed that the practice got absorbed by a larger entity. Thanks for explaining the connection, and for your work. Then the hospitals want you to donate to their special programs. Not a chance.
Your PCP may have been forced to quit (possibly) by the larger entity. Many of these big chains forced some docs to quit in order to increase their profits. Often, they go after the older physicians, many of whom would love to keep practicing but being forced to retire. My parents had a fantastic PCP who was forced to retire by the big hospital chain that bought his practice.
Obamacare connection:
In order for Obamacare to pass Congress, Obama had to get Congress to sign off. Therefore, lobbyists who pay congress had to sign off. Lobbyists who work for Big Pharma, Big Insurance & Big Hospital Chains.
The Big Hospital Chains +Big Insurance team up, approach small private practices & say "You must sell your practice to us, or else we will take you off of all insurance networks". Meaning, the patients would no longer be able to see these docs, because the docs would not be covered under those insurance plans.
Obamacare caused many bad things. 1) Much increased paperwork, bureaucracy, excessive clicking on computers that wastes time, less time spent with patients & more time spent on endless clicking 2) Hiring lots of administrators to do all this paperwork which increases health care costs 3) Private practices are forced to sell to Big Hospital Chain monopolies which increases costs, forces docs to see more patients in less time 4) Patient satisfaction scoring, which increases patient morbidity & mortality & opioid crisis
Thank you for your insight. I’m in Canada and only became aware of the “top down” medical control, both in hospitals and to doctors in private practice (who are reimbursed by the healthcare system) during the last three years. I support universal healthcare but it can’t come at the expense of the freedom of individual practitioners.
Agreed. My husband was in pain and got progressively weaker and nearly lost his eyesight and was dismissed as his imagination by multiple doctors. But as a doctor himself he did the research and fought for testing and finally got a diagnosis and then identified a surgery and had to fight for that too. Then navigating insurance was a full time job. He’s almost cured now.
I shudder to think what happens to people without training or subject to the whims of overworked doctors and clerks at insurance companies who say no to everything.
I do as much research as I can online and ask the drs. a lot of questions, which they hate, then I get a second opinion without telling the 2nd. dr. about the 1st. dr. It's like buying a car from a used car salesman, but it's my money and my body, and my life. The worst is when they lie to you. The dr. who did my prostate op better hope I never see him on the street. I don't have insurance so I don't have to deal with that level of ignorance.
you probably should also not tell the 1st dr about the 2nd dr. like if you say "i'm going to get a second opinion" that would annoy them & not benefit you in any way.
I'm currently dealing with 3 doctors, None agree with the other. One is a total mercenary who lied to my face. I did my own research and I'm now the best informed in the group.
This was an extremely informative article. It’s hard to wrap my head around the psychological roller coaster you were put on. The medical establishment gas-lighted you! I think every single doctor who misdiagnosed you needs to read this article. Every ER doctor needs to read this article. Every medical student should be required to read this. I hope you have support working through any emotional fallout in the years to come. You’re a brave woman.
I'm sorry you went through this. I have been there as have so many women. I have endometriosis, interstitial cystitis, and pelvic congestion syndrome in addition to a connective tissue disorder. I learned that most doctors are useless for chronic disorders. However, good ones that listen to their patients actually do exist. It just takes time to find them. I've had better success with direct patient care doctors that work independent from insurance companies.
This is a better take than some of the others. It is unfortunately true that the American healthcare system is much better at treating gunshot wounds and acute infections than it is at diagnosing chronic illnesses with vague symptoms.
First of all, I'm sorry that you had to endure that pain for so long. That had to be miserable as you described. I'll make two points. A good gynecologist (or family physician) would have had this diagnosis in their differential after a few visits. You should not have suffered that long and I would suggest your example is unusual. Secondly, we may be seeing more of this delay in diagnosis in the future because of new guidelines passed about 10 years ago regarding the frequency with which pap smears are required, including not needing one until age 21. There are reasons for that which I wont go into (I'm a family physician- it has to do with HPV, pathology, immunology etc.) but the un-intended consequence is that the public thinks that this means they don't have to see their gynecologist or primary care doctor but every three to five years for their pap smear, and so they are not coming in for their pelvic exam and for an annual gynecological history. This has been a real problem and frustration for physicians, and there has even been a bump in the incidence of cervical cancer diagnosis. Bottom line is that women should still see their gynecologist or pcp annually for the ability to take a history like yours, and perform a pelvic exam if indicated. Best wishes for your future health!
I’m not a doctor but am pretty clued in to medical conditions from my and other’s lived experiences throughout my 60 years. As Abigail continued explaining her symptoms, I guessed “endometriosis” in my head. Why couldn’t a trained physician do the same much earlier in her life? That’s pretty confounding to me. I don’t understand why this story pivoted to gender discrimination when it’s more likely she just had some subpar medical providers (who are extremely overworked these days.)
A trained physician probably did not make the diagnosis precisely because he/she is a "trained" physician. See Dr. Martin's comment above about what is taught in medical school -- if it's not revealed by a blood test or scan, it doesn't exist.
That's something I became frustratingly aware of in the decade before I got diagnosed with fibromyalgia. It is very disheartening to hear, repeatedly, "I can't find anything wrong with you." I'm not sure how a doctor can look at a patient who is clearly in distress and deny that anything is wrong with them because the lab tests came back "normal."
Very glad you were able to be diagnosed and treated properly. I too had 7 years of many tests and various doctors, around the country. Most of the tests were searching for the "cancer"! I spent almost 7 years thinking I had cancer of something... but they couldn't find it! Finally in 2021, I saw a rheumatologist and started my treatment for RA .. Much damage has been done and reversal is impossible, but I am starting to get some relief. Good luck with your treatments, as well :)
That’s because it’s a diagnosis of exclusion. Once other causes of pain are ruled out by a history, physical examination and lab investigations, what’s left is the diagnosis of fibromyalgia. That’s how it is at present, in the future a specific test and targeted treatment may become available.
My SIL is 69 and she was diagnosed with endometriosis and had excision surgery in the 80’s. It was all pretty straightforward back then. I can’t understand why it’s so complicated today, or was so for Abigail. The Mayo Clinic’s website describes this all pretty clearly. It also says that having a low BMI predisposes a young woman to endometriosis, and I suspect that as a ballet dancer (dancing 8 hours a day?) she was under tremendous pressure to be bone thin. Could have been where it all started.
Thank you for a well written, intense consolidation of a very painful and traumatic medical issue that hopefully helps many other women find relief. You actually under played your very horrible experience and that made your writing even more impactful. Wishing you only happiness and success as you move forward in life.
If this happened to a Black woman, Democrats would work as hard as they possibly could to convince her that it was because the doctors are all racists.
The downside for the woman is it results in helplessness and resentment and the medical issue not being addressed. The downside for me is that this psychopathic approach to politics results in people voting for even more communism, which I have to pay for.
This would be true if it happens only to black women, but it affects white conservative women as well so all politicians basically ignore women's health until it suits their political agenda.
It’s really only Black women who are targeted and subjected to aggressive, psychopathically manipulative Democrat propaganda designed to convince them that doctors and nurses are racists and that this explains negative experiences.
Democrats have a different and somewhat less aggressive approach for women generally where the goal is to con them into believing ‘the patriarchy’ is causing their problems and the solution is more government.
Progressive women that believe socialized care is the answer have no clue what they are asking for. While I agree that healthcare costs too much, I have the freedom to find and go to competent specialists. They are the top in their field, but many have opted out of accepting insurance so these companies can't dictate how they practice. They often use compounded medications which are typically cheaper than prescription drugs but without the toxic chemicals that are usually added to these drugs. I have met a lot of patients from Canada, the UK and even Sweden that travel to the US for care. Similar specialists in these countries have years long wait lists and you need a referral just to get on the list.
They have to get creative to get medications sent to them, because they aren't even available in their countries.
Agree 100%. Our system is disgusting, but socialized healthcare is hardly a panacea for people with chronic illness. Nor will it fix the bias against women described in this article.
I did not and will never suggest socialized healthcare. Look at the NHS in the UK to know that doesn’t work. That doctors are owned and controlled by giant faceless corporations is a travesty . Every time I hear someone say “ my dr is terrible and doesn’t even look at me , but it’s the only name on my insurance panel” I think “ what do you expect then? The doctors are trapped as well as the patients. I don’t have THE answer but do have some ideas based on decades of experience. Different fields of medicine require different solutions. Now it is more and more costly to the patient for less and less care.
There do seem to be significant disparities in outcomes for black women, particularly in obstetrics. We need to find out why, with objective studies and rationality, rather than the Chicken Littles who run around screeching about racism at any opportunity.
Not another bloody study. The answer, EVERY FEKKIN' TIME, is "One size doesn't fit all". For instance, the US is a melting pot; your genes are likely to come from everywhere moreso than practically anywhere else. The problem would probably go away if notice was taken of work ALREADY DONE.
Well-designed studies are the only way to get reliable, objective data, but they have their own problems, to be sure. Check out Vinay Prasad’s Substack.
Much more money is spent on women’s health than men’s health. And it has nothing to do with bias. It is because women have more health issues because of their reproductive reality.
Bingo. Kevin is trying to score political points by shifting the blame onto lefties when the truth is everyone has a share of it and we're all guilty to an extent.
Hopefully Abigail will have a full recovery and a wonderfully full life ahead of her. Abigail, you are a wonderful writer. This article makes clear that medicine is not as simple as we all like to think. And makes clear that we need the best and the brightest to be doctors for those of us who have unusual medical issues. Many of us have learned from our own experience that all doctors are not created equally. And yes med schools need to refocus on teaching medicine and science and get the hell out of politics. We all want Dr Gregory House when something really awful is happening to us. And he never even wore a white coat.
God bless you. An ex-girlfriend of mine had endometriosis. I cared for her in the weeks after her surgery.
Unfortunately, misdiagnosis or lack of diagnosis is way too common in allopathic medicine. I've come to learn when I need to consult another doctor or two or three.
This may be on the fringe, but when it comes to auto-immune disease (endometriosis is not currently classified as one but is associated with them), I recommend the work of Gabor Mate, especially his recent book, _The Myth of Normal_. It wasn't until I established firm boundaries with people, even cutting a lot of friends and family out of my life, that my sarcoidosis went into total remission. Coincidence? maybe.
I spent the past five years trying to get doctors to take my reproductive health seriously. I was told everything was fine, multiple miscarriages are normal, it’s in my head, I’m causing the miscarriages myself with worrying - and my favorite - maybe you should try sex in a different position. I don’t know where that last guy got his medical degree.
It took 7 doctors before someone took the time to help me, and within 6 months under her care, I finally got answers and am now pregnant and the furthest along we’ve ever been with a healthy baby boy. NaPro doctors who practice functional medicine are a Godsend.
The vast majority of western doctors are just drug dealers now. Few of them actually care about their patients and they know *absolutely nothing* about nutrition.
Couldn’t agree more. My IVF doctor knew endo was a possible cause of my infertility and yet she fed me estrogen like candy, adding fuel to the fire. They saw dollar signs when they saw me and my husband at age 31 walking into the fertility clinic with a healthy AMH. At $25,000 out of pocket per round, I knew it was time to move on when they suggested a 3rd ivf round with a different protocol. 10 months after my endometriosis excision surgery and eating low inflammatory diet I conceived our daughter completely naturally. Wishing you a healthy pregnancy!
'Highlight; click "Search for x"; read headlines' will work for ~95% of queries. Don't insult the intelligence of the commentariat; you'll be marked down as a prat.
I’m so sorry you went through this and yet I’m also glad you have survived it and are now thriving, so that we can learn from you and do better going forward. So many female issues are still just ignored, as you said, despite the profession being 85% female now. Menopausal issues have also been ignored, demonized, minimized. The sad truth is we must all advocate for ourselves medically in all healthcare situations and push hard for what we know we need. This is only going to worsen for the time being because doctors are leaving the profession in droves these days. Thank you for writing this!
I’m disappointed in the comments treating this article as if it’s ridiculous and questioning why TFP would bother with it. Our broken medical system is just as worthy of discussion as everything else that’s broken in our country. These conversations start with anecdotes like Abigail’s. Personally, I would love to see further analysis of broken institutions and systems because it’s all intertwined. The medical system, pharma, agriculture, the crap the FDA allows in our food, how CDC recommendations come about, etc. If you don’t think all of these things are relevant and part of the political mess in this country, you haven’t been paying attention. Remember: you’re easier to control if you’re preoccupied with being sick and poor.
1000% agree. Also this young woman is an intern. And I interpret the subtext of this as Bari and her team supporting young writers by letting them test their wings. I’m kind of disgusted by the negative comments tbh.
Women’s health is so undervalued. Im so sorry you went through this for so long, and I’m hoping you have found relief after diagnosis and treatment. If men ever suffered from endometriosis, a cure would have been found decades ago without any hesitation about coverage from insurance.
I disagree. It’s not because of gender bias. As Abigail points, 85% of gynaecologists are female. Women have more reproductive issues and illnesses than men. This makes diagnosis more difficult.
Also consider that the art of medicine, being able to listen to a patient, take the time to ask the right questions to elicit a proper history, then perform an adequate, directed physical examination, and put all that data together to formulate a differential diagnosis, has all but disappeared from medical education. Nowadays if a disease does not reveal itself via blood tests, CT or MRI scan, the diagnosis may well be missed.
I don't really blame the practitioners overall, but rather the system. That said, bias against women does exist. I've had women doctors apologize for not being able to figure out what was going with me, but they don't blame me for it.
My experience with male doctors is totally different in that they blame the patient rather than admit ignorance.
Male doc #1: Said my abdominal pain was depression.
Male doc #2: Said my bladder pain was caused by "fear of pregnancy."
Male doc #3: Said I wouldn't be able tell the difference between between gynecologic pain and bladder pain.
Male doc #4: I had a two week long severe sore throat and illness two years ago.
I suspected I had mono. Doc prescribed antibiotics and refused to test for mono after I requested it. Went to another male PA, he tried to insist I had strep despite negative swabs, but agreed to test for mono after I begged for it. Turns out I was right and had mono and got a proper prescription to help.
I could go on...
I don't go to male doctors anymore.
I’ve had only male doctor I can remember who listened to me and was a true partner in my health care. In my experience, most other male doctors I’ve seen have been dismissive and downright condescending. So yeah, I too now see exclusively female doctors.
Even female doctors have sometimes had their souls sucked out by medical school. Thinking in particular of the female doctor who didn't refer me to a rheumatologist for my symptoms (ended up being fibromyalgia) until AFTER I had cussed at her nurse on the phone for offering me pain pills (at the doctor's direction) instead of some path to diagnosis.
I have found that Nurse Practitioners are usually far better than the doctors they practice under. Most of them are female, which helps.
I agree. Nurse Practitioners are great!
The NPs I work with are great & always ask us docs for help w/ anything complicated (outside of pt's earshot).
BUT: There is the right time/place for NPs. NPs have far less knowledge/experience (500 hrs clinical training vs >20,000). This often leads to patient deaths.
You need to watch this:
https://www.newsnationnow.com/investigation/transparencyinhealthcare/
If you have a straightforward medical problem, then by all means, NP is fine. However, if you have an emergency, in the ER, request a physician in the ED. If you have something somewhat complicated, see a physician.
If you have something very complicated, do not see a private practice doc or NP. You need to go to an Academic Medical Center with a teaching program (residency or fellowship). They will spend a lot of time with you, they are not financially incentivized at all & they will get to the bottom of what is going on. They will figure it out & they will help you.
NPs take more time to listen as well, at least in my experience.
it is not a male female thing but a problem with many Doctors it is called attitude . The best Docs do one thing well , they listen
I'm a female physician and I work in a practice with both male & female doctors. Our styles are totally different. I would say that most women doctors are better listeners & spend more time listening to the patient. Studies back this up. We are more likely to admit if we are wrong & not ashamed to admit we don't know everything. I'm not bashing male doctors at all and they are excellent, skilled, knowledgable and great doctors. The style is just different.
I should also mention that the male doctors I work with are kind, not at all sexist, and do their best to be understanding of women's needs. They offered me great support during my pregnancies, maternity leaves, breastfeeding and pumping, etc.
You’re being kind saying it’s style differences. One can be taught to listen and ask questions better in order to do their job. And can learn not to blame a patient. Thank you for lending to the convo, truly. May you’re great style rub off on your peers!
Women doctors are better listeners and are more concerned with fixing the patient than treating them. I am a senior man so it’s not coming from any bias against men.
I had an ob/gyn tell me during a high risk pregnancy that he “couldn’t treat a problem that exists only in my head”. The very next day, I went to the ER and was admitted for 7 days of IV antibiotics. He never apologized.
Almost all of my current doctors are female. Younger male doctors (Gen X e.g.) are much less arrogant, in my opinion, than the older ones were.
Let's take this as being true. Let's say it's an awful experience. Let's say it happens with some regularity.
But let's also take into account all the people who get antibiotics for infections they don't have. Let's consider the people who got opioids for pain that they didn't need and then went on to become addicted and maybe die. Let's consider that American healthcare is the most expensive in the world, in no small part because of all the unnecessary tests and treatments that we do.
Even giving full weight to the ugly cases where patients' concerns are incorrectly dismissed, America has more of a problem with too much medicine than too little.
And, having read your post, I cannot begin to tell you how much we appreciate it.
Ha ha.
19th century diagnoses of female hysteria is alive and well in the male medical profession. Not all male doctors but enough to give us all pause.
This will sound old-fashioned, but listen: women's bodies -- at least the reproductive part -- are perceived as more complicated (they are) and mysterious (they shouldn't be) than the male counterpart.
Then again, look at how far beyond usual doctor training is (still) on nutrition, diet, weight, and how it's all related to metabolism, diabetes, and inflammation. Only in the last few years or so have I seen any conventionally trained medical types start to really wake up to it. COVID certainly played a role -- a friend whose sister is a nurse in NYC said the first year of COVID in the ER was, "really old people" and "really big people." No healthy 30 or 50-year-olds. Focused work on the vulnerable was hysterically (sorry) rejected for two+ years.
"a friend whose sister is a nurse in NYC said the first year of COVID in the ER was, "really old people" and "really big people." No healthy 30 or 50-year-olds. "
You're right! And that's how I knew, right away, that it was a lab leak. When Fauci & company were censoring the lab leak theory, saying it was a natural virus, I knew that they were lying to the public. I knew it was a man-made virus.
Because COVID overwhelmingly targets the elderly & the obese. No natural virus does that. There is no other virus that targets obese people. When I saw that, I knew this was un-natural.
Total lie... You are 50 years out of date.
Thank your Sam for your kind words.
My wife has been through some weird medical things over the past few years (early 30s). We’ve also had 2 kids in that time, so we’ve been to a lot of doctors m, PAs, and PTs across several different disciplines. The only negative experiences have been with an ER doc (well, and the impatient a-hole that gave her a misplaced epidural in June, nearly killing her and our daughter, but that’s a different story).
I suspect that some of the issues with unsympathetic drs is where they went to school, but I mostly think it’s an ER issue. Emergency medicine is a joke (though there are good practitioners), and a lot of the reason why is that many family practices won’t see anyone when they actually have problems. Thus the ER doc that is at the end of a 24 or 48 hour shift isn’t in the mood to actually do any work. It’s just a bad setup.
I’ve found DOs to be way better listeners than MDs too. Also, where we live, the corporate, for profit hospital is awful. We are lucky to be with the smaller, non-profit hospital on our insurance, and they are way better, actually wanting to help.
Anyway, long post to say that the medical system sucks, and it doesn’t have to.
Medicine is not an art. You just need to follow the guidance produced by the Supreme Federal Democracy Government or you will have your license taken away. Trust the science!!!
Sarcasm is inappropriate here.
That isn't sarcasm; that is righteous disgust.
His answer to everything is hurr durr the government!
This is an article about endometriosis and he still ties it back to communism somehow, like wtf. Stale.
In the last two years, the medical care was extremely politicized. The treatment options for COVID were prescribed by the government, and those who did not follow, lost licenses and were ostracized. These is a connection, unfortunately. I do see a reason for his sarcasm.
Communism? You're the one mentioning communism.
It is in fact completely appropriate.
Not the way it was expressed. This was a heartfelt first person report by a woman barely out of her teens. Comments should address her story and concerns. Somethings are too important to be simplified to partisanship. Otherwise I enjoy your comments.
I’m not sure that’s sarcasm.
Kevin’s about sarcasm, just like Com Prof is all sophistry.
Way to go Bill. Let's censor opposing opinions.
I believe that it is appropriate.
No its not....we live in a world were people think a man can become a woman. Insanity
Trust the same science thats telling us that women can have penis or men can have a vagina?
I'm surprised I didn't see a reference to it in the article...
Talk about specious comments.
Insert <snark></snark> from SML (Snark Markup Language).
Some of those responses don't even sound like they were generated by a medical school educated mind. I have had both good and bad experiences with both make and female doctors. There likely are some sex differences, but those have not been what made the salient difference in my personal experience.
When will medical school teach that a dismissal of a patient because standard tests can't diagnose opens a new universe of possibilities to explore? It seems this learned in practice not school.
Forget about male/female doctors, what count is good medical practice.
Good medical practice has been extinguished by a bureaucratic and technology-based system. It's a terrible loss.
Due to the ACA (Obamacare). In order for Obamacare to pass Congress, Obama had to get Congress to sign off. Therefore, lobbyists who pay congress had to sign off. Lobbyists who work for Big Pharma, Big Insurance & Big Hospital Chains.
Obamacare caused many bad things. 1) Much increased paperwork, bureaucracy, excessive clicking on computers that wastes time, less time spent with patients & more time spent on endless clicking 2) Hiring lots of administrators to do all this paperwork which increases health care costs 3) Private practices are forced to sell to Big Hospital Chain monopolies which increases costs, forces docs to see more patients in less time 4) Patient satisfaction scoring, which increases patient morbidity & mortality & opioid crisis
I have found that female doctors relate to women’s issues especially gynecological ones very differently than male doctors. Particularly when first making a diagnosis. Specialists are a whole different story but if you need to have a referral, you have to get past that first hurdle.
You mean like in good old days? When doctors had to use their heads and broad knowledge?
"Dismisal" of a patient is not an appropriate outcome.
But it is important to realize that most physicians regularly see lots of patients who say or think that they have some serious physical illness that they do not actually have.
A responsible physician has to consider non-obvious medical diagnoses, but psychosomatic illness, hypochondria, malingering and factitious disorders, and plain old idiopathic illness (medical speak for we don't know what's going on) are always on the list.
It's not about doctors seeing patients who think they are sick but aren't. It's about pervasive gender bias in healthcare research and medical practice. Google it. If you don't have the energy to do that, here's a couple of links: https://www.nejm.org/doi/full/10.1056/NEJMp2201180
https://www.cedars-sinai.edu/research/news/cedars-science/2019/examining-gender-bias-in-medical-care.html
I've done a lot more than Google it. Those links don't contain any useful information.
Doctors are wrong for a variety of reasons. "Pervasive gender bias against women" is not one of them.
I have high respect for medical profession and doctors ~ I come from two generations of doctors, my grandfather and both my parents were doctors. Granted they were “old type” doctors with different ethics. I could never imagine my mother saying “ it is all in your head” to a patient. She was an excellent diagnostician, and people seeked her advice when nobody else had an answer. She could really think “out of the box” and never relied as much on tests as they do now, but on her knowledge and research.
I don’t think male doctors are prejudiced. I hope not. However, this is what happened to me a few years go. Come to your own conclusion. I almost never have headaches. Until one day my head was throbbing, and a sharp pain in the side of my head returned every 30 seconds. I went to an urgent care. Two very thoughtful and attentive doctors talked to me and prescribed a strong painkiller. It didn’t do a thing. The next day I called my family doctor, and she recommended I go to an ER immediately. I went to a hospital a few blocks from me. I live in NYC, and it is a good teaching hospital. A very respectably-looking male attending doctor in his 50s with a flock of medical students around him told me that he did not believe me I had a severe headache because I looked good and because my pupils looked normal. I could not believe it. He also pointed to the medication they had given me in the urgent care and said I was lying that I had never had headache since I had the painkiller. When I showed him the date on the bottle, which was the day before, he shut up but did not apologize. I am sure he wanted to catch me in a lie. They gave me MRI, which did not show any abnormalities. Because I insisted I continued to have pain, they finally gave me an IV, and the pain went completely away. When my family doctor called in the evening to check on me, she said she thought I was having a stroke. I don’t know what this episode was, as I am sure ER doctors see all kind of walk-ins. But when I look back, I think “you look good and cannot have that much pain” was a chauvinistic remark and still feel insulted by it.
There are physiological S/S of pain. Tachycardia, Hypertension, vomiting and when you ask the pt what is there pain level they tell its a 10/10 while the text on their phone. So looking at a pt's behavior can help confirm pain or not.
Of course. I am not an idiot. Taking vitals is important as is asking simple questions. But they do not always paint the whole picture. Empathy and an ability to listen to the patient may help when the situation is not as straightforward as in a medical textbook. This is used to be at the heart of the medical profession. And that’s the whole point of this discussion. Do you think telling a patient you look good and your pupils are not enlarged so I do not believe you experience any pain is appropriate? And in front of a group of students. That’s what they will learn.
What you experienced is appalling medical malpractice. That this kind of thing is still a commonplace experience for women, and particularly women of color, makes me seethe.
For medical malpractice (or negligence) one has to satisfy 3 conditions:
1) there has to be an injury or bad outcome
2) the 'proximate cause' of such injury has to be something the practitioner did (or failed to do)
3) it must be proven that the practitioner deviated from the standard of care, defined as what a similar practitioner would do in the same circumstance and which is demonstrated to be the "standard of care" by commonly accepted practice or - even better - by consensus guidelines for managing that particular condition set by the standard-setting organization for that medical specialty.
In the above case as told by Just an observer, these definitions were not met, ergo no "appalling medical malpractice." Just because someone was not treated empathetically, or the interaction felt rude or disrespectful or the patient felt their medical symptom(s) were not taken seriously, does not constitute malpractice.
I had a good female neurology resident. Her organization quit taking my insurance, so I got an experienced male neurologist, who kept me on steroids too long, resulting in neuropathy in both legs that adversely affected my gait. I know I can't generalize from this experience, but I certainly would never hesitate to see a woman physician.
True that. I saw a female NP in the instacare for symptoms of a UTI (blood, burning, etc). She had all my history with cancer treatment. Tests came back negative and she legit sighed like I was making shit up. Told me that possibly I didn’t know what a UTI felt like (I do!). Went to my male radiologist the next day for a follow up and he immediately realized I was probably having inflammation from my cancer treatment and expressed his frustration that she hadn’t prescribed me the pain meds for UTI since they would still help. He prescribed them and told me to just let him know if I needed more. Sure enough, symptoms ended when treatment ended. Some medical professionals are really good at thinking outside the box, some seem very intent on moving bodies through their schedules and if your tests are negative their brains shut down.
The NPs I work with are great & always ask us docs for help w/ anything complicated (outside of pt's earshot).
BUT: There is the right time/place for NPs. NPs have far less knowledge/experience (500 hrs clinical training vs >20,000). This often leads to patient deaths.
https://www.newsnationnow.com/investigation/transparencyinhealthcare/
If you have a straightforward medical problem, then by all means, NP is fine. However, if you have an emergency, in the ER, request a physician in the ED. If you have something somewhat complicated, see a physician.
If you have something very complicated, do not see a private practice doc or NP. You need to go to an Academic Medical Center with a teaching program (residency or fellowship). They will spend a lot of time with you, they are not financially incentivized at all & they will get to the bottom of what is going on. They will figure it out & they will help you.
Yep, learned my lesson there. I have other NPs and PAs that I love but they only work during the weeks so any weekend need is always a toss up. I agree that an academic medical center is the best, that is where are my cancer drs are and my oncologist did more to research my possible treatment than the MD Anderson dr I saw. But that is probably due to ego associated with working at a top medical center than anything else 🤷♀️.
Dr. Martin, thank you for your comment. I am forwarding the article to a friend who is currently beginning his second year in medical school and intends to focus on family medicine with an interest in serving in more rural areas. He has already discovered the value of “listening” as an essential component of building trust between physician and patient where this trust is absolutely required in order to elicit from the patient a full and accurate understanding of not only their physical state but the environment in which they are living and in which any plan for “healing” must take place. I personally want to support him in his efforts to develop his appreciation for and perseverance in developing a similar skill along with solid medical knowledge and experience. Your words of wisdom reinforce this.
As an old timey doctor I couldn't agree more.
Your disagreeing doesn't make it untrue. Most pharmaceutical tests are still only done on men as default. The drugs are then released to the market as safe without ever being tested on women.
And don't even get me started on the massive gaslighting when women reported the Covid vaccine was impacting their periods. The Science (TM) told them the were imagining things. Move along.
The propaganda goal of having a COVID vaccine that objectively neither prevented infection or reduced the frequency of infection was more important than the truth.
That does not apply to endometriosis. Sounds like a lot of incompetence, in this case.
Medical incompetence should not be underrated. I visited several urologists about having a 25yo vasectomy reversed. Several told me that extracting viable sperm without reversing the whole thing was impossible. Then I saw a competent specialist (a woman) who promptly did what was deemed impossible by a bunch of men.
> Most pharmaceutical tests are still only done on men as default. The drugs are then released to the market as safe without ever being tested on women.
I'm going to have to call you out on that one...
https://www.fda.gov/regulatory-information/search-fda-guidance-documents/evaluation-gender-differences-clinical-investigations
https://www.fda.gov/science-research/womens-health-research/fda-research-policy-and-workshops-women-clinical-trials
https://www.fda.gov/science-research/womens-health-research/understanding-sex-differences-fda
https://www.fda.gov/about-fda/office-commissioner/office-womens-health
https://www.fda.gov/media/75648/download
Your links are to the FDA guidelines. They're not evidence the pharmaceutical companies and medical industry are actually following them. And after everything we've been reading here, you want me to believe everything the FDA says???? Seriously???
It's 2023. More women than men graduate with medical degrees (https://www.aamc.org/data-reports/workforce/data/figure-12-percentage-us-medical-school-graduates-sex-academic-years-1980-1981-through-2018-2019) The board of directors of Johnson & Johnson is 5/11 women (https://www.jnj.com/leadership/our-leadership-team). DEI is at an all-time high and is a *major* part of clinical trials at every level, from university to corporate. Medical malpractice and drug recalls are extraordinarily expensive. To imagine that "drugs are then released to the market as safe without ever being tested on women" happens today is ludicrous. This sounds like something that might have been true 75 years ago, but we've moved way beyond that.
If you have any sources to share, please do so -- if there are still studies being done on pharmaceuticals with such extremely biased test groups, that's a massive cause for concern.
We have not moved "way beyond that". Medicine has had centuries to establish biases against women. That doesn't get erased in a couple of generations, and it doesn't get erased because the government puts out some guidelines and recommendations and commitments.
That’s just not true Terence. 85% of gynaecologists are not women and pharmaceutical companies did not deem women important enough to use them for research. The only thing that works is to be your own advocate. Much easier to do in Canada because of our healthcare system, which allows us to see multiple doctors. Still, in the end women have to campaign on behalf of ourselves to get concrete answers
That statistic is from the article, with a link to back up the claim.
Aw, diagnosis is so hard, even women can't do it. I call BS. The structure of medicine is still strongly male-dominated, and research dollars go to what will be profitable. If men paid as much attention to the complexities of women's reproductive issues as they pay to the production of erections, we'd have solved endometriosis by now. And that is the definition of gender bias.
Perfect response 👏
It's the system and the insurers. Doctors won't perform what insurers won't reimburse them for. So even if 85% of OBGYNs are women, who makes the decisions at the insurer level on what treatments will be paid for?
https://www.zippia.com/ob-gyn-jobs/demographics/#
You are right, Terrence. 85.4% are women.
“If men ever suffered from endometriosis, a cure would have been found decades ago”
——————————————————-
Reading this baseless and nonsensical conspiracy theory you have presented caused me some pain that I imagine is comparable to endometriosis.
I dunno, Kevin. I’ve read a lot about medical history. I give a lot of credit and gratitude to the men of the Victorian era and early 20th century for their truly world-changing discoveries...but the field was ruled by and exclusive to men. Since most of us have some degree of gender bias, it is not illogical to conclude that it had its effects on these men as well. Clinicians aren’t always as clinical as they should be. It’s not even confined to the field of gynecology; studies have indicated that heart disease is often missed or misdiagnosed in women because they present with atypical symptoms vis-à-vis the guidelines--which were created based on presentation in men. Thus it’s not wildly implausible to think that if women had had a larger role in the development of the modern medical model, women’s health issues might not have so often been diagnosed and dismissed as hysteria.
And I am dismissing your argument because you seem hysterical.
😂😂🙏🙏
Lol!
I initially agreed with your premise that women are more likely to go to the doctor when something is wrong, but reassessed. Anecdotally, I have to be dragged kicking and screaming to the doctor’s office. My husband OTOH is super diligent about check-ups and is much more likely to see his doctor for a simple complaint. And generally, I would think that young moms, who are harried with jobs and child care and ferrying kids to after-school lessons and practices, may be less likely to go to the doctor simply due to lack of time.
I am not dismissive of anecdotes but in this case I think your situation is non-standard.
I’m pretty sure that, for evolutionary reasons, women are less sensitive to pain, which points in the direction of your argument. Also, men certainly get injured more but that’s not really relevant. It makes sense to me that women on average are more cautious and conscientious about health issues but maybe I’m wrong there. But there’s certainly plenty of money and prestige available in the women’s health sphere. Also there’s the thing about how companies charge more for women’s stuff which is an incentive maybe?
But I agree that women should focus more on cooking and cleaning instead of coming up with schemes where they get to meet handsome doctors.
😂😂🙏🙏
(sorry once I get going with the misogyny jokes it’s hard to stop)
All excellent points, including the desire to meet handsome doctors. 😉 I haven’t seen any studies on whether women are more likely to visit the doctor’s office than men, but now I’m intrigued.
(And I know we are atypical, as evidenced by the day that I was out in the garage, drinking beer and smoking cigarettes with the plumber, while the hubs was in the kitchen rolling out dough for homemade ravioli. 🤣)
I would maybe agree with you if there wasn’t a substantial rewards system in place that handsomely compensates medical advances regardless of the gender you are solving the problem for. And I believe women are more likely to seek medical attention (because guys are stubborn and irresponsible and stuff) so you actually probably get rewarded more for addressing/solving women’s medical issues, both financially and in terms of prestige.
Which aspect are you referring to?
I think a lot about our medical model. It’s so advanced and yet so broken. I don’t think socialized medicine is necessarily the answer, but the more advanced the technology becomes, the more expensive the care.
I know a doctor who has MS but manages it with lifestyle and is symptom-free. She lectures in medical schools about the importance of educating patients to exercise choice to avoid preventable diseases. We need a lot more of that, in my humble lay person’s opinion.
I think you nailed it. I also think this has lead to the state of modern medicine in the US - medical decisions determined by algorithm.
How do they manage their MS? I've a frienemy who has this and I'd like to still be scrapping with them in thirty years time.
She manages it with a whole-food plant-based diet, good sleep hygiene and exercise. Look up Saray Stancic. She’s not running her wellness practice anymore, but her story is out there. She also made a documentary called Code Blue about the need to address wellness and disease prevention in medical education.
Part of the trouble here is that if a doctor tells a patient to live a healthy lifestyle and does not order a bunch of expensive tests or prescribe a controlled substance, many patients will complain that they are being ignored.
You are probably up your own arse on this: the pattern of behaviour goes back to Galen and before. It might have magnified and exacerbated the problem; but it goes back to when you could, with justice, argue there was a patriarchy.
Joe Biden has healed our nation’s soul and united our allies and he has cured most diseases and he has empathy and he returned the classified documents and is cooperating unlike Trump.
Don't bother with logic or facts with this guy: he's immune.
Relying to myself - woren’s health complaints are ignored and dismissed all the time. Undervalued was probably not the correct word.
Agree. The men above are way off base here. And, even ignorant. Women are very often misdiagnosed and dismissed as emotional about health issues. It’s a statistical fact in the overall misdiagnosis of 40000-80000 people a year.
“Women are more likely to wait longer for a health diagnosis and to be told it’s ‘all in their heads’. That can be lethal: diagnostic errors cause 40,000-80,000 deaths in the US alone.”
https://www.bbc.com/future/article/20180523-how-gender-bias-affects-your-healthcare
Heart attack is the number one killer of women but often dismissed at the crucial beginning stages of heart disease because of psychology and emotion and the intricacies of women’s bodies (as the child bearers of all humanity) in those diagnoses.
It's ridiculous that men are telling women they aren't experiencing bias in healthcare. How the hell would they know???
How the hell would we women know? Personally, I only know what it is like to be treated as a woman. I don't have personal experience being treated as a man. I can observe stories men tell me, but then, men can also observe stories women tell them. The notion that men can or can't tell whether women are experiencing bias is as reasonable or absurd as the notion that women can or can't tell that men are similarly treated. Though I do believe that doctors are less likely to take women's pain seriously, because men tend to be more reluctant to go to the doctor, so when they go, there is more likely something wrong with them. But, that said, I find it weird that people would expect doctors to be able to help them most of the time. Because they don't.
Thank you for putting it so well. The lack of critical thinking on this point is frustrating. Bias can’t be determined from personal experience. This issue was addressed humorously in a Curb Your Enthusiasm episode, where Larry David feels slighted by a waitress and determines that it’s because he’s bald. To him that’s how it seems. Not necessarily true though.
The difference is that the women here aren't telling the men they are wrong about their own experiences as men, but some of the men are doing just that to the women that are describing their own experiences. I think area of agreement is that the system sucks for all.
I am a female doctor. I can’t countenance your attitude towards my male colleagues - mostly intelligent, conscientious and honest. Female doctors do not have a monopoly over these qualities.
Hi Vivien,
I seem to recall that you "liked" my May 8 comment on Stanley Goldfarb's The Free Press article "How America's Obsession with DEI Is Sabotaging Our Medical Schools". In my comment I tried to analyze DEI ideology by conjuring up my inner (fake) "Woke" persona to see what it had to say.
Anyway, I was curious what it was about my post that inspired you to give it a like (yours is the only like I got for it). Since this is a bit off-topic, if you choose to reply perhaps you might do so to the original article at "https://www.thefp.com/p/how-americas-obsession-with-dei-is".
Some things men, without direct experience, should observe- contemplate - and then speak. Some of the usual commenters here- and I enjoy many of them- are quite defensive and demonstrating they are not listening and are as entrenched in their mindsets as those they oppose.
As a man, I probably shouldn't weigh in, but ... A large part of the problem in diagnosing women's heart attacks is that the symptoms are different between the sexes. A similar situation exists in men's breast cancers.
And while it is well-established that there HAS been gender bias, that is gradually shifting/changing as more and more women are becoming doctors. When you consider that our institutions of higher education are 60/40 women to men, and the rate of older doctors (mostly men) leaving the profession is spiking, we will have a preponderance of female doctors in the not-too-distant future. Yes, there will still be some male doctor/female patient bias but now we'll also have significant female doctor/male patient bias to "balance" it.
Let's face it - doctors are human. Like all people, some good, some bad; some caring and some just in it for the money. As best I can tell, neither sex has a monopoly on either type.
I think eventually things will become more equal...equally bad.
They said, "Cheer up! It could be worse." I cheered up and - sure enough - it got worse.
Of course you should weigh in, and of course, we do agree, but the reality of the now- and of the past- is that it is clear that many women face this issue, and it is life threatening and life altering, that it shouldn't have taken this woman that long to be diagnosed and treated because of the reality of the now by all those close to her and the medical profession.
I think we're in violent agreement.
Interesting term "violent agreement". Possibly another legacy issue.
You are man'splaining son; cut it out.
So no one can add their thoughts without your castigation? Cut it out.
Thank you for being a very clear and obvious example of dismissive and condescension. Are you a doctor?
Women have a 5-6 year life expectancy over men. I have no doubt that there is bias in healthcare but I highly doubt it is as simplistic as “doctors only care about men”. The majority of PhDs and MDs in science and medicine go to women these days and it is very unlikely this hasn’t decreased the bias. I highly doubt women doctors and PhDs leave school and then suddenly assume women are usually “hysterical” when they come in for treatment. There are certainly structural issues in healthcare and western society in general but it presents negatively in both genders in ways not always seen.
For instance, Men are less likely to go to the doctor until something is seriously wrong. They also overwhelmingly perform the most dangerous jobs and experience the most stress induced suicides. I already previously mentioned the longevity disparity and that is truly an advantage that even money can’t buy.
Lastly, Endometriosis is also a disease that is very hard to diagnose. I’ll bet men and women suffering from similar maladies (such as MS) experience similar journeys to get a proper diagnosis. I just don’t think it’s at all accurate or constructive to read this and lazily assume it’s caused by the “patriarchy” rather than really searching for ways to make things better while being willing to accept answers or solutions that contrast with your own preferred narrative.
No one is implying anything about patriarchy. We are merely asking you to look at some facts so that changes could be made. The article very clearly demonstrates that women are dismissed- dismissed- much of the time at first blush as being emotional about their health concerns, as did her own parents.
That is real and is most likely a legacy issue in medicine overall. Endometriosis has been around a very, very long time- my best friend suffered with it and was diagnosed in 1979- but it is also still continually missed, along with heart and stroke diagnoses. Women's bodies are more complex, yes, but the perspective and lens all doctors use to diagnose must continually improve.
There have been implications, for example - if men suffered from endometriosis there’d be a cure by now.
You yourself state that “men are way off base” and “ignorant” indicating this is a gender bias issue and there could be no other explanations. I’m fact, you chastise men for having an opinion that differs from you and state that they just need to listen because they can’t possibly understand how women are treated. This ignorant if not disingenuous. If men can’t understand what women experience then women can’t know what men experience and then we should even talk at all. I believe people can put themselves in other people’s shoes and think it’s a necessary starting point to having discussions that improve things. Additionally, I think many women would be surprised by men experiencing similar treatment they believed was unique to women.
Lastly, I believe we need to be careful in believing that your experience or that of a close friend or relative is what everyone of that same race, gender, religion etc receives. I have personally been dismissed about medical issues by both male and female doctors and have had those same issues correctly diagnosed by doctors of both genders. My mother was dismissed out of hand by her female doctor and it was a make doctor who then listened to her and found the cause of a chronic problem.
There is no doubt we can do better for diagnosing and treating primarily female health issues. However, I think a significant portion of the disparities can be blamed on 1) doctors being imperfect (insurance coverage incentives to see as many patients as possible, arrogance, time constraints, etc ) and needing better diagnostic tools, protocols and training in general. Abigail’s experience is heart wrenching but if you think there are thousands of uncounted men with undiagnosed medical issues causing them exhaustion, pain and low quality of life then you need to expand your willingness to accept differing ideas. Most men just suffer through those issues without ever going for treatment. This is not to minimize women’s medical issues but rather to preach caution about lazily assigning blame for a complex issue around a poorly understood disease.
Try this for bias. I have pelvic congestion syndrome which is essentially varicose veins in the pelvis. It's very painful. It's treated with a relatively minor surgery by an Interventional Radiologist. There is a lot of data to support the surgery's effectiveness. Men can have the same problem, but it's called a varicocele. It's very painful. It's treated with the exact same surgery. My insurance (UHC), won't cover the surgery for my condition but it's covered for men. Their reasoning is that it's "experimental" for women, but not for men for the exact same problem.
My insurance will however cover me taking GnRH agonists (aka puberty blockers) because they have shown a modest reduction in pain. The side effects listed are rather horrendous so it's only offered as a short term solution, but apparently they are fine for kids with healthy bodies experiencing Gender Dysphoria.
"doctors being imperfect (insurance coverage incentives to see as many patients as possible"
I actually like seeing fewer patients & spending more time with them. Many docs do.
But thanks to Obamacare (ACA), private practices were forced to sell off to Big Hospital Chain monopolies & so now most docs are Employed by Hospitals. Also thanks to Obama, there are more & more Bureaucrats in Hospital Chains who tell doctors what to do. They dictate that we see more & more patients. They cut doctors salaries to enrich themselves & pay more to Administrators. They simply won't allow you to spend more time with patients. They treat us as assembly line machines.
Reread me. I didn’t imply any of those things. You read into them all in your perspective. You’re off base because that tunnel vision.
My SIL was diagnosed with endometriosis in the early 80’s after being married for 10 years and no pregnancy despite constant trying. According to the Mayo Clinic, a lot of women with this condition have no symptoms and are discovered when they come in with fertility problems. She had the excision surgery, which cured the endometriosis, but still couldn’t get pregnant, so they did IVF, but that didn’t work either. Ultimately they just reconciled themselves to being childless. Her husband didn’t want to adopt. He didn’t want a child that “wasn’t really his”.
Same for my friend.
Women do not have more complex bodies than men.
I don't think it is about the patriarchy. It's more about the understanding that women are biologically different than men so studies on men do not always translate to women in terms of outcomes. Traditionally no one (public or private) wanted to do studies on women because they would have to account for their monthly cycles and hormone fluctuations.
You are man'splaining and dripping condescension; cut it out.
If that were true, wouldn’t there be a cure for prostate cancer? And the author specifically states that the majority of gynecologists are women. I also suffered from endometriosis for 30 years before I had surgery. There is no diagnostic tool other than surgery.
This is a nasty condition and I am glad the author received care as a young woman.
They were too busy focusing on ED and how to make sure Viagra was covered by insurance to address prostate cancer. I kid I kid…only a little.
Similar to how birth control is free. Such hyperbolic statements undermine your argument. Endometriosis is awful. After surgery, it comes back unless you agree to medical menopause. But it is not easily diagnosable. It took my female GYN years before she determined surgery was appropriate. This is not a female v. Male issue.
But the little pink pill is not. And birth control has only been free since Obama. Before that we all paid for it monthly. I happen to disagree with you, it absolutely is a gender issue, but just as I’m sure you’re not changing my mind, I don’t think I will change yours.
As a woman in my 70s, I’ve never felt that my health was undervalued.
Whether my doctor was male or female, and I have had the good fortune of having both male and female doctors who have really appreciated my health and helped me.
You’re very fortunate. That hasn’t been my experience over the years particularly with reproductive and menopausal health. My mother has been brushed off as well as my daughter. We should all be as lucky as you and I’m saying that sincerely.
I wonder what makes me lucky?
Is it luck or is it because I have walked away from any doctor who I decided was bullshitting me?
Is it luck if I have carefully researched and chosen the doctors who I have worked with over the years?
I have been willing to pay extra for second opinions.
I have had had high expectations.
I am definitely lucky that I do not live in Canada.
The author's attempt at claiming "sexism" is self-beclowning. Her issue was not understood to be related to being female until it was diagnosed, which in her telling is when the "sexism" ended.
Meanwhile, she wraps herself in the cloak of "being female" when telling her story (instead of telling it honestly as a more general tale of doctors being skeptical of hard-to-diagnose symptoms) precisely because she understands that society is actually very sexist in women's favor, and so framing her story this way gets her more attention.
Wraps herself in the “cloak of being female “ are you joking? Let me explain this: every single month a woman with endometriosis suffers excruciating pain that can literally have you pass out on your front lawn from the pain. Every month. Do you believe if women had been writing medical journals they would have come up with the word “hysterectomy? Even that is patronizing. Like we are just so hysterical that we can’t stand a little pain. You have blood flowing through your rectum every month, no where no escape, building up with more blood every month, forming masses of endometrial tissue that pulsate with pain every month because the blood cannot flow out.
I don't get the sense the author claims sexism. Some commentators here have done so. But I don't see this some "gender wars" piece; simply telling her own story, and the specific issues she went through with this disease, which is easily misdiagnosed and only applies to women.
My snarky response is that from what I keep hearing there are no real differences between men and women. Its a social construct.
75% of RN, NP, PA, and MDs are female! Its not true that "womens health is so undervalued". Women account for roughly 82% of NP, 95% of RN, and mid to low 70% for PA. Women Docs make up 54% of total MD.
Additionally, to tell women the medicine "undervalues" is a self fulfilling prophecy.
Your point? Are you a woman? If not then move along. If you are and haven’t experienced any issues with doctors not taking your health concerns or pain seriously, then you’re lucky but your experience is not the norm.
Total nonsense
Why does a solution depend on men? The author points out that most OB/GYN specialists are women.
I would suggest that medical studies fail to include women because most people, including prospective subjects, are almost as leery of experimenting on women as they are about experimenting on children.
What a dumb comment.
If men suffered from endometriosis, it would never have been researched, would never be present in any medical textbook, the men who had it would receive no treatment and would be laughed out of the ER if they came in asking to be treated for their mysterious pain, and anyone who claimed it was real would be excluded from polite society.
THANK YOU, thank you thank you!!! for shedding light on this horrible disease! I didn’t even need to read past the first few paragraphs to know you were talking about endometriosis.
I have endo and it went undiagnosed for 15 years. My symptoms manifested in so many ways - but my worst symptom of all has been infertility.
I always knew endometriosis was a potential reason for my infertility struggle. An obgyn in my teens once mentioned it to me after I came in for a visit after passing out in the shower from my period pain. She told me you only get diagnosed with it if you are struggling to get pregnant, but you’ll only officially get diagnosed after you have surgery to see if you even have it. (It never dawned on me that it would be the reason behind so many of my other health issues.)
I spent tens of thousands of dollars over the years on failed fertility treatments after doctors I saw were adamant that IVF was a workaround for endo. They told me excision surgery to remove lesions was likely not worth it and they may not even find anything when they’re in there. They could not have been more wrong.
After my third miscarriage and failed embryo transfer, the IVF doctor suggest another round with a new protocol and I told them I was done throwing good money after bad and called Dr. Seckin (founder of the endometriosis foundation) and scheduled an appointment for surgery consultation. I was under the knife 6 weeks later and they found over 50 lesions of deep infiltrating endo everywhere, also on my appendix, bowels, bladder - all over. I have never been more relieved to be diagnosed with a disease.
I immediately felt better after my recovery, as if I had been given a new body. I didn’t even need Tylenol during my periods. But best of all, 10 months after surgery I naturally conceived my daughter, who turns 1 next month. She is truly a miracle and my biggest blessing in life, and I know I would not have been able to have her if I hadn’t took matters into my own hands and elected to have excision surgery.
It is appalling to me that in an era where we are so concerned about women’s reproductive rights, doctors are SO uneducated about this disease and how it manifests. I’m hopeful in my lifetime we will have more answers and a better treatment for women who are suffering.
MK, thank you for sharing your story and I appreciate your last paragraph. “It is appalling to me that in an era where we are so concerned about women’s reproductive rights, doctors are SO uneducated about this disease and how it manifests.”
I am wondering if where we live impacts healthcare options and outcomes? Are there better doctors in cities?
Are women better served with women doctors with women issues?
It seems exploratory surgery is the efficient way to confirm or eliminate an endometrial diagnosis.
My internal medicine doctor’s mantra is “the devil is in the details”.
Abigail, thank you for sharing your story and ultimate resolution for your pain and suffering.
Going forward, medical care has to provide better care and diagnosis options.
I wonder. I lived in New York City for 10 years and at the time I worked for large companies with good insurance. I would say my healthcare options were probably some of the best available to us in this country. My surgeon Dr Seckin (male) and Dr Goldstein (female) are some of the best at what they do. It is not lost on me how fortunate I was to be able to have that access to care.
On the flip side, I also was a patient at one of “the best” fertility clinics in New York City and my not-yet-officially-diagnosed disease was largely dismissed as not a real issue. All I needed was excision surgery, not more IVF and hormones like the reproductive endocrinologists suggested. They saw dollar signs and a 30 year old newlywed desperate to be a mother.
And yes, at this point exploratory surgery is the only true way to diagnose endometriosis. A scary prospect for a teenage girl who’s only had a few years of “painful cramps” to electively go under the knife. My biggest fear was “what if they don’t find anything, then what?” It turns out my ibs, anxiety, exhaustion etc was all endo related, but only developed in the years after I started my period. Hindsight is 20/20.
I hope with more awareness and funding we might find ways to diagnose in a less invasive way, and earlier. And a treatment (other than birth control!) and excision surgery would be considered a huge victory over the disease.
I was a married lawyer in my 30’s in New Orleans during the 80’s and had multiple miscarriages, which is an emotionally devastating experience. I went to the “famous fertility doctor” there at the time (all the other female lawyers and professionals who had fertility problems went to him, including one of my law partners) and that man messed me up so bad that I stopped having periods. When my husband got transferred and we moved to a smaller town, I went to a plain old OBGYN (male) and he took me off all the meds the other guy had prescribed, told me to not get pregnant for 6 months to clear out my system, and then start over. Long story short, turns out my problem was not producing enough progesterone during the pregnancy and when it fell off the charts, I would start bleeding and eventually miscarry. The small town OBGYN simply put me on progesterone pills for the majority of my pregnancy and I went on to have a healthy full term baby girl. She turned 37 on August 8th, and I love her to pieces.
A beautiful ending! I am glad you found a doctor who listened and truly helped you. I guess it doesn’t matter where you are, you just need to be lucky enough to find a good one who cares.
Yes! It also helps to have a doctor who, when your body is doing things the “books” say it can’t do, the doctor puts the books back on the shelf and treats YOUR body. In my case, the new doctor suspected a progesterone problem, so I went in for weekly blood tests of my progesterone levels. When they dropped he gave me a one week prescription and then next week, repeat. After 16 weeks the placenta is supposed to take over and make the progesterone and keep it elevated to stop bleeding and maintain the pregnancy. Mine just kept disappearing way past 16 weeks (which is about when my miscarriages had happened). What the doctor told me was, and I quote, “All the books on that shelf (in his office) say that after 16 weeks this cannot happen, and yet here you are facing me and it is happening. Therefore, we are going to to treat you and your body, which is not following the rules. I always treat the patient in my office, not the one in the book.”
Dr. Fred Lind - RIP
That’s amazing and so incredibly lucky you were able to connect with a doctor like that. If only that were more common! I had to fight to be taken seriously during my fertility journey (as I’m sure you can understand from your struggle). Each IVF appointment felt like I was part of a flock of sheep being herded from room to room. Ultrasound. Bloodwork. More bloodwork. Another ultrasound. Follow drug protocol by the book. Rinse, Repeat... No thinking outside the box. Truly sad.
Wow that’s amazing. Congrats on the little one
Thank you!
Thank God for your miracle baby! Such a blessing!
If you are able, God-willing, to conceive a second child in the next year or two, it would also be beneficial in terms of endometriosis. Pregnancy and breast-feeding are very helpful, because you don't have periods, so the endometriosis does not progress. It is also a good idea, so there will be fewer chances of having secondary infertility.
Yes that’s the intent! I have never felt better than during the 9 months I was pregnant (well minus being 9 months pregnant in august in the south 🫠) The endo will come back, but I have said it over and over that I would gladly walk into that OR to have that surgery every time if it meant having my daughter here (or future children)
Can you hear the cheering from here? Congratulations on your daughter, and enjoy her first birthday!
Thank you Mark!! We will for sure. Every milestone feels exceptionally joyous given what we went through to have her.
Thank you for sharing, your story follows up on mine.
I really appreciate you sharing your story. Several emotions rushed back to me as I remembered some similar experiences that I also went through. It saddens me to think that many doctors still have little knowledge about this disorder and many more women continue to go undiagnosed. It is even worse that this is a cause for infertility that could possibly be prevented if women were diagnosed sooner. I hope that many others read your story and gather knowledge to help them make the best decisions on their health care journey.
I feel everyone’s pain. I was going to college in the 70’s and was taking a course in public health and the topic of infertility came up tied to endometriosis. I thought to myself, this will be me in the future. I had very painful periods (not many pain killers in the late 60’s) and suffered every period. I started experiencing cysts that ruptured (talk about pain!). Had surgery to remove a large cyst in my late 20’s, that is when they discovered bad case of endometriosis. The doctor prescribed birth control pills, continue to take without a period for a couple of years then stopped when I was trying to get pregnant. Another procedure (cyst again), and put on Lupron (hormone blocker) for 3months. Got pregnant after the end of the third month! Had another son 2years later. Thank the Lord! However symptoms started again and started birth control pills up until I reached 60! Thank God for menopause! Symptom Free!!
You do understand that the hoopla over "reproductive rights" is code for abortion, right? I think your story, Abigail's and the countless others pretty conclusively establish that.
Yes, I do. I wish there was more hoopla over endometriosis. Maybe we’d come closer to finding better treatment for the 10% of women who suffer through it 🙂
Let me ask, Lynne, what healthcare other than abortion that Planned Parenthood puts on the table?
It's not a gotcha question. It is a question that I, as a male, am unable adequately to answer. Doesn't the mania around that organization become a major factor in the misinformation to which the general public is treated?
I am stunned that, here, thirteen months, after the Dobbs decision was released hat more states haven't acted to clear abortion into statute law. I find that inexplicable.
Could you help me out, here?
According to their website (Planned Parenthood Gulf Coast), they offer the following services:
Abortion, Annual wellness visit, Birth Control, Breast cancer screening, Cervical cancer screening, HIV and Rapid HIV testing, HPV testing and vaccine, Morning After pill, Pregnancy options counseling, pregnancy testing, PrEP/nPEP (HIV prevention), Primary care, STI testing, Trans care (hormones), Urinary tract infection treatment, and Vasectomy (so LK, they can treat you too 😉)
Thanks for the reassurance, Ann.
I'll go with what a friend of mine said after the twin-engine airplane that he was piloting smacked into a house when both engines failed on take-off. He woke up in the ER just as he was being prepped to have his second leg amputated. "No, that's mine" he said.
I understand where he was coming from, and I generally think it is wise medical treatment to keep what you have as long as you can have it.
I haven't been to PP in many years, but through my 20's, I and many friends who didn't have health insurance used it for normal well woman exams, birth control, and emergency treatment for even bladder infections and such. Years ago you couldn't get treatment for a yeast infection OTC which is ridiculous, so people went to PP to get an affordable RX.
It's really sad that all the attention is put on the abortion provision when in fact, they're the only women's health care that a lot of poor women have.
Well Ann and Jane have weighed in on the what else part of your question. As for why some states have not cleared abortion into statutory law that is simple - those states represent their citizenry who do not believe abortion is justified. Personally I find that refreshing. You do understand that Congress could enact such legislation, right Of course that would mean doing their job and debating meaningful legislation so it is not likely to happen. The Supreme Court did not say abortion could never be lawful nor did it say it was an issue relegated to the states. It just said Roe was improperly decided. I agree with that opinion and commend those brave justices as it is a legislative matter, whether state or federal.
Thanks for the non-reactive answers...I think what my preamble suggests is that little is said by disinterested third parties as to what Planned Parenthood actually does, and that lack of untainted information drives discussions into worm holes from with little useful emerges. Your remarks seem to validate my impression.
I will address your thoughts on Dobbs sometime over the weekend. I agree on some levels and urge your reconsideration on others. It is the others that I will address in another posting. I need to reread the opinions first so that I am sure of my ground.
Thank you, Anne and Lyne, for your measured responses instead of the immediate turn to the emotional backmail screes that usually attend this topic.
I rarely find myself on the fence but I do on this issue so you should not read anything about how I feel about abortion into my comment. I really was addressing the methodology of using "reproductive rights" instead of saying what is really meant - abortion. The two are hardly synonymous, although one is a subcategory of the other. As for the larger issue, personally I do think there might be an argument to be made for a privacy claim under the penumbra clause but I do not think Roe did that. Roe was, IMO (and that of the Dobbs court), a judicial usurpation of legislative authority. Frankly I begin to think the worst problem the nation faces is a Congress that fails and refuses to do its job on any matter of significance.
No. I was not reading anything about your position on abortion. I was indicting my appreciation of your the discussion from the side of a reasoned opinion as opposed to an emotional one.
Let me give you a heads-up regarding my reply to you: The Ninth and Tenth Amendments which were very much a part of Alito's opinion. They move the topic into constitutional areas that are frequently bypassed due to the emotional hard points.
It's not only women who are dismissed by the medical profession. If a man doesn't fit the drs. definition of what is wrong, they too are dismissed. Take this drug and if you still have a problem come back. Having undergone 2 botched surgeries, I will never trust another dr. In my 84 yrs. I've met only 1 Dr. who knew what he was doing, a dermatologist, the rest were guessing.
In my many years as a Disability Benefits attorney, I witnessed a stunning number of undiagnosed and misdiagnosed patients—men and women, and by male and female doctors. Well-intentioned or not, it became clear that too many doctors were unwilling or unable to take the time and effort to carefully listen to and evaluate their patients’ signs and symptoms, and they would dismiss, in varying degrees of concern (or lack thereof), the seriousness of the problem presented to them. Diseases such as MS and lupus—and yes, endometriosis—frequently would take years to be properly diagnosed and treated. And then to further slap my clients in the face, some Social Security Administration Administrative Law Judges hearing these clients’ cases would decide that, ok, “yes you deserve disability benefits, but only as of when the diagnosis (of whatever) was made”—even though the medical records corroborated my clients’ testimony that he/she was having severe symptoms and functional limitations, impairing the ability to sustain work, for years prior thereto. This resulted in the tragic and unjust loss to these clients of thousands of desperately-needed dollars and the unwarranted delay of Medicare insurance.
The so-called "invisible diseases" are extremely difficult to get taken seriously. I was finally diagnosed with fibromyalgia in 2004, but I had been having weird and inexplicable (and therefore scary) symptoms for several years before that. The depressing thing is that I could have been diagnosed back in grad school, when the student clinic doctor ruled out several other diseases with lab tests and mumbled vaguely about the possibility of fibromyalgia...but didn't refer me to a rheumatologist.
True that. Your frustrating experience has been repeated innumerable times, predominantly by women. Fibromyalgia is still considered by many doctors—and some judges— to be a “wastebasket” diagnosis, not to be taken seriously as an “organic” problem. Granted, like many syndromes, there are still no verifiably “objective” tests for the diagnosis, but an experienced, attentive practitioner—usually a rheumatologist, but sometimes an informed PCP— can make a medically sound diagnosis based on signs and symptoms. This then reassures the patient that the pain, fatigue, etc. is not “all in your head,” and thus begin a treatment management program.
Unfortunately, since they aren't sure yet what causes fibro, treatment is basically "throw stuff at the wall until something sticks."
Personally, I discovered something that helped completely by accident. I had already been taking Lexapro for depression before my fibro diagnosis. But it tended to make me sleepy. I had read that Wellbutrin could counteract that, AND that the Lexapro+Wellbutrin combination was better overall. So I requested to try it.
It did mitigate the sleepiness. But the unexpected thing it did was mitigate the fibro pain! And I got an unexpected confirmation of that when my doctor accidentally sent in a mail order prescription for the XL instead of the SR formulation: fibro flattened me again on XL, and was relieved when I went back on SR.
I agree that, as with many other “syndromes,” we are stuck with the trial-and-error approach. FM, because—as you noted—the etiology remains unclear, and also because there is such a broad and varied constellation of symptoms reported by patients, often similar to symptoms characteristic of other syndromes and diseases; e.g., degenerative disc disease, will continue to be a problem in which the patient’s self-help is particularly critical.
Years ago I found some terrific books for FM sufferers: “The Fibromyalgia Advocate” by Devin Starlanyl, MD; and “The Fibromyalgia Survivor” by Mark Pellegrino, MD. These are now pretty old, and I know Pellegrino and others have written more recently.
Good for you for finding medications, even if accidentally, which have given you some relief.
There are a few common characteristics seen in most people with fibromyalgia:
- inexplicable pain, generally near but not IN the joints
- intestinal issues resembling IBS
- "fibro fog" (decrease in ability to focus and think clearly)
- lack of energy, even with plenty of sleep
- atypical responses to medications
Some list insomnia, but since that is often a product of unrelieved pain, I don't.
There are many theories (some of them pretty out there!), but the current theory that seems most reasonable to me is a semi-latent viral infection of the vagus nerve.
I'm glad you finally found something that helped. But yes, many diseases that primarily impact women get the ole eye roll.
Yeah... My wife has fibro and Endo (detected leproscopically) and doctors were very bad at detecting either. Treatment involved years and years of trying many drugs for insomnia and pain.
I do think it's in a sense a mixed bag of conditions (although very much real). It's crazy but she used CBTI to very easily solve the insomnia after maybe 15 years on relying on multiple drugs to fall and stay asleep
We have similar problems in England.
For anyone in the UK who might be affected by such, or knows someone who is, these folk have been very helpful to me and dozens of others I know in navigating this thicket: https://www.benefitsandwork.co.uk
I actually like seeing fewer patients & spending more time with each patient. Many docs do.
But thanks to Obamacare (ACA), private practices were forced to sell off to Big Hospital Chain monopolies & so now most docs are Employed by Hospitals. Also thanks to Obama, there are more & more Bureaucrats in Hospital Chains who tell doctors what to do. They dictate that we see more & more patients. They cut doctors salaries to enrich themselves & pay more to hospital Administrators. They simply won't allow you to spend time with patients. They treat us as assembly line machines. Thankfully, I'm at a private practice and I'm allowed 30 minutes per pt, but there are many places where Docs are only allowed 5-10 minutes per patient!! Not by choice. Not something docs want. It is due to Hospital Chain Stockholders, administrators & business people seeking profits at the expense of patients.
My PCP, who has been a doc for 30 years, probably, just up and bailed. No forwarding practice info, done. During COVID he'd call me back at 7 or 8pm. I also noticed that the practice got absorbed by a larger entity. Thanks for explaining the connection, and for your work. Then the hospitals want you to donate to their special programs. Not a chance.
Can you explain the Obamacare connection though?
You're more than welcome!
Your PCP may have been forced to quit (possibly) by the larger entity. Many of these big chains forced some docs to quit in order to increase their profits. Often, they go after the older physicians, many of whom would love to keep practicing but being forced to retire. My parents had a fantastic PCP who was forced to retire by the big hospital chain that bought his practice.
Obamacare connection:
In order for Obamacare to pass Congress, Obama had to get Congress to sign off. Therefore, lobbyists who pay congress had to sign off. Lobbyists who work for Big Pharma, Big Insurance & Big Hospital Chains.
The Big Hospital Chains +Big Insurance team up, approach small private practices & say "You must sell your practice to us, or else we will take you off of all insurance networks". Meaning, the patients would no longer be able to see these docs, because the docs would not be covered under those insurance plans.
Obamacare caused many bad things. 1) Much increased paperwork, bureaucracy, excessive clicking on computers that wastes time, less time spent with patients & more time spent on endless clicking 2) Hiring lots of administrators to do all this paperwork which increases health care costs 3) Private practices are forced to sell to Big Hospital Chain monopolies which increases costs, forces docs to see more patients in less time 4) Patient satisfaction scoring, which increases patient morbidity & mortality & opioid crisis
Most of the docs I work with are liberal (except for me) & like Obama. But they hate Obamacare.
Very interesting, thanks for the info.
And yes, enough already with the surveys. I've taken my email off of half of my charts because it's like having a stalker.
Thank you for your insight. I’m in Canada and only became aware of the “top down” medical control, both in hospitals and to doctors in private practice (who are reimbursed by the healthcare system) during the last three years. I support universal healthcare but it can’t come at the expense of the freedom of individual practitioners.
Agreed. My husband was in pain and got progressively weaker and nearly lost his eyesight and was dismissed as his imagination by multiple doctors. But as a doctor himself he did the research and fought for testing and finally got a diagnosis and then identified a surgery and had to fight for that too. Then navigating insurance was a full time job. He’s almost cured now.
I shudder to think what happens to people without training or subject to the whims of overworked doctors and clerks at insurance companies who say no to everything.
I do as much research as I can online and ask the drs. a lot of questions, which they hate, then I get a second opinion without telling the 2nd. dr. about the 1st. dr. It's like buying a car from a used car salesman, but it's my money and my body, and my life. The worst is when they lie to you. The dr. who did my prostate op better hope I never see him on the street. I don't have insurance so I don't have to deal with that level of ignorance.
you probably should also not tell the 1st dr about the 2nd dr. like if you say "i'm going to get a second opinion" that would annoy them & not benefit you in any way.
Right. I just say, let me think about that for a couple of days. Their egos are very fragile.
https://fixpriorauth.org/
I'm currently dealing with 3 doctors, None agree with the other. One is a total mercenary who lied to my face. I did my own research and I'm now the best informed in the group.
I bet the 3 blind mice love that.
Excellent writing, Abigail. Well done! Thanks for sharing your harrowing story and highlighting this important issue.
This was an extremely informative article. It’s hard to wrap my head around the psychological roller coaster you were put on. The medical establishment gas-lighted you! I think every single doctor who misdiagnosed you needs to read this article. Every ER doctor needs to read this article. Every medical student should be required to read this. I hope you have support working through any emotional fallout in the years to come. You’re a brave woman.
I'm sorry you went through this. I have been there as have so many women. I have endometriosis, interstitial cystitis, and pelvic congestion syndrome in addition to a connective tissue disorder. I learned that most doctors are useless for chronic disorders. However, good ones that listen to their patients actually do exist. It just takes time to find them. I've had better success with direct patient care doctors that work independent from insurance companies.
This is a better take than some of the others. It is unfortunately true that the American healthcare system is much better at treating gunshot wounds and acute infections than it is at diagnosing chronic illnesses with vague symptoms.
First of all, I'm sorry that you had to endure that pain for so long. That had to be miserable as you described. I'll make two points. A good gynecologist (or family physician) would have had this diagnosis in their differential after a few visits. You should not have suffered that long and I would suggest your example is unusual. Secondly, we may be seeing more of this delay in diagnosis in the future because of new guidelines passed about 10 years ago regarding the frequency with which pap smears are required, including not needing one until age 21. There are reasons for that which I wont go into (I'm a family physician- it has to do with HPV, pathology, immunology etc.) but the un-intended consequence is that the public thinks that this means they don't have to see their gynecologist or primary care doctor but every three to five years for their pap smear, and so they are not coming in for their pelvic exam and for an annual gynecological history. This has been a real problem and frustration for physicians, and there has even been a bump in the incidence of cervical cancer diagnosis. Bottom line is that women should still see their gynecologist or pcp annually for the ability to take a history like yours, and perform a pelvic exam if indicated. Best wishes for your future health!
I’m not a doctor but am pretty clued in to medical conditions from my and other’s lived experiences throughout my 60 years. As Abigail continued explaining her symptoms, I guessed “endometriosis” in my head. Why couldn’t a trained physician do the same much earlier in her life? That’s pretty confounding to me. I don’t understand why this story pivoted to gender discrimination when it’s more likely she just had some subpar medical providers (who are extremely overworked these days.)
A trained physician probably did not make the diagnosis precisely because he/she is a "trained" physician. See Dr. Martin's comment above about what is taught in medical school -- if it's not revealed by a blood test or scan, it doesn't exist.
That's something I became frustratingly aware of in the decade before I got diagnosed with fibromyalgia. It is very disheartening to hear, repeatedly, "I can't find anything wrong with you." I'm not sure how a doctor can look at a patient who is clearly in distress and deny that anything is wrong with them because the lab tests came back "normal."
Very glad you were able to be diagnosed and treated properly. I too had 7 years of many tests and various doctors, around the country. Most of the tests were searching for the "cancer"! I spent almost 7 years thinking I had cancer of something... but they couldn't find it! Finally in 2021, I saw a rheumatologist and started my treatment for RA .. Much damage has been done and reversal is impossible, but I am starting to get some relief. Good luck with your treatments, as well :)
That’s because it’s a diagnosis of exclusion. Once other causes of pain are ruled out by a history, physical examination and lab investigations, what’s left is the diagnosis of fibromyalgia. That’s how it is at present, in the future a specific test and targeted treatment may become available.
My SIL is 69 and she was diagnosed with endometriosis and had excision surgery in the 80’s. It was all pretty straightforward back then. I can’t understand why it’s so complicated today, or was so for Abigail. The Mayo Clinic’s website describes this all pretty clearly. It also says that having a low BMI predisposes a young woman to endometriosis, and I suspect that as a ballet dancer (dancing 8 hours a day?) she was under tremendous pressure to be bone thin. Could have been where it all started.
Yup...had a girlfriend in HS in 1980 who had horrible pain during her periods, did not take long for an endometriosis diagnosis.
I was thinking the same thing.
Covid, mate. "Trust me, I'm a doctor" has no value today. Of course, if you want a good kicking...
It is not unusual at all. This is bog standard treatment in the USA.
Thank you for a well written, intense consolidation of a very painful and traumatic medical issue that hopefully helps many other women find relief. You actually under played your very horrible experience and that made your writing even more impactful. Wishing you only happiness and success as you move forward in life.
The country isn’t fixated on reproductive rights, it’s fixated on abortion.
If this happened to a Black woman, Democrats would work as hard as they possibly could to convince her that it was because the doctors are all racists.
The downside for the woman is it results in helplessness and resentment and the medical issue not being addressed. The downside for me is that this psychopathic approach to politics results in people voting for even more communism, which I have to pay for.
Please stop voting for communism.
This would be true if it happens only to black women, but it affects white conservative women as well so all politicians basically ignore women's health until it suits their political agenda.
It’s really only Black women who are targeted and subjected to aggressive, psychopathically manipulative Democrat propaganda designed to convince them that doctors and nurses are racists and that this explains negative experiences.
Democrats have a different and somewhat less aggressive approach for women generally where the goal is to con them into believing ‘the patriarchy’ is causing their problems and the solution is more government.
Progressive women that believe socialized care is the answer have no clue what they are asking for. While I agree that healthcare costs too much, I have the freedom to find and go to competent specialists. They are the top in their field, but many have opted out of accepting insurance so these companies can't dictate how they practice. They often use compounded medications which are typically cheaper than prescription drugs but without the toxic chemicals that are usually added to these drugs. I have met a lot of patients from Canada, the UK and even Sweden that travel to the US for care. Similar specialists in these countries have years long wait lists and you need a referral just to get on the list.
They have to get creative to get medications sent to them, because they aren't even available in their countries.
Lucky and blessed are you that you can afford to “ go out of network “ and pay for concierge care. Millions simply can not
Agree 100%. Our system is disgusting, but socialized healthcare is hardly a panacea for people with chronic illness. Nor will it fix the bias against women described in this article.
I did not and will never suggest socialized healthcare. Look at the NHS in the UK to know that doesn’t work. That doctors are owned and controlled by giant faceless corporations is a travesty . Every time I hear someone say “ my dr is terrible and doesn’t even look at me , but it’s the only name on my insurance panel” I think “ what do you expect then? The doctors are trapped as well as the patients. I don’t have THE answer but do have some ideas based on decades of experience. Different fields of medicine require different solutions. Now it is more and more costly to the patient for less and less care.
There do seem to be significant disparities in outcomes for black women, particularly in obstetrics. We need to find out why, with objective studies and rationality, rather than the Chicken Littles who run around screeching about racism at any opportunity.
Not another bloody study. The answer, EVERY FEKKIN' TIME, is "One size doesn't fit all". For instance, the US is a melting pot; your genes are likely to come from everywhere moreso than practically anywhere else. The problem would probably go away if notice was taken of work ALREADY DONE.
Well-designed studies are the only way to get reliable, objective data, but they have their own problems, to be sure. Check out Vinay Prasad’s Substack.
Much more money is spent on women’s health than men’s health. And it has nothing to do with bias. It is because women have more health issues because of their reproductive reality.
Bingo. Kevin is trying to score political points by shifting the blame onto lefties when the truth is everyone has a share of it and we're all guilty to an extent.
Your perseverance is remarkable, particularly in the face of zero support (not even from your parents!)
So glad you had the grit to stick it out and get medical care you needed, a bold example of courage and self-advocacy
Hopefully Abigail will have a full recovery and a wonderfully full life ahead of her. Abigail, you are a wonderful writer. This article makes clear that medicine is not as simple as we all like to think. And makes clear that we need the best and the brightest to be doctors for those of us who have unusual medical issues. Many of us have learned from our own experience that all doctors are not created equally. And yes med schools need to refocus on teaching medicine and science and get the hell out of politics. We all want Dr Gregory House when something really awful is happening to us. And he never even wore a white coat.
God bless you. An ex-girlfriend of mine had endometriosis. I cared for her in the weeks after her surgery.
Unfortunately, misdiagnosis or lack of diagnosis is way too common in allopathic medicine. I've come to learn when I need to consult another doctor or two or three.
This may be on the fringe, but when it comes to auto-immune disease (endometriosis is not currently classified as one but is associated with them), I recommend the work of Gabor Mate, especially his recent book, _The Myth of Normal_. It wasn't until I established firm boundaries with people, even cutting a lot of friends and family out of my life, that my sarcoidosis went into total remission. Coincidence? maybe.
Thanks for the book rec. Gabor Mate is a brilliant, compassionate human. Many blessings to you and yours!
I spent the past five years trying to get doctors to take my reproductive health seriously. I was told everything was fine, multiple miscarriages are normal, it’s in my head, I’m causing the miscarriages myself with worrying - and my favorite - maybe you should try sex in a different position. I don’t know where that last guy got his medical degree.
It took 7 doctors before someone took the time to help me, and within 6 months under her care, I finally got answers and am now pregnant and the furthest along we’ve ever been with a healthy baby boy. NaPro doctors who practice functional medicine are a Godsend.
The vast majority of western doctors are just drug dealers now. Few of them actually care about their patients and they know *absolutely nothing* about nutrition.
Couldn’t agree more. My IVF doctor knew endo was a possible cause of my infertility and yet she fed me estrogen like candy, adding fuel to the fire. They saw dollar signs when they saw me and my husband at age 31 walking into the fertility clinic with a healthy AMH. At $25,000 out of pocket per round, I knew it was time to move on when they suggested a 3rd ivf round with a different protocol. 10 months after my endometriosis excision surgery and eating low inflammatory diet I conceived our daughter completely naturally. Wishing you a healthy pregnancy!
Abbreviations are frequently almost useless in communicating. Please realize you won’t get your point across if you don’t spell it out.
https://fertilitycare.org/what-is-naprotechnology
'Highlight; click "Search for x"; read headlines' will work for ~95% of queries. Don't insult the intelligence of the commentariat; you'll be marked down as a prat.
I’m so sorry you went through this and yet I’m also glad you have survived it and are now thriving, so that we can learn from you and do better going forward. So many female issues are still just ignored, as you said, despite the profession being 85% female now. Menopausal issues have also been ignored, demonized, minimized. The sad truth is we must all advocate for ourselves medically in all healthcare situations and push hard for what we know we need. This is only going to worsen for the time being because doctors are leaving the profession in droves these days. Thank you for writing this!
I’m disappointed in the comments treating this article as if it’s ridiculous and questioning why TFP would bother with it. Our broken medical system is just as worthy of discussion as everything else that’s broken in our country. These conversations start with anecdotes like Abigail’s. Personally, I would love to see further analysis of broken institutions and systems because it’s all intertwined. The medical system, pharma, agriculture, the crap the FDA allows in our food, how CDC recommendations come about, etc. If you don’t think all of these things are relevant and part of the political mess in this country, you haven’t been paying attention. Remember: you’re easier to control if you’re preoccupied with being sick and poor.
1000% agree. Also this young woman is an intern. And I interpret the subtext of this as Bari and her team supporting young writers by letting them test their wings. I’m kind of disgusted by the negative comments tbh.
Sorry - clarification: subtext of her opportunity.
Vote RFK, Jr.