Women’s Health | Science confirms women’s vision

The page Spotted Montreal, a message board on Facebook which has 25,000 members, is mainly used to report a lost object, to denounce an absurdity or to obtain a recommendation for a hairdresser. The content is pretty mundane, most of the time.

But on February 2, a call to everyone as surprising as it was disturbing appeared. “I’m taking a chance here, because I’m desperate… Is there any woman who has had to have an operation for pelvic varicose veins? I would like to have contact details for specialists who carry out this type of intervention…”

The author’s name is Caroline Fontaine. After three years of medical appointments and years of debilitating suffering, she was finally able to get a diagnosis. But since then, no one in the health network seems able to direct her to an expert capable of performing the intervention that would relieve her. Neither public nor private.

The pain seriously reduces the quality of life of this mother. Hot baths, cycling, jumping, that’s no. Penetrative sex? Impossible for four years now, which has not moved or concerned a single specialist consulted.

Angry and disappointed, Caroline feels “abandoned by the system”. Her esteem for doctors has plummeted, because they don’t push enough to understand, she denounces. “When a 45-year-old patient arrives crying… it seems to me that I would help her! »

No one is better placed than Cassandre Marmin to sympathize. For 13 years, pelvic varicose veins ruined his life. The Montrealer consulted seven doctors, which never allowed her to know the origin of her illness. At 34, it was “hell” to get up in the morning, “torture” to bend over to put on shoes. She came to consider buying fentanyl on the street.

A gynecologist, although an expert in endometriosis and pelvic pain, added a layer of suffering: “Where you have pain, there is nothing. It is not possible. »

“I persist. I look for. I search. I’m going back to the web. A chance that he exists, he doesn’t judge me,” says the Montrealer, deploring the psychological effects of such a quest.

Luckily, a friend in France told him about her diagnosis of pelvic congestion caused by varicose veins. Cassandre Marmin questions her doctor. “He told me it was controversial in Canada. » Having nothing left to lose, she made an appointment at a hospital in France. In January, a test confirmed the presence of pelvic varicose veins, and the next day, a $2,500 operation changed his life. About 85% of the pain is gone.

In light of her experience, the professor is today “deeply convinced” that medicine is “sexist, discriminatory, arrogant” and “that we do not listen to women”.

In his recent book It’s in your head, ex-journalist Valérie Bidégaré tackles precisely this problem of women’s credibility when they describe their symptoms. The title also takes up words that were thrown in her face before she was diagnosed with endometriosis, a long journey of six years.^⁠1.

“I was told this sentence verbatim. Between that and a punch, there is no difference. It even hurts more, because we invalidate what you feel. »

It was by going on the web that she made the link between her list of symptoms and endometriosis, a disease that women’s magazines have been talking about for at least 30 years. Her doctor didn’t believe it, given that Valérie Bidégaré had three children. Her numerous interviews with members of the medical community to flesh out her essay led her to this observation: “It is really anchored in the imagination that a woman is too emotional to have judgment. This has been said several times. »

These stories could be simple anecdotes if scientific studies did not confirm that the phenomenon of medical sexism persists throughout the world.

We are lucky, in Quebec, to live in one of the most egalitarian societies in the world. But in the health system, there is still a long way to go. Even though women are the majority among doctors, certain diseases that are typically or uniquely feminine remain misunderstood and struggle to be properly diagnosed.

It’s the same everywhere.

Medical News Today published a report in 2021 on gender bias and its consequences^⁠ based on a series of scientific studies². First observation, doctors know less about women than men, because scientific research is conducted more on men. Second, women take longer to get a diagnosis, researchers found by combing through records of Denmark’s entire population.

Science also notes that the symptoms described by women are treated less adequately, because their pain is often considered “exaggerated”. And some doctors have been found to ask women fewer questions than men about their symptoms and prescribe fewer medications.

For some conditions, women have a higher death rate. In the event of a cardiac arrest, women have half the chance of survival as men.

One of the causes: their symptoms – different from those of men – are less known to doctors. Two out of three research studies focus on men^⁠3.

In France, the National Institute of Health and Medical Research published a report in 2020^⁠ about fibromyalgia, a disease that affects the central nervous system and causes intense pain⁴. The findings are discouraging.

We learn that “its diagnosis, its management, and even its clinical reality, remain subjects subject to controversy”. The crux of the debate is whether fibromyalgia is “real”. Moreover, this condition still does not have disease status, even though the World Health Organization (WHO) has recognized its existence since 1990.

The authors add that “the need for support [est] sometimes underestimated” and that fibromyalgia is considered “too difficult, time-consuming and unrewarding by certain health professionals”.

The worst thing is that the consequences of all this can be tragic. Suicide rate among women with fibromyalgia is three times higher than in the general population, meta-analysis published in 2023 found^⁠5.

Researchers who looked at the cases of 188,751 patients point out that fibromyalgia is often considered an “imaginary illness”. In light of their findings, they recommend that patients be “taken seriously.”

That’s the lesser of it.

1. Read the article “Endometriosis – Body Pain? It’s in your head! » by Valérie Simard

2. Read the report from Medical News Today (in English)

3. Visit the women’s health page on the Heart+Stroke website

4. Check out a report from the National Institute of Health and Medical Research

5. Consult the page “Fibromyalgia may be associated with an increased risk of suicide” on Médisite

What do you think ? Express your opinion