Myocardial infarction? A disease of men. The Depression ? A women’s affair. In the field of health, too, gender biases are still numerous and can influence the use of care and business operations.
At first her legs hurt. Her doctor thought gout or maybe pregnancy: “It’s probably just your hormones.” She doubted her own feelings and endured seven years of pain before ending up in the emergency room. She was again assured that her discomfort was related to the baby she had just given birth: “toxic heart disease after delivery”. Before a rheumatologist finally identifies the origin of his disease as lupus, an autoimmune disease characterized by a dysregulation of the immune system.
Drawing on her own experience, feminist historian Elinor Cleghorn published last June Unwell Women: A Journey Through Medicine and Myth in a Man-Made World †Sick Women: A Journey Through Medicine and Myth in a Man-Made World† This Brit tells in this book how women’s health has been consistently misunderstood and misinterpreted throughout history.
A taboo that continues to exist
“The so-called +nature+ of women, the representations made of them as weak beings, have long permeated medicine.” confirms neurobiologist Catherine Vidal.
She wrote an illuminating report on the subject last year for the Supreme Council for the Equality of French Women and Men: Taking gender and gender into account for better care: a public health concern† She explains that in patients, first of all, the social codes linked to the female and male sex influence the expression of symptoms, the relationship with the body, the demand for care. Among health professionals, gender biases are also likely to influence the interpretation of clinical signs and the management of pathologies.
So-called “female” or “male” diseases seem to be a good example. Women are more vulnerable than men to cardiovascular disease: 56% die from it, compared to 46% of men. However, myocardial infarction is still underdiagnosed in women because it is mistakenly considered a disease of men who are stressed at work.
And women are on average twice as likely to suffer from depression as men. But the main reason is not due to female hormones, as has long been claimed. Research has shown that the gender difference in the prevalence of depression varies with socioeconomic background.
Other diseases related to women’s sexual and reproductive health are also poorly considered. For example, endometriosis, now recognized, has long been underdiagnosed, mainly because it referred to the taboo on menstruation.
“It was only in 2020 that this disease was included in the 2nd cycle of medical studies”regrets Catherine Vidal, who calls for a major effort to educate health professionals on gender issues.
But delays in treatment or screening are sometimes linked to the women themselves. In France, a study showed that in the event of a heart attack, they call the Samu on average 15 minutes later than men. This increases the chance of residual symptoms or less good care.
“Women worry less about their health, they often put it on after their family or work† †
Claire Mounier-Vehie, cardiologist
At the heart of the “Bus de coeur” itinerant operation, which since September aims to provide screening and prevention advice to vulnerable women, this department head of the University Hospital of Lille is concerned that 200 women die every day from cardiovascular diseases . “In eight out of ten cases, the disease can be prevented by screening”she assures.
It must be said that the warning signs are sometimes different, sneakier when it comes to women, such as persistent fatigue or digestive disorders. here again, “If the health care provider doesn’t know, we can fear a diagnostic error”warns Claire Mounier-Vehier.
“We must stop believing that when a man collapses, he is in cardiac arrest, but when it is a woman, it is vagal discomfort.”