Let There Be Hysteria: Why We Must Clamour For Women’s Health Research

Wandering Womb. Ovaritis. Hysteria. Womb Fury. These are not just meaningless words threaded together for exaggerated comic effect. These are real medical diagnoses related to women’s reproductive health, documented in medical treatises right from ancient Greece, up until the 19th century.

Philosopher Aristotle described the female body as the inverse of the male body, with the genitalia “turn’d outside in.” In “Diseases of Women”-- one of the seminal texts attributed to Hippocrates, the “father of medicine”-- the female body is recognised as being inherently prone to disease and atrophy, with marital sex and childbirth being the only remedies for wellness.

Since the time of understanding the human body, the idea of health and disease, and the idea of women’s “infirmity” has existed. The concept of “hysteria” was deleted as a common diagnosis from the official Diagnostic and Statistical Manual of Mental Disorders, only in 1980. 1980. That is, 268 years after the steam engine was invented, 33 years after India gained independence, and 11 years after man landed on the moon. 

It is no wonder, then, that a recent study found that 63% women strongly feel that medical professionals tend to dismiss women’s pain in clinical settings. In 2015 the National Institute of Health (NIH) in the US instituted a policy to consider “sex” as a factor in medical research. In 2017 the NHS issued a dictum that doctors must “listen to women” in the context of endometriosis diagnosis. 2017. That is, 107 years after the first commercial flight was operated, 138 years after the light bulb was invented (according to Edison), and 67 years after India adopted the Constitution.

Women’s health, since always, has been clinically under-researched, culturally blindsided, and horribly underfunded. Putting “care” back into women’s healthcare has therefore been a long, hard journey, and we are still not there.

Women were banned from clinical trials till 1993 until the FDA approved it. Medical practitioners today have the onerous task of going against the grain of history, and mending the “gender pain gap”.

Here are 10 things no one tells you about women’s pain, hormones, and chronic illness:

• ​​A US Government study found that 8 out of 10 drugs pulled from the market between 1997 and 2000, posed a bigger health risk to women.
• A 2015 review found that 79% of pain studies used only male mice, and have not been tested on women. This includes the common over-the-counter painkillers.
• In the case of chronic pain, 80% of study participants are male even though 70% of those affected by chronic pain are women.
• When women visit the emergency room in the UK with abdominal pain, they wait on average 65 minutes while men only wait 49.
• Women are also 25% less likely to be prescribed pain relief than men and are much more likely to be told that their pain is psychosomatic, rather than being guided towards more tests and investigations.  
• A 2016 study found that women are on average 50% more likely to be misdiagnosed when they have a heart attack, because women present symptoms that differ from men’s when having a heart attack, but doctors fail to recognise this. This phenomenon of misdiagnosis even has its own name! It’s called the “Yentl Syndrome”.
• 24% of women report that pain had led them to feel depressed, compared with 18% of men.
• There has been more than 5 times the amount of research into erectile dysfunction than there has been into premenstrual syndrome. This is despite 90% of women reporting some symptoms of premenstrual symptoms, whereas less than 1 in 5 (19%) men experience erectile dysfunction over the course of their lifetime.
• Only 2.5% of publicly funded research in the UK is dedicated to women’s reproductive health, even though 1 in 3 women will experience severe reproductive health issues in their lifetime.
• Women are 25% less likely than men to receive pain relief. 
• Women are the primary sufferers of chronic diseases that cause pain – including endometriosis and autoimmune conditions such as lupus and rheumatoid arthritis. Between 5% to 26% of women worldwide face chronic pelvic pain, nearly 56% report low back pain around menopause, and around 80% of women face period pain at some point in their life.
• In the landmark 2001 study, "The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain," Diane Hoffman and Anita Tarzian found that "women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively." 

So, what’s the path forward? It is certainly not a straightforward one.

From symptom identification to diagnosis to long-term holistic care, and from prevention to cure, there needs to be more funding for clinical research, a re-examination of medical course work, upskilling of practitioners, awareness in communities at all levels and policies that recognise women’s health outcomes as key public health agenda.

However, the very first, critical step is to consider women as reliable narrators of their own pain and medical history. Not doing THAT in 2023, would be hysterical.

Swarnima Bhattacharya is the Co-founder & Chief Product Officer of Gytree. Views expressed by the author are their own

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