A lack of understanding about gynaecological conditions and female sex hormones could be preventing us from seeing the full picture when it comes to COVID-19.
With 34.3 million cases (and counting) of COVID-19 worldwide, and many more undiagnosed, plenty of people have been feeling the effects. While billions of people around the world have undergone unprecedented lifestyle changes, experiencing coronavirus symptoms is something else entirely. So, what do you do when suspicious chest pain, a persistent cough, or any other number of ailments start cropping up at this worrying time? Most people would contact a medical professional, because most people would assume they’d be taken seriously at a time when a potentially fatal virus, which is still far from fully understood, is sweeping the globe. But unfortunately, this is not everyone’s experience.
Personally, I contracted COVID-19 in the UK at the end of March and felt dismissed by medical professionals because I’m a woman. The chest pain, difficulty breathing, complete exhaustion, migraines, stomach distress, cough — I ticked all the boxes. However, when I went to see my GP about a recurring UTI which kicked in at the same time, and a deep pain in my kidneys, I was told I’d probably pulled a muscle lifting my son. I was probably just tired because I’m still breastfeeding. I probably have anxiety and I should take a holiday (during lockdown…). I pointed out that the pain was in the area of my kidneys, not my muscles. I am very familiar with feeling tired and this was different. And, by the way, my breastfeeding journey is none of your business and irrelevant. The doctor agreed it was odd that the pain wasn’t in my muscles. "It must be radiating," he said. "You’re just tired." And he sent me on my way, so I treated myself with antibiotics I picked up from the pharmacy and natural remedies.
While I can’t be sure my UTI had anything to do with having coronavirus, urinary frequency has been cited as a potentially overlooked symptom in COVID-19 cases, including in a University of Munich study from May this year. Moreover, as Healthline reports, acute kidney damage was observed in some cases of coronavirus which required hospitalisation. However, this is also the case for other major organs in the body.
There are also growing numbers of people with so-called long COVID, in which individuals experience a variety of non-typical symptoms for more than 30 days. As the Guardian reports, those in long COVID support groups are already reporting feelings of dismissal and a lack of help, so how might this be compounded when you’re an individual from a marginalised group?
I started asking other women about their experiences with their doctors during the outbreak and what I found was very disconcerting. Diane Sheenan from Charlotte, NC says “When I felt I needed help for my symptoms, I could not get appointments with specialists until my husband got involved on my behalf. It added insult to injury that I wasn’t given appointments until he stepped in.”
Yuni LaFontaine, from Pasadena, California says “As a Black woman, having my symptoms dismissed by doctors has been a life-long experience when seeking medical help. And it’s extended into taking my kids to the doctor too. Twice doctors have tried to dismiss me and send me home with a sick or injured kid only to have X-rays prove that what I was saying was real.”
On top of physical symptoms, many women are now having to face a strain on their mental health as a direct result of having their experiences minimised or ignored. And the really scary part? This dismissal of female health conditions and symptoms is nothing new.
A report published in 2017 by the All-Party Parliamentary Group on Women’s Health revealed that women are consistently struggling to get diagnosed and treated for a wide variety of gynaecological health conditions, with many saying they felt they were “going mad” after being continuously told by medical professionals that there was nothing wrong with them. As part of this report, a survey of 2,600 women with conditions such as endometriosis and fibroids found that 40% had to visit their GP 10 or more times with a single complaint before being referred to a gynaecologist.
Melissa Cliffe, Psychotherapist and spokesperson from the UK Council for Psychotherapy (UKCP) says “Dismissal appears to be more common with issues [not experienced by cis men] such as pre-menstrual dysphoric disorder (PMDD), endometriosis or pregnancy related conditions. Often symptoms are minimised, the suggestion being that they should simply bear their suffering.”
But even with coronavirus, which affects all genders, the misunderstanding of and lack of research into gynaecological conditions and female sex hormones could be preventing medical professionals and the public from seeing the full picture, both in the long and short term. (Even the study into urinary frequency as a potential COVID-19 symptom from the university of Munich only refers to male participants.)
GP and Menopause Specialist, Dr Louise Newson, has hypothesised that oestrogen works to reduce the severity and death rate from COVID-19, through her work with a national consortium of leading academics from Liverpool University and other institutions. “This is robust data that has been obtained from looking at around 60% of hospital admission data of patients proven to have COVID-19 in England, Scotland and Wales.” Newson says “The women’s health funding to do more research in this area and study the underlying mechanisms has been refused, despite data showing women with lower levels of oestrogen experience an increased severity and higher death rate from COVID-19. Clearly, this discrimination against research in women’s health is very disappointing and also perplexing because this is a large public health problem which needs addressing.”
But what can those at risk of unfair treatment do to advocate for themselves in the meantime? Cliffe believes that the message many women receive, even from female doctors, is that they are making a fuss, playing into internalised negative beliefs that women shouldn’t be a nuisance. This can impact self-esteem or make someone feel hopeless and deflated. It can even lead you to question your own version of reality.
“The medical profession is held in high regard, they hold a great deal of power and authority. It may feel difficult to challenge a doctor with years of medical training who questions the way you feel but with the right toolkit you may feel more confident in doing so,” says Cliffe.
How to advocate for yourself with medical professionals.
- Educate yourself. See what you can find out about your condition so that you are prepared when you visit your doctor.
- Don’t be afraid to challenge your doctor. Try saying ‘I’m not comfortable with that decision,’ ‘can you tell me more about why you believe this is best for me,’ ‘what are the alternatives,’ or ‘I don’t think you have understood me fully.’
- Trust yourself. You know your body, what is familiar and normal for you and what is not.
- If you don’t feel that your doctor is taking your concerns seriously ask to see a different doctor. Ideally you should be working in partnership, a meeting of their expertise with the information you give them which enables you to find the best solution for you.
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