Medicine Has A Man Problem: How A Woman's Pain Becomes A Debate
- Madhuparna Chakraborty
- Jul 3
- 5 min read
“….It blighted my whole life– I used to feel like I had a pelvis full of razor blades. Nobody was sympathetic, not even other women who thought I was exaggerating.”
The words of this 58 year old woman are also the reality of hundreds of women worldwide. Unfortunately, standing in this day and age, where modern medicine has taken humanity to heights unimaginable, the plight of these women continues. Ignorance and dismissal form the backbone when topics such as endometriosis take the center stage. All over the world there are thousands of cases where the cries of help have fallen to deaf ears.
How Male Became The Norm:
Up to this day, we don’t truly know how women metabolize and react to many medicines, why some ADRs are more common in women, nor how women experience or manifest pain. The efficacy, dosage, and ADRs of many drugs were never tested in women.
Research published in 2020 from UC Berkeley and the University of Chicago analyzed data from several thousands of medical journal articles and found clear evidence of a drug-dose gender gap for 86 different medications approved by the FDA (including antidepressants, cardiovascular and anti-seizure drugs, and painkillers).
Women are twice as likely to develop anxiety disorders in their lifetime. 75% of the patients of over 80 auto-immune diseases are women. Women are at a greater risk of having osteoporosis and various depressive disorders.
Despite these chilling discoveries made by researchers through the decades, the scales are yet to be balanced. For centuries in medical research, the male anatomy has been taken as default, dismissing the differences in physiology between the sexes. This has created a gap in understanding the female body and has led to dissatisfaction and agony misjudged as hysteria.
Developed by the World Economic Forum, in collaboration with McKinsey Health Institute and a multistakeholder coalition championed by Ferring Pharmaceuticals, the report finds “for every one woman diagnosed with a health condition, roughly four go undiagnosed”.
Moreover, in a systematic review and meta-analysis of 122 US-based COVID-19 clinical trials with 176 654 participants, female participants were underrepresented in treatment trials.
Despite making up over half of the global population, this representation isn’t reflected in clinical trials or medical research. According to Imperial College London, less than 2% of medical research funding is spent on pregnancy, childbirth and female reproductive health.
Just Cramps or a Cry For Help? The Diagnostic Delay
Women Know Too Well
Hallie Fischer, a student from Montana has shared her story of dealing with a hereditary case of endometriosis. This brave 18 year old girl has spoken up about her struggle of finding a trustworthy health professional and proper care. “They said I was too young to have endo or that a lot of young girls have issues with their cycles” was what she confessed, says the Endometriosis Foundation of America. From the ages of 13 to 17 the doctors put her on birth control, gave her estrogen, or put her into medically induced menopause.
These stories tell us about the reality of more than 190 million women globally. Most of them go through their teens and much of their twenties without ever knowing a remedy. On average, a person has to wait for 7 to 11 years for a proper diagnosis. Years of pain and a plethora of medical expenditures are made just to get a name for their illnesses. Several of them are asked to “bear it” or that “it's a part of being a woman” adding to the history of dehumanization of women throughout history. Inefficient medical professionals are quick to label a disease as hysteria when it comes to women. A lack of knowledge and refusal to see logic has made this patriarchal system a house of horror for about 49.6% of the global population.
The Unseen Labour Beneath Maternal Ideals:
Whilst many with endometriosis will be able to get pregnant naturally, endometriosis is one of the leading causes of infertility in women and those assigned female at birth in the UK. For many with a diagnosis of endometriosis, fertility and fertility preservation is a significant concern. For some, a diagnosis of endometriosis comes as a result of investigations following fertility issues. For others, the lack of a timely diagnosis of endometriosis means they can lose the opportunity to consider the potential impact on fertility and to take steps towards fertility preservation.
What women have to say about the disease:
“I visited the GP multiple times as a teenager with debilitating period pain and was put on a number of different painkiller medications, followed by the pill. I only got referred to a gynaecologist in my 30s after struggling to conceive, which was when endometriosis was first mentioned and I had a subsequent diagnosis.” (diagnosed in 2022).
“A GP told me, ‘If you want children you’re going to have to deal with what’s normal for a woman, it seems you’re overreacting.” (diagnosed in 2020).
Women with Stage I and II endometriosis may become pregnant on their own, however, medical studies do suggest that if laparoscopy is done in women who have infertility, they are more likely to have endometriosis than women who become pregnant with no difficulty. There is some evidence that pregnancy rates may improve if Stage I or II endometriosis is removed surgically, however some data shows that this does not help.
In general, when women are young (less than 35 years old) it is reasonable to remove any visible endometriosis to see if pregnancy occurs. If women are 35 or older, other fertility treatments are recommended instead of laparoscopy. If Stage III or IV endometriosis is present, pregnancy rates are higher after surgery is performed to remove scar tissue or large endometriotic cysts. If pregnancy does not occur within 6 months after surgical treatment of endometriosis, other fertility treatments should be discussed.
Unfortunately, some women with endometriosis can have cysts that come back. If cysts are removed over and over, this can cause a loss of eggs from the ovaries, and can make it harder to become pregnant.
Rewriting the Female Pain Narrative—
Milestones in Women's Health Research
In 2024, a clinical trial from the University of Oxford presented data which could lead to radically improved diagnosis of endometriosis for women across the globe. The clinical trial is currently ongoing.
The study involves using a specific imaging technique using a marker called 99mTc-maraciclatide. The researchers had 25 participants with endometriosis undergo the scan before their surgery to confirm the presence of lesions. The scan works by detecting specific molecular components called integrins. The findings from the scan were then compared to findings from the surgery.
The preliminary results showed the accurate detection of not only superficial endometrial lesions but also deep endometriosis during the early stages of the disease.
Previous research shows how DCA, previously used to treat mitochondrial disorders in children, could be used to treat endometriosis. In the study, researchers found that pelvic cells from women who had endometriosis exhibited altered mitochondrial function compared to normal cells. Upon treatment with DCA, this function returned to normal and the size of the lesions were reduced in mice models.
Following this, an EPiC clinical trial was carried out to see if DCA could be used to treat endometriosis. The trial involved treating 30 women diagnosed with endometriosis with DCA. The results were positive, with 79% of the participants experiencing reduced pain, 62% of participants using less pain-relief medication and improvement of the overall health profile of the participants.
This clinical trial enabled the initiation of the second round of EpiC, EPiC2, where researchers aim to determine which dose of DCA can reduce painful endometriosis symptoms with the fewest complications.
If successful, the drug could be the first non-contraceptive treatment for endometriosis, a breakthrough for the medical research community, and a relief for many women struggling with the condition.
These initial results paint a hopeful picture for the future of the clinical trial and for women with endometriosis, potentially putting an end to the extortionate length of time it takes for a woman to receive a diagnosis.
Comments