Gender norms are reflected in healthcare and can be held by various healthcare professionals leading to gender bias and differences in the treatment of men and women [1][2]. Gender bias in women’s healthcare in Ireland was the topic of a live panel discussion at a recent Science Week event organised by HRB Mum & Baby.
It was with great pleasure that PCOS Vitality was asked to provide some insight into the experiences of being diagnosed with PCOS and how given the link to both menstrual health and reproduction to date the condition has not really been taken very seriously. You can watch our interview here.
You can watch the BIAS: Gender Inequality in Healthcare and Research panel discussion in full here:
Dr. Laura Kelly, historian and lecturer at the University of Strathclyde, explained that during the 19th Century, women’s health problems were attributed to 'hysteria'. Frequently, women’s failure to fulfil their societal role of child-bearing and home making was met with mistreatment or admission to an asylum thus providing the early link between gender norms and healthcare.
While gender inequality in healthcare has improved somewhat, effects are still being felt by women today. This is never more notable than in relation to PolyCystic Ovary Syndrome or PCOS. Traditionally regarded as a reproductive disorder, PCOS is now established as a life-long metabolic disorder with serious long-term complications. Many women report feelings of not being taken seriously and of dissatisfaction with their treatment by healthcare professionals [3]. Delayed diagnosis is common, taking on average 2 years and 3 doctors for a woman to be diagnosed with PCOS and often those who are diagnosed are dismissed and told to return when they want to “have a baby” [4]. Similar experiences are found in relation to Endometriosis and Mental Health with more evidence highlighted during the current pandemic.
Panel member, Dr Michael O’Reilly, a researcher and endocrinologist at Beaumont Hospital and Royal College of Surgeons, spoke of his special interest in polycystic ovary syndrome. PCOS affects up to 10% of women, and those with the condition are at an increased risk of menstrual dysfunction, hirsutism, subfertility, miscarriage, obesity, cardiovascular risk factors, womb cancer and a seven fold increased risk of Type 2 Diabetes. Despite the high prevalence and serious implications of the disorder, the first international evidence-based guidelines for assessing and managing it only came to be published 2 years ago.
There is a need to address inequalities regarding women in decision making in healthcare. There is also a need for a Menstrual Education programme in Ireland to both empower women and girls and normalise menstruation. Frank discussions on issues such as periods, PCOS, Endometriosis and Mental Health will allow women to become aware of their own bodies, how they work, what is normal and more importantly know when to seek help for abnormalities. Rachel Kenna, of the Women's Health Taskforce, encouraged women to get involved directly.
Given the level of negative experiences of women in healthcare, it should be of great value to provide more research and education in this area to raise health-care providers’ awareness about potential gender bias and thereby improve equity in health and the treatment of all patients.
References
[1] J.D. Greenspan, R.M. Craft, L. LeResche, L. Arendt-Nielsen, K.J. Berkley, R.B. Fillingim, M.S. Gold, A. Holdcroft, S. Lautenbacher, E.A. Mayer, J.S. Mogil, A.Z. Murphy, R.J. Traub, Studying sex and gender differences in pain and analgesia: A consensus report, Pain. 132 (2007). https://doi.org/10.1016/j.pain.2007.10.014.
[2] A. Samulowitz, I. Gremyr, E. Eriksson, G. Hensing, “Brave Men” and “Emotional Women”: A Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain, Pain Res. Manag. 2018 (2018). https://doi.org/10.1155/2018/6358624.
[3] L.R. Hoyos, Ma. Putra, A.A. Armstrong, C.Y. Cheng, C.K. Riestenberg, T.A. Schooler, D.A. Dumesic, Measures of patient dissatisfaction with health care in polycystic ovary syndrome: Retrospective analysis, J. Med. Internet Res. 22 (2020) e16541. https://doi.org/10.2196/16541.
[4] M. Gibson-Helm, H. Teede, A. Dunaif, A. Dokras, Delayed diagnosis and a lack of information associated with dissatisfaction in women with polycystic ovary syndrome, J. Clin. Endocrinol. Metab. 102 (2017) 604–612. https://doi.org/10.1210/jc.2016-2963.
© PCOS Vitality 2020
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