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Forget the pay gap: How the gender pain-gap harms Aussie women

Numerous studies have shown that gender bias in medicine regularly overlooks women’s pain. So when will we start taking it seriously? Bek Day investigates.

The doctor sighs, checking his watch distractedly. 

“Look,” he says, assuming the slightly impatient air of a parent talking a toddler down from a tantrum, “I know that, to you, it feels like you’re in a lot of pain, but the objective signs aren’t really there.”

Doubled over in pain like a woman in labour, Sally – my best friend of over two decades – looks up at him through tears.

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“What does that even mean?” I ask, thinking I must have misheard.

“Her blood pressure is normal. Her heart rate is 90 bpm – a little elevated, as the normal resting heart rate for your age is between 60-80bpm – but not what we’d expect to see with the kind of pain she is describing.”

“I know it’s hard,” he said, turning his attention back to Sally, “but I think maybe if you calmed down a bit your symptoms might ease.”

Five hours earlier, Sally – 32 at the time – had called me at 2am, barely able to speak through the agony. Her left ovary, on which she’d had surgery to remove a cyst two weeks prior, felt like it was being stabbed from the inside. 

I’d driven her to the emergency room of a Sydney hospital. There, over the next several hours, despite being told about the recent surgery (and the fact that her surgeon had mentioned ovarian torsion – a condition in which the ovary twists in on itself – as a potential complication of the procedure), the doctor on duty had refused to send her for an ultrasound or provide any pain relief stronger than paracetamol.

“But I have a resting heart rate of 40 bpm,” Sally tells the doctor through gritted teeth, eyes still closed, “I remember because doctors always comment on how low it is.”

What the doctor was about to say in response we’ll never know, because at that point, overwhelmed by pain, my friend vomited violently for the third time that night.

Finally – perhaps swayed by the ‘objective’ sign of pain on display – the doctor agrees to give her a shot of morphine. 

An hour later, woozy but still in agony, we tell the doctor the morphine hasn’t touched the sides, begging him to investigate for a torsion.

“I’ll give your surgeon a call,” he eventually agrees, “although I highly doubt it’s a torsion – that level of pain would be astronomical.”

“Honestly, it felt like I was in some kind of horror movie,” Sally recalls of that night, “nothing I could say would move the needle and get him to take me seriously.”

After a few more hours and a call to Sally’s surgeon – who thankfully, advises the doctor to get her an ultrasound immediately – my friend is diagnosed with – you guessed it – ovarian torsion.

She’s rushed via ambulance to the women’s hospital to undergo emergency surgery. She loses part of her left ovary and fallopian tube. A complaint she files with the hospital after her recovery gets a response weeks later: “We investigated and found no neglect or wrongdoing.”

Sally’s experience is horrifyingly commonplace. Historically and currently, women’s pain is overlooked at alarming rates in the medical profession. 

On average, a woman with endometriosis will suffer for seven to 10 years before receiving a diagnosis. Almost without exception, she’ll be told her pain is “normal” by several health professionals before they even investigate. 

PMDD – another crippling and under-diagnosed condition – is often written off as ‘normal’ mood changes before menstruation, rather than a complex and (as usual in the world of women’s health) under-researched hormonal condition.

And this is not just anecdotal evidence – several studies have shown that gender bias in medicine regularly overlooks women’s pain. A 2022 study found women waited, on average, 29 minutes longer than men to be evaluated for a heart attack when presenting to hospital with symptoms. Another study found that women who presented to the emergency department with pain of any kind were 25 per cent less likely than men to be given opioid pain relief, but more likely to be referred for psychiatric assessment. 

The gender pain gap has been consistently proven to be a threat to the health and safety of women worldwide. 

Now, an initiative from Health Victoria aims to work towards closing that gap.

Submissions for the Australian-first Inquiry Into Women’s Pain opened last week after a survey found two out of five Victorian women suffer from chronic pain. 

“[The survey findings] won’t be a mic drop moment for the majority of Victoria’s population,” Premier Jacinta Allen told body+soul, “because every woman has either experienced it for herself or knows someone who has. But now we have the evidence to prove it.”

The aim of the inquiry, which will hand down a final report in December this year, is to “provide recommendations to inform improved models of care and service delivery for Victorian girls and women experiencing pain in the future.”

“It’s time we stopped treating women’s health like some kind of niche issue,” says Premier Allan. 

“We deserve to have our pain believed and relieved.”

For Sally, for whom the traumatic hospital experience still rankles seven years later, the inquiry is an important step in the right direction. 

“In my experience, it’s so entrenched in medical culture to devalue women’s pain, which is why this inquiry is so important in calling out the unconscious gender bias at play,” she says.

“Hopefully,  it can start to shift things in a meaningful way – because too often throughout history women have been treated as ‘hysterical’ rather than legitimate patients deserving of proper care and treatment.”

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