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Why Dont Doctors Listen to Women?

RustyJ

Contaminated Cell Line 'RustyJ'
Messages
1,200
Location
Mackay, Aust
Oh I think there is a huge gulf separating the sexes. But the perceived bias may not just be bias... could be ignorance (I am referring here to medical ignorance). And it is not all one-sided. Try going to doctor when you are a male with downstairs (euphemistically speaking) issues. A lot of males with ME have urination, testicular dysfunction, pain, performance issues. There is not much info on the web about these issues and what is is mostly hearsay. I think what I am trying to say here is that for males and females there is major bias, social conditioning etc which makes it difficult for us. And of course you have the old chestnut: women want to talk about a problem, convey their feelings. Men want to solve the problem, not share their feelings. If the problem can't be solved eg in the case of ME in the doctor's surgery, then the male doctor is placed in a difficult personal situation. Nothing in his little pigeon holes fit, except maybe hysteria and whinging.
 

Dolphin

Senior Member
Messages
17,567
But, I think it is harder for a man to be diagnosed. I know a man who went many years without diagnosis of fibromyalgia. He had to quit his job of band director. He later came back as band director of middle school, he never has gone back to directing high school. There were lots of talk at the time about the fact he had pain and had to quit after years of trying to get diagnosis. Later, much later, years later, I was told they found out it is fibromyalgia. I guess the doctors just couldn't imagine a man would have fibromyalgia.

Tina

Here is a recent study that found this in general:

Gender bias in diagnosing fibromyalgia.

Gend Med. 2010 Feb;7(1):19-27.

Katz JD, Mamyrova G, Guzhva O, Furmark L.

Division of Rheumatology, The George Washington University, Washington, DC 20037, USA. jkatz@mfa.gwu.edu

Abstract

BACKGROUND: Both patient- and physician-centered characteristics may influence disease classification c fibromyalgia (FM).

OBJECTIVE: This study assessed the diagnostic criteria for FM and how rheumatologists use these criter in clinical practice.

METHODS: Practicing rheumatologists were surveyed. Participants were asked to read a brief case description of a patient with FM and then to select those criteria most important to them for confirming tt diagnosis. Case studies of either male or female patients were randomly assigned. Data were analyzed using a random forests classification analysis to abstract the strongest variables for distinguishing disease classification--in this assessment, stratified by gender of the case study.

RESULTS: A total of 61 surveys were analyzed. Four rheumatologists (6.6%) chose the 2 (and only the 2 criteria for FM classification (tender points and widespread pain) proposed by the American College of Rheumatology (ACR). The candidate diagnostic criteria discriminating between rheumatologists (when stratified by gender of the case study) consisted of (1) tender points, (2) normal erythrocyte sedimentatio rate, (3) normal thyroid tests, (4) fatigue, and (5) poor quality of sleep. Of these, the criterion of tender points was chosen by rheumatologists statistically more frequently for male patients (P = 0.047).

CONCLUSIONS: This study provides insight into the diagnostic thought processes of rheumatologists. minority of practitioners relied solely on the published ACR classification criteria for the diagnosis of FM. We also report gender bias with regard to disease classification, because rheumatologists were more likely to require a physical finding to support a diagnostic conclusion in male patients.
 

oerganix

Senior Member
Messages
611
FWIW, in my experience DOs, Doctors of Osteopathy, have a better attitude and are more likely to listen, than MDs.

And younger doctors, especially male ones, are much better than older ones. Younger men have grown up with equality, so it's only the "doctor arrogance" that we have to deal with, not so much the male superiority idea.

The stereotype of women wanting to talk about their feelings and men wanting to solve the problem is just that: a stereotype. Many people have told me I "think like a man"...and they thought it was a compliment. I have met men with ME/CFS in support groups who wanted to talk about their feelings...and guess who they came to talk about them with...me!

As for men with ME/CFS having genital and reproductive organ problems, well so do women, and most of us end up having to talk to male doctors about it. Think about it. How would you guys like to have to get naked and spread your legs for a female doc? Women often have no choice, as there just aren't that many female docs.

I have to come back to the fact that CFSAC is under Women's Health. Why? It's not a gynocological issue unless somebody is still thinking "hysteria". Seems like a legitimate thing for guys with CFS to complain about to the powers that be. I've complained about it and got the generic 'thank you for sharing your concerns' letter back.
 

Dolphin

Senior Member
Messages
17,567
there are more women than men out there that have it. so maybe that's why the thread was started by a woman or there are more women whining?
The article that was published on the Ms Magazine blog was called, "Why Don't Doctors Listen to Women?" - that's what prompted the thread, I think.

My guess is that publication/blog wouldn't have been in a rush to publish an article, "Why Don't Doctors Listen to Men?"
 

RustyJ

Contaminated Cell Line 'RustyJ'
Messages
1,200
Location
Mackay, Aust
Tomk... you walk a dangerous path, my friend. Nice pick up with the study, although these sorts of studies are always a bit iffy.

I question some of the other statistics about ME and FM. I know there are many studies citing more women predominantly suffer ME and Fibro than men but I don't really understand why this could be. Perhaps there are other reasons for these figures. For example what if men were more reluctant to seek treatment, hence were undiagnosed. I still think there is more social stigma for a male to admit he has ME - sort of the flip side of some of the arguments in this thread.
 

serenity

Senior Member
Messages
571
Location
Austin
ha, well i was ready to take the bait - just not ready to argue about it. i see your point, i would hate to think of any of the men i care about having to deal with this disease... my father, my husband... it's just not socially acceptable for men to talk of ailments. & i hate that. men have them & need to be seen for them. so i think we both we have problems to deal with here. some different & some the same but really neither better or worse.
yes TomK that was the point i was making - trying to, ha, that the article was titled that & that was the reason for the post.
i would have to agree my DO is more understanding than most docs i've seen. i adore him, but being an older male i still get a lot of "it's stress" stuff from him. i actually have been thinking of seeing his younger partner he just introduced to his practice. i have seen him once & he seemed more "hungry", more interested in thinking about things. he doesn't have my doc's well deserved rep yet & can be resting on his laurels, so he still has a drive to find out about new things. i think my doc is close to retirement, has seen it all & is kinda phoning it in at this point. tho he's still the best doc i've seen even if he just phones it in.
 

oerganix

Senior Member
Messages
611
One obvious reason for more females with CFS/ME would be that it is probably an immune disease or has a huge immune component. Women generally have more "autoimmune" diseases, such as lupus. This is because the female immune system is different from the male; women have to able to tolerate foreign DNA in order to remain pregnant with a fetus that has the father's DNA as well as the mother's.

I recall that one study found that boys and girls got CFS at about the same rate, but at adolescence more boys got better and more girls got worse. Hormones may have something to do with it, too.
 

Dolphin

Senior Member
Messages
17,567
One obvious reason for more females with CFS/ME would be that it is probably an immune disease or has a huge immune component. Women generally have more "autoimmune" diseases, such as lupus. This is because the female immune system is different from the male; women have to able to tolerate foreign DNA in order to remain pregnant with a fetus that has the father's DNA as well as the mother's.

I recall that one study found that boys and girls got CFS at about the same rate, but at adolescence more boys got better and more girls got worse. Hormones may have something to do with it, too.
It may be the case that a higher percentage of men are undiagnosed but with all the data from random digit studies, etc. I think ME/CFS is really more common in females than males.

One interesting thing I heard once from Dr. Betty Dowsett was that at a certain part of a woman’s cycle, one of the hormones encourages viral replication/is not so good at keeping viruses in check.

So maybe more males clear the virus from their body initially???
(Of course, it might not be a virus, but I’ve always had a soft-spot for viral theories).
 

RustyJ

Contaminated Cell Line 'RustyJ'
Messages
1,200
Location
Mackay, Aust
Serenity, I give up. You are too reasonable.

You should bite the bullet and see the younger guy. He may surprise you. I hardly ever get the same doctor and it continues to amaze me how varied the responses to "I've got ME", good and bad, are. I still cringe with embarrassment when I say I've got ME and try to avoid it if I can. Sometimes I get the feeling that the some of the ones who seem to listen sympathetically are really saying "cuckoo, cuckoo" in their heads. When I first came down with ME, the doctor I was seeing appeared very sympathetic and was treating everyone with expensive VIT C and B drips - he was making lots of money out it. When it came to supporting my case for disability he very quickly excused himself.
 

RustyJ

Contaminated Cell Line 'RustyJ'
Messages
1,200
Location
Mackay, Aust
So maybe more males clear the virus from their body initially???
(Of course, it might not be a virus, but I’ve always had a soft-spot for viral theories).

The science really confuses me (brain fog). I thought it was Androgen that was a factor. If men are less likely to get it, why do some men get it and others don't. Maybe more women get it (and I'm not really disputing the figures, just critically analysing them), because they interact physically more... if indeed XMRV is contagious through physical contact. Or is that another sex biased assumption?
 

serenity

Senior Member
Messages
571
Location
Austin
haha, reasonable isn't something i'm called often. ;)
i may - i am going to take Otis' advice & get my records. if my doc has said anything unnerving i will make an appt with the younger doc. what bothers me most is that my doc said "you are doing fine, dont' try to reinvent the wheel" the last time i saw him. he is very kind, so i took that to mean "there is no more treatment", but it could also mean "you're full of it" - so... i need to find out which. either way, he seems to be pretty done - & he's done a lot for me, but maybe all he can. he did tell me he would look at XMRV & i believe him, the man is not a liar. as you can tell i'm attached to him & it's both sad for me to see him close to retirement & somewhat a loyalty issue - but i know that is silly. i have to think of my illness first & think of my doc as a man i pay to treat it rather than a person i have come to trust & care for.
i have ignored any doc that tried to treat me with vitamins. i just dont' buy it. i think any lengths we go to for better health are good, but i believe XMRV will turn out to be our culprit & even before it i didnt believe i had anything simple enough to cure with vitamins. i take a lot of flack for it, but that is how i feel & i must treat myself as i see fit.
 

RustyJ

Contaminated Cell Line 'RustyJ'
Messages
1,200
Location
Mackay, Aust
I recall that one study found that boys and girls got CFS at about the same rate, but at adolescence more boys got better and more girls got worse. Hormones may have something to do with it, too.

This is at odds with other studies which show there is a very small percentage of those with CFS who recover. Unless you actually do mean got better and didn't recover.
 

Dolphin

Senior Member
Messages
17,567
This is at odds with other studies which show there is a very small percentage of those with CFS who recover. Unless you actually do mean got better and didn't recover.
I'm not sure I've seen that much data on children but what I recall some people say (I think it gets repeated as fact) is that the incidence is similar in both genders before adolescence but then a big gender gap emerges.
 

RustyJ

Contaminated Cell Line 'RustyJ'
Messages
1,200
Location
Mackay, Aust
the incidence is similar in both genders before adolescence but then a big gender gap emerges.

I think I have seen the same. Doesn't necessarily mean anyone recovered. Could mean earlier studies were biassed towards women (for any reason: more women had it, or men less diagnosed, etc). More recent cases evenly spread. For a start, adolescents would be less likely to suffer social stigma. Also as disease becomes better known, better acceptance.
 

Dolphin

Senior Member
Messages
17,567
I think I have seen the same. Doesn't necessarily mean anyone recovered. Could mean earlier studies were biassed towards women (for any reason: more women had it, or men less diagnosed, etc). More recent cases evenly spread. For a start, adolescents would be less likely to suffer social stigma. Also as disease becomes better known, better acceptance.
The number of CFS cases in children are so small that they tend not to show up much or at all in random studies.
Often what they have is Chronic Fatigue and Chronic Fatigue Syndrome mixed together as numbers are so small.
I have less confidence in things they might claim in that area (about gender breakdown etc in children).

I think they might be better working out biomarkers first.

BTW, I got ill when I was a child technically (16).
 

richvank

Senior Member
Messages
2,732
Hi, all.

On the gender ratio in CFS prevalence, I believe the epidemiological studies. They find that more women than men have CFS, though they don't agree on the exact ratio.

I've offered a hypothesis to explain this phenomenon, and it can be found at www.cfsresearch.org. I have gathered some evidence for it over the past few years, but there hasn't been a legitimate study to test it.

The basic idea is that some people, both men and women, inherit polymorphisms in the enzymes CYP1B1, COMT, and one or more of the GST enzymes. If a man inherits these, it isn't such a big deal. If a woman inherits them, it biases her body toward oxidative stress every month when she is metabolizing estradiol. The problem is that having these polymorphisms causes her body to be subject to what is called redox cycling, and that generates a lot of oxidizing free radicals.

This ties into the glutathione depletion--methylation cycle block hypothesis for CFS, also described on that site, because this is just one more thing that places a demand on glutathione, and if glutathione goes low enough, a person with the appropriate other collection of inherited polymorphisms will develop a partial block in the methylation cycle. This then forms a vicious circle with the glutathione depletion, and that's what makes CFS a chronic condition.

The evidence I have is that several women who have CFS and who have run the Genovations Detoxigenomic Profile and have shared their results with me have turned out to have these polymorphisms.

So, there you have it.

Best regards,

Rich
 

aquariusgirl

Senior Member
Messages
1,732
pmt

rich
wouldn't you have to show that these snps occur at a higher rate in women with cfs than women in general to prove yr argument?

so many of the snps implicated in this disease are so common, that it makes me wonder.

i know the argument is that it's the combination of all these snps...clustered around certain pathways. that add up to a genetic predisposition to the illness ..but in the absence of comparative genome-wide studies, it's kind of a hard sell isn't it?

how many of the panels you have mentioned have you seen from women that don't have cfs.

Does genovations share that info? Probably not, right?

Having said that, wld your hypothesis explain why so many women with cfs feel worse when they are premenstrual?