Too often a woman’s heart disease is labeled as stress and anxiety. If it is an autoimmune disorder, it is labeled as depression. Ovarian cysts are overlooked.

The Katz Institute for Women’s Health recently published a series of articles on the subject. Four specialists from the Institute were asked what women should do if they are being sent home without a diagnosis; told they have exaggerated the severity of their pain and perhaps should see a mental health professional.

The term used most frequently is ‘gaslighting.’ The doctors were asked their opinion on the subject of gaslighting.

Dr. Jennifer Mieres, Sr. VP of the Center for Equity of Care, conceded that gender bias still exists within the medical profession. She said, for example, that there are gaps remaining in coronary heart disorders with respect to women. Dr. Mieres pointed out that gaslighting often occurs consciously, but there is still a percentage carried out unconsciously.

Dr. Stephanie McNally, whose specialties are gynecology and obstetrics, agrees with Dr. Mieres. Dr. McNally reminds us that “hysteria” is a word that originated from “uterus,” a Greek word.

She said that unfortunately many doctors still believe that when a woman mentions pain, it must be related to hormones or may be imagined.

Dr. McNally commented that it is not the hormones that are upsetting the patients but the condescending attitude of the doctors.

Women are prejudged for exhibiting the same emotions that are acceptable when expressed by men.

Dr. Bella Grossman, specializing in Clinical Psychology, offered her opinion. Dr. Grossman said she believes men are usually more persistent about their concerns. Women believe they should be model patients and accept their doctor’s advice. Women, therefore, are silencing their inner voices.

Lastly, Dr. Robert Duarte, Director of Clinical Neurology at the Jewish Medical Center in Long Island, N.Y., spoke about improvement in understanding chronic pain in the last five years. Yet Dr. Durate admits that he still sees women who were sent to various clinics and then to a psychologist. Many times it is due to having pain that does not fit the cookie-cutter definition for a specific disease.

Dr. Duarte added that chronic pain can be complex, extending to various locations in the brain. Sleep, anxiety, and depression are often affected. For that reason, every patient with chronic pain must be evaluated extensively. The evaluation should include a thorough psychological assessment.

Dr. Mieres agreed with Dr. Duarte. She gave a case history of a fifty-year-old lawyer who came to her for a second opinion. The patient had been dismissed by her own doctor and was told that she should not worry about her symptoms. Her doctor suggested that they were perimenopausal and were from the stress and pressures of her job.

After a thorough examination, Dr. Mieres saw that the cause was uncontrolled hypertension. Her family had a history of heart disease. Dr. Mieres’ patient developed plaque in several arteries, and her symptoms were due to early heart disease.

The Doctors Were Asked Why Gaslighting Still Occurs and How They Would Remedy the Situation

Dr. Mieres offered that there are still mid-career or senior physicians who practice medicine on a “one-size-fits-all” basis. There is no gender and sex-based approach. The second issue had been explained by Dr. Grossman. So many women do not have the courage to speak about their health or wellbeing. Dr. Mieres said that they should be encouraged to speak up.

Dr. Grossman pointed to the integrated programs that now take in various aspects of a women’s health such as medical history and lifestyle factors. She indicated that when integrated teams are in charge of examination and treatment, there are fewer instances of gaslighting.

Dr. McNally agreed with Dr. Mieres. She also said that having her own children gave her a better understanding of what her patients are experiencing on a daily basis.

Dr. McNally said that now she is even more in tune with a woman’s choice involving childbirth issues. She agrees that there must be a dialogue between the patient and her provider so that the patient feels empowered.

The Doctors Were Asked What Role Hormones Play in Health Conditions

 Dr. McNally was the first to answer. She said that yes, hormones do contribute to changes in the body but they are generally not the root cause. To mitigate changes, it is important to maintain optimum nutrition and strength training. Our hormones may affect us, she said, but we must be at their mercy.

In general, the doctors agreed that if a woman believes her doctor is using gaslighting techniques, she should ask for a second opinion.

Note: This is part one of a two-part story. Stay tuned for part two.