The main reason only middle-aged and older male subjects were used in researches for heart disease, is because men had heart attacks during their working years, potentially limiting their economic productivity. There is, therefore, both little research on heart attacks in women and the incorrect stereotype that heart attacks are a male disease.
A second reason is that female biology is different. Women tend to have smaller hearts and arteries, increasing the risk of death during bypass surgery.
“Sex is a biological construct. There are sex differences between men and women, and how those differences manifest and what happens, from a genetic level to how the body operates, is different,” comments Dr Tamarra James-Todd, an epidemiologist at Harvard Medical School.
Finally, the symptoms of heart attack that men commonly experience – for example chest pain and pain down the left arm – are often absent in women. Instead, they experience symptoms such as nausea, shortness of breath, indigestion, and fatigue.
As such, women only realise they are in need of emergency medical care when it is too late. Even then, they are six times more likely than men to be mistakenly sent home from emergency rooms by unsuspecting doctors. Unfortunately, heart disease is not the only illness in which women are left undiagnosed.
Which other illnesses are often missed in women?
1. Chronic fatigue syndromeChronic fatigue syndrome (CFS) is a prime example of an illness in which gender disparities mean women have suffered missed diagnoses. Historically, CFS was thought to only affect upper-class men in intellectual professions.
"Long-term fatigue was viewed as a legitimate disorder, a result of the heroic efforts of the upper-class male. Today, it is a stigmatising disorder, understood as an expression of women's lack of ability to cope with their lives, a kind of breach of character," says Professor Olaug S Lian, a sociologist at UiT The Arctic University of Norway.
Today, women suffer from CFS far more than men. However, the stigmatisation leads to mean that women are afraid of seeking counsel with their GP for fear of how weak they may appear. The range of symptoms also means that doctors often have to cycle through a number of possible causes before landing at CFS.
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2. Coeliac disease
Coeliac disease, surprisingly, is the third most often missed disease in women, and it has particular consequences for female health. Left untreated, coeliac disease can wreak havoc on the reproductive system. It can cause stillbirth, miscarriage, early menopause, infertility, menstrual irregularities and absences, and reduced duration of breastfeeding.
Although coeliac disease is easily treated, doctors often need to go through a range of possible causes before reaching coeliac disease. Additionally, low weight – a visible sign of coeliac disease – is more frequent in men. The disease strikes women three times more than men, and can take six to 10 years to diagnose.
3. LupusLupus is a degenerative autoimmune disease that is 10 times more likely to affect a woman than a man. It tends to occur in people of ages between 15 and 44, and is two to three times more common among African Americans, Hispanics, Asians and Native Americans.
Symptoms for lupus vary wildly – since it affects almost every organ in the body – and can cause significant reproductive problems. It is hoped that the attention bought to the young, popular singer Selena Gomez’s diagnosis of lupus, will bring awareness to more women around the world about the illness.
4. Lung cancerOf all the cancers, lung cancer kills more women every year than breast, ovarian and uterine cancers combined, and is shockingly widespread in young, non-smoking women. The biggest reason for lack of research into this is simply because not enough women were included into early research in lung cancer.
Now, thankfully more women are included into research trials. Scientists are slowly uncovering that hormones – in particular oestrogen – have an influence on lung cancer development and mortality, and that some treatments work better for women than men. Despite this progress, there is still concern that researchers are continuing to fail in including gender-specific information into their reports.
5. Alzheimer’s disease (AD)
Alzheimer’s is typically thought of as a disease that predominantly affects men. Surprisingly, two thirds of the current 5.1 million sufferers of Alzheimer’s were actually women, as reported in 2015. In fact, it is more common than breast cancer.
Scientists previously believed that the higher number of female sufferers was because women live longer. New research, however, suggests that hormonal changes during menopause and differences in gene expression may be the reasons.
In 2016, researchers from Albert Einstein College of Medicine in New York also found that the female brain’s ability to remember better despite significant brain deterioration and inbuilt buffer, means women are diagnosed too late. MIMS
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