In our NHS, women's lives are still less important than men's

The report about women being given less pain relief than men from Kings College London below was compiled and published in September. The article on the BBC website was published on Monday - what is the point of gender equality if your healthcare is less important? Can you imagine a man who has part of his testis growing inside other organs being told it was just part of being male? Women with endometriosis are often left, even without a diagnosis, in pain as a result for years.

I have some skin in this game on the pain front. I have urethral pain syndrome caused by M.S., and when the first painkiller, pregabalin, stopped working in 2010, a less sympathetic GP looked a bit bored until I said, "If we were to put your penis in boiling oil, that's where I am." He put me on morphine for 3 months while I waited for an appointment with a pain clinic (of which there aren't enough). Acute pain ineffectually treated becomes chronic, costing the NHS ￡.8 billion and the UK economy billions more.

Currently the NHS is not funded to keep the country physically up and running. Instead, it's there to try to keep you alive. Pain is not a priority, as it means you are alive! The painkillers I now take solved all the issues. What I went through is nothing compared to the women in the BBC article.

The Kings College London 04 September 2024

"Study finds women less likely to be prescribed pain relief than men

Women are less likely to be prescribed painkillers than men even when they are experiencing similar levels of pain – a new study has found.

In a study of thousands of hospital patients, researchers found that not only were healthcare providers less likely to prescribe women with pain relief medication than men, they were also less likely to record their pain score and kept women in emergency departments for longer.

Researchers believe misconceptions around the ability of women to tolerate pain, as well as beliefs around pain exaggeration, are behind the disparity, which could be causing unnecessary suffering among women.

The researchers said: 'Our work reveals a systematic sex-related disparity in pain management: a female patient discharged from the emergency department is significantly less likely to receive treatment for a pain complaint, compared to a male patient.

Datasets from emergency departments revealed that female patients were less likely to receive a prescription for any type of analgesic medication, both opioids and nonopioids, compared to male patients.

Female patients were less likely to receive analgesics for every pain score and at every age group, even when controlling for multiple patient and emergency department characteristics.

Females also received fewer analgesics from both male and female physicians. Their pain score was less likely to be recorded by triage nurses, and they stayed longer in the emergency department.'

The findings were revealed in a new study, Sex bias in pain management decisions, co-authored by Moses Shayo (King’s College London), Mika Guzikevits (Hebrew University of Jerusalem), Tom Gordon-Hecker (Ben-Gurion University of the Negev), David Rekhtman (Hadassah Medical Centre), Shaden Salameh (Hadassah Medical Centre), Salomon Israel (Hebrew University of Jerusalem), David Gozal (University of Missouri), Anat Perry (Hebrew University of Jerusalem), Alex Gileles-Hillel (Hadassah Medical Centre), and Shoham Choshen-Hillel (Hebrew University of Jerusalem).

Data for the study was drawn from the hospital discharge notes of more than 21,000 people with pain complaints in the US and Israeli healthcare systems.

Data from Israel showed that a patient’s likelihood of receiving a pain-relief prescription was lower for women (38 per cent) than men (47 per cent). The finding was supported by similar data from the US, with women (26 per cent) less likely to receive pain relief prescriptions than men (31 per cent).

The researchers believe that pre-existing biases held about men and women and perceptions of pain may explain the disparity seen in their results.

They said: 'Previous work has shown that individuals tend to perceive females’ pain as less intense than that of males. This perception bias has in turn been explained by a gender–pain exaggeration bias: People view females as more emotional and assume that they overreport their experienced pain compared to males.

The literature has suggested additional stereotypes that may also explain why female patients receive less pain treatment, such as the perception of females as more capable of physically tolerating pain than males.

While other stereotypes may be at play, our findings of bias in healthcare providers’ pain perception are in line with the exaggeration mechanism.”

BBC News website:

"Gynaecology waiting lists double, leaving women in pain.

Smitha Mundasad - Health reporter Catherine Burns - Health correspondent BBC Website 18th November 2024

Waiting lists for gynaecology appointments across the UK have more than doubled since February 2020, BBC research reveals.

Records show around three-quarters of a million (755,046) women's health appointments are waiting to happen - up from 360,400 just before the pandemic.

This would suggest around 630,000 people - at the very least - are on the list to be seen for problems that range from fibroids and endometriosis to incontinence and menopause care.

Health ministers across the UK say they are working on plans to improve the situation, but health leaders say that women are being let down.

'The illness controls my whole life'

Anna Cooper, 31, from near Wrexham in North Wales, has had severe endometriosis since her teens.

The condition - where tissue similar to the lining of the womb grows outside it - has left her with permanent organ damage.

She has had to have 17 operations, including a hysterectomy to remove her womb.

She also has two stomas in place for life because much of her bladder and bowel have had to be removed. She lives with her partner and young daughter.

'The disease controls my social life, my work life and my ability to function every day. It is not just a period problem - it is a whole body problem. It ripples through your body,' she says.

The BBC spoke to her in 2023 about setting up her own charity,?Menstrual Health Project: https://menstrualhealthproject.org.uk/about/

A year on, she says she is still in pain and is on the NHS waiting list yet again because she has experienced bleeding after her hysterectomy.

Anna wears a morphine patch to help deal with pain every day.

But for years, she says medics did not listen to her, and told her the pain was 'in her head' and that she had to 'just get used to it'.

She feels getting a diagnosis sooner would have changed her life: 'The delay in my care has cost me some of my major organs. Doctors have told me that if they'd caught it sooner, I wouldn't have ended up the way I am, living with two stomas and being in early menopause at the age of 31.'

In the last three years she made the decision to spend ￡25,000 on private operations, borrowing money to help.

She counts herself lucky to get private care but feels she was 'almost left with no choice' because the waiting lists are so long: "I can be a mum who isn't just in her bed constantly because she is crippled with pain.'

Endometriosis has 'mentally tormented' her for the most of her adult life.

'It is really difficult dealing with a condition where I look absolutely fine from the outside, but internally, I'm just in despair.'

'Lack of priority'

'Women are being let down' and change is 'urgently needed,' says Dr Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists (RCOG).

The college's?new report looks at the impact on people waiting for care: https://tinyurl.com/mvfew3ut

'Gynaecology is the only elective speciality that solely treats women and has one of the worst waiting lists across the UK. This reflects the persistent lack of priority given to women and women’s health,' Dr Thakar says.

"Women are suffering. We know it is affecting their mental health. They are not able to go to work, they are not able to socialize."

Dr Thakar adds that if the women had been treated earlier, their conditions wouldn't have progressed as much, and they would continue to contribute to society.

A?recent report led by the NHS Confederation suggests being absent from work because of heavy periods, endometriosis, fibroids and ovarian cysts costs the UK economy nearly ￡11 billion each year.

https://tinyurl.com/2xwwaa33

The RCOG is calling for governments to commit more long-term funding, to ensure people get the help they need.

There are some signs that waiting lists are starting to improve...the situation is still much worse than pre-pandemic. In February 2020, there were 66 gynaecology waits of more than a year. Now there are more than 22,000."

GPs need more gynaecological training so women are referred and treated for endometriosis earlier before the disease controls their lives. Gynae funding should be at the top of Wes Streeting's to-do list.

#UnderFundngGynae