By Elyse Simich
September 5-9 is Women’s Health Week. It’s an initiative first established in 2013 by Jean Hailes for Women’s Health, because there were no other events dedicated to women’s health in Australia. The aim is to get women to talk about their health and will focus on the central theme “Am I Normal?”
Many health issues women can be faced with are difficult to diagnose. Obviously, a multitude of problems occur when health concerns are ignored or misdiagnosed.
The word ‘cardiovascular’ encompasses the veins, arteries and heart. Often problems affecting the heart result in a heart attack or a stroke. According to Jean Hailes for Women’s Health, cardiovascular disease is the leading cause of death in women, despite it often being associated more with men. In fact, it kills three times as many women as breast cancer does.
Heart Foundation CEO Garry Jennings said coronary heart disease often occurs about ten years later in life for women than it does for men. According to a 2010 report in the Netherlands Heart Journal this creates the misconception that women are somehow ‘protected’ from it. This means they often underestimate their symptoms, so it’s recommended they know what to look out for.
“Chest pain is the obvious one,” said Dr Jennings. “[With angina] typical pain occurs in the centre of the chest on exertion and settles with rest. More serious symptoms suggestive of a heart attack include a crushing chest pain that will not settle with rest.”
He warns that pain is not always typical.
“It may be nothing more than a niggle in the front or back of the chest,” he said. “It often radiates to the arm or neck.”
He said the major risk factors are high blood pressure, abnormal blood fats like cholesterol and diabetes.
There are some conditions that are less common, but occur more frequently in women.
“These include some forms of heart failure and some valve problems,” said Dr Jennings.
He said women most commonly visit the doctor in relation to pregnancy or contraception.
“Anecdotally where they do miss out is when minor symptoms are ignored or assessment is delayed in the context of a busy life and competing priorities with family and work.”
Fibromyalgia is a chronic disease that is so complex; it is difficult to describe. Dr Bernadette Fitzgibbon from Monash University said it’s most often characteri sed by widespread musculoskeletal pain.
“It’s associated with a constellation of other symptoms,” she said. “A number of health issues, like fatigue and sleep disturbances.”
According to the Fibromyalgia Support Network of WA, women are 11 times more likely to suffer from this condition than males are. Since there is no known cause for this disorder, the exact reason why is unknown.
One likely cause is the way women field stress.
“Outside of fibromyalgia there are a range of disorders that disproportionately affect women more than men,” she said. “These can include depression, PTSD and autoimmune disorders. These all have stress components, so it may be a way of dealing with stress. But that is most definitely going to be linked to genetics, to hormones and to immune response as well.”
Since no one knows exactly what causes fibromyalgia, it takes approximately two years to diagnose. It also means there is no test to diagnose it. Often, before fibromyalgia gets misdiagnosed as another health issue like chronic fatigue, irritable bowel syndrome or types of arthritis.
Fibromyalgia affects each individual differently, depending on its severity. Dr Fitzgibbon said despite this, it is generally “quite a disabling disorder.”
“There are people that can go about and function with fibromyalgia. They still socialise, they still go to work.”
However, more often than not, the patient’s professional and social lives are highly affected.
“For a lot of people fibromyalgia can make it difficult to work because of the fatigue,” she said.
“It can have a huge impact on your family life, your personal life, your friendships. Your ability and your desire to go out and socialise,” she said.
This can lead to relationship breakdowns and mental health issues. However, there are support groups out there, such as Chronic Pain Australia and Pain Management Australia. These groups have the resources to help people who are undiagnosed and struggling with pain, as well as those who do have a diagnosis.
Women’s mental health concerns are often ignored or misdiagnosed according to Dr Natalie Thomas and Dr Caroline Gurvich from the Monash Alfred Psychiatry Research Centre (MAPrc) Women’s Mental Health Team. They said it’s an area that requires a tailored understanding and specific treatment. However, this is often overlooked.
“Research and treatment specifically targeting women’s mental health has been traditionally neglected,” they said.
“Medicine has remained somewhat ‘gender blind’ to date, and diagnoses plus treatments are often based on the archetypical patient being a Caucasian male.”
Dr Thomas and Dr Gurvich said psychological and biological differences — such as the interaction between genes and environment — mean women respond to treatment in a different way to men.
“These interactions can affect many biological systems including chemical and hormonal systems, which not only differ between men and women, but also vary across the course of the lifespan.”
They also said gender stereotypes can hinder accurate identification and treatment of mental health disorders.
“Doctors are more likely to diagnose depression in women compared with men even if they yield similar scores on standardised tests or present with identical symptoms.
“From a treatment perspective, it has also been shown that being female is a predictor in and of itself, for being prescribed mood altering psychotropic drugs.”
Gender differences are also evident in the way people seek help.
“Violence-related mental health problems are poorly understood and identified,” Dr Thomas and Dr Gurvich said.
“For women aged between 42 and 52, depression rates increase up to sixteen times,” they said.
“This is reflected in the increased rates of suicide ideation in women during the peri-menopausal depression.”
“Depression can also occur for the first time in women who have not previously experienced depression.”
Despite the unique biological and psychological characteristics associated with the menopausal transition, most health professionals continue to treat women in this age group in the same way as men and women in other age groups.
“More women than men are affected by mental illness in Australia; but women’s mental health affects everybody; an investment in women’s health is an investment for all.
“New tailored approaches are urgently needed to address the gender-specific aspects of mental illness.”
We’re all guilty of getting swept up in our busy lives and forgetting to take care of ourselves, so take this Women’s Health Week as an opportunity to raise any health concerns you have.
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