‘Aurat ko dard nahi hota’

Anshumaa Sharma

To add insult to injury, the doctor turned to her parents “and said I must be lying about my diet because I am fat”. At the age of 29, Sharma instantly felt infantilised, invisible before the doctor who was meant to fight for her medical rights. “I asked sarcastically, ‘Why are you talking to my parents and not me? I am eating nothing but lauki [bottle gourd] and curd.”

After weeks of being bent over in pain and looking for answers, Sharma went to a radiologist for a test and it was she who listened to the full medical history and recommended a doctor — another woman — who finally identified a pattern to the symptoms and made a diagnosis: Coeliac disease, a painful autoimmune condition that strikes the small intestine.

Within four months, not only was the pain much better, but Sharma’s thyroid levels also stabilised, and her weight started dropping too. Sharma says she has more energy through the day, and is even able to hit the gym. 

It’s a story that most women will relate with — the dismissal of genuine health concerns with a callous prescription of: “Lose weight”. The systemic neglect of their pain by medical practitioners who blithely say, “Don’t be dramatic. If you can’t bear this pain, how will you bear children?” There’s a term for it: medical misogyny. And, unfortunately, Sharma is far from the only woman to be acquainted with it.

As we celebrate International Women’s Day and are bombarded with spa discounts and distracted with jewellery coupons in our inbox, let’s not forget to ask the tough questions — is the medical fraternity, especially your trusted family doctor, really listening to your pain?

Did you know?

Venus Williams

The tennis star’s uterine fibroid symptoms — pain, heavy bleeding — were dismissed by doctors for years as “normal”

Halle Berry

The actor was misdiagnosed with herpes after complaining of pain after sex. It later turned out to be a symptom of perimenopause.

‘Oh, you’re being dramatic’

Shivani Lia had always had a painful period. “Even my first year was very painful and I bled for 12 days. I’d miss a lot of school, but teachers wouldn’t take me seriously because none of the other girls were facing this issue,” recalls the 29-year-old event operation manager. 

She’d been to many gynaecologists, to no avail. “It was constantly implied that I was being dramatic. But it felt like someone had taken a grater to my insides.” In Class 8, a women’s health specialist told her parents, “Get her married soon so she can have a baby, and everything will be resolved”. “I was 13 years old then,” she recounts.

Shivani Lia struggled with debilitating pain for years before being diagnosed with endometriosis. Pic/Nimesh Dave

It would be years before she found answers on a Facebook group for endometriosis, a painful condition in which cells similar to the lining of the uterus (endometrium), grow outside it. On the same group, she found a specialist in Mumbai. 

“He assured me that my pain was real, that I wasn’t making it up. I wept — it was the first time I felt seen,” says Lia. She was diagnosed with endo and adenomyosis (endometrial tissue grows into the muscular uterine wall, causing it to enlarge and thicken). Four years on, she has had as many surgeries.

Lia rues the lack of research even today, “The crazy thing is, there’s such little research even now about endometriosis, but there are multiple papers on how it can impact the partner’s pleasure [patient is more likely to refuse sex because of pain] and on how people with endometriosis are attractive.” 

The default is male

Until the 1990s, women were not even part of most clinical trials because their monthly menstrual cycles added unwanted variables to the research. This means that modern medical textbooks don’t teach how the same ailment can present differently in a man and a woman. Take heart attacks; a University of Leeds study found that women are 50 per cent more likely than men to be misdiagnosed because doctors often mistake their symptoms for acid reflux.

Dr Sukhpreet Patel MD Obgyn (India), MPH (UK), and founder of MenopauseWize, points out that in medicine, male is default mode. “We have paediatrics, a branch of medicine just for children, because we recognise that their physiology is very different. There are specialists for paediatric neurology, paediatric cardiology. But what about women? Our bodies are structurally, anatomically different, and yet there is no dedicated research or practice around this,” she says. 

Women’s health issues get clustered under the umbrella of gynaecology. But the gynaecologist — like any other specialist — is taught to focus on their field: women’s reproductive health. “For instance, we talk about menopause as a separate gynaec problem. Is it really separate? It impacts neurology, cardiology, orthopaedics, and so much more. Which means each of these practitioners should have been educated about what happens at menopause,” says Dr Patel,  who recently launched a menopause-dedicated clinic at Nana Chowk.

The issue is manifold, she adds, including the social conditioning of women to make as few complaints of demands as possible. “Every woman must speak up for herself, to say I am NOT taking no for an answer,” she says, while adding, “But doctors in training should go through sensitisation training to stop us from dismissing a woman’s pain.” 

Add to that, there’s little funding for research on women because of low purchasing power among a gender restricted to unpaid labour at home for generations. A 2024 report by the McKinsey Health Institute estimates that the women’s health gap equates to 75 million years of life lost due to poor health or early death per year, or seven days per woman per year. It also pointed out that closing this gap could boost the global economy by $1 trillion annually by 2040.

‘Fed up of being gaslit’

Mini Mathur, TV personality and founder of Pauseitive (@pauseitive.in), a perimenopause platform

‘When I hit perimenopause a few years ago, it started with brain fog, insomnia, and anxiety. It felt off because I was doing nothing differently with diet or food. A GP recommended sleeping pills and anti-anxiety medication, while a gynaec just said “it’s normal”. I was fed up of being gaslit and decided to study menopause for two years. I certified in the US in women’s health, functional nutrition, and hormone health. Now, I’m using this knowledge to advocate for women and their health in midlife, and developing Pauseitive, a platform for women to learn more about perimenopause, menopause. I think what’s most important is for the narrative around menopause to change, for women to become aware about it and their long-term health.’  

Talk medicine to me

Even in fields that work closely with women, such as gynaecology and IVF, doctors lack the sensitisation to communicate clearly with patients. Aparna Kulkarni (name changed) recalls going for IVF rounds with little to no warning about the side effects and limitations. “There was no counselling for me or my partner on how the hormones would wreak havoc. My husband had no idea why I wanted to kill him until he started reading about it online,” she quips. Even more problematic is the promise of guaranteed conception that some IVF centres make, when outcomes are much still hit-and-miss. Kulkarni and her husband read up extensively, but even they were not prepared for the final shock: women can only undergo three to four cycles of IVF, after which the risk of hormone-sensitive cancers (like breast or cervical) rises. After the fourth cycle, they were forced to abandon their attempt at conception.

Hold the judgment

Manjusha Pillai had been suffering from shortness of breath for a few weeks when she went to see a pulmonologist.  Strangely, he never asked her if she was a smoker. “It seemed like he’d assumed I didn’t smoke because I’m a woman,” says Pillai, “When I told him that I smoke, he asked if I was married. I said yes. His next question was, ‘Doesn’t your husband mind that you smoke?’” When Pillai asked how it was relevant to her breathing problem, “He brushed it off saying I should be careful about smoking if I plan to have children. I never went back to him again.”

50%
Likelihood of heart attack being misdiagnosed in women over men
*Source: University of Leeds

7
Estimated number of days of life lost per woman per year due to the health gap
* McKinsey Health Institute, 2024