I lecture often on the topic of women, hormones, and hearts. Heart disease is the number one cause of death in women – in fact, it kills more women every year than cancer.
However, research shows “significant” disparities in the way women are treated – in terms of diagnosis, management and outcomes – compared to men. This issue isn’t confined to heart disease – the gender pain gap is causing women to wait longer for treatment in the emergency room, and can even lead to female patients being misdiagnosed – one study carried out by the American Psychological Association revealed how women with chronic pain are more likely to be given a mental health diagnosis instead.
The question therefore arises – why are these things happening and what can and should be done to improve the care and the outcomes for women? I think a great deal of the problem is women’s self-deprecating behaviors and their feelings of deference to male authority figures – and even to themselves. They are more likely to repeat such things as, “I’m sure this is nothing,” or, “I’m probably making too big a deal out of this.” They don’t want to be a bother or to complain, so they downplay their symptoms – with potentially fatal consequences.
Female physicians tend to empathize more and listen to their female patients, and are often more aware of female cardiac manifestations. In return, female patients feel less intimidated and able to vocalize their true concerns and feelings, making them less prone to minimizing their symptoms and belittling themselves for “bothering” anyone.
However, the ultimate solution would be to better educate women on the early symptoms of heart attacks, and the importance of self-advocacy for their health and their lives, regardless of whether their attending physician is a man or a woman. And physicians need to be better educated as well, to clearly recognize the varied and subtle ways heart attacks can present in women.
I also have to include a plug for my beloved hormone – estrogen. Prevention is the best medicine, so let’s recognize the profound impact of menopause on women’s hearts. Women have heart attacks, arrhythmias, and heart failure for a reason, and the role that the loss of ovarian estrogen production at menopause plays cannot be overstated.
I hope to become a force for women’s cardiovascular wellbeing by educating all on the vast and varied roles played by estrogen in the female cardiovascular system, and lead the charge in taking action to keep women healthy and save lives. If menopausal women were prescribed physiological doses of estrogen, along with progesterone and testosterone, I believe it is possible for a large percentage of female heart attacks could be prevented in the first place.
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