A woman experiences chest pain, fatigue, and migraines — she goes to the hospital and receives a diagnosis of a panic attack. She returns home still feeling unwell, carrying the sense that it was not merely “fleeting anxiety.” A young woman experiences severe cramps during her menstrual period, goes to the hospital, and receives a prescription for generic painkillers. Years later, she is diagnosed with endometriosis, while the woman diagnosed with a panic attack was living through the early symptoms of a heart attack.
This scenario is part of the daily routine in emergency rooms, clinics, and hospitals. It is an issue rooted in the structural origins of medicine — women treated as simply dramatic, consequently being misdiagnosed. This is structurally tied to the fact that the male body has always served as the standardizing benchmark for medical studies and research.
“Seeing men as the human default is fundamental to the structure of human society. It’s an old habit, and it runs deep—as deep as theories of human evolution itself,”
By Caroline Criado Perez in Mulheres Invisíveis (2022), a work exposing how the data organizing the world—from science to politics — ignores the female sex.
Female pain is often initially viewed as purely psychological—linked to a daydreaming mind incapable of rational thought. For centuries, any unexplained physical symptom in women was attributed to “irrational” emotional or biological instability. The concept of Hysteria—a term derived from hystéra, the Greek word for uterus—was shaped in various ways over time.
For Hippocrates, the uterus was viewed as a sort of ‘animal’ that roamed the body in the absence of sexual activity, suffocating other organs, with marriage offered as a ‘cure.’ Centuries later, French neurologist Jean-Martin Charcot approached hysteria at La Salpêtrière hospital as a nervous system disorder, using hypnosis to demonstrate that symptoms were real, even without visible organic lesions.
Thus, across different medical currents, the term hysteria was commonly maintained to define an illness of the nerves and desire, governing emotions and outbursts. Although the word itself fell into disuse due to its reductionist biases, the habit of reducing female pain to anxiety or mere PMS remains in practice.
Bias can prove fatal when analyzing a patient’s symptoms. Heart attack symptoms, for instance, differ significantly between men and women—while men typically experience acute chest pain, women feel fatigue, back pain, and nausea. A study published in 2016 by the British Heart Foundation states that women are up to 50% more likely to receive an incorrect initial diagnosis when suffering a heart attack compared to men.
In 1991, American cardiologist Bernadine Healy coined the term Yentl Syndrome—inspired by the movie Yentl (1983), starring Barbra Streisand, in which the protagonist disguises herself as a man to pursue her studies, and explain that women frequently receive correct medical care only if they present symptoms identical to those of men.
Due to this difference in clinical presentation, women are frequently diagnosed and treated late: women with severe abdominal pain wait an average of 65 minutes to receive pain medication, while men wait 49 minutes (16 additional minutes of pain). Furthermore, women are 13% less likely to receive strong analgesia (opioids) for pain of equal intensity, according to a study from the University of Pennsylvania School of Medicine.
Behind this disparity in doctor’s offices lies a technical cause: the deliberate exclusion of women from clinical trials for decades. The frequent justification was that the hormonal fluctuations of the menstrual cycle would ‘disrupt’ or ‘pollute’ the data. It was only in 1993 that the National Institutes of Health (NIH) and the FDA made the inclusion of women in scientific research mandatory in the US. Until then, the vast majority of drug trials considered only the metabolism of the ‘standard 70 kg man’.
Girls deal with menstrual pain from an early age, recurring monthly in varying intensities. A study conducted by Instituto Alana and Instituto Equidade.Info shows that 40% of female students in Brazil miss school every month due to menstrual pain. The survey reveals that severe cramping and the fear of leaks generate deep insecurity and exclusion in the daily routines of students and teachers. This data illustrates that while most girls suffer from these pains, they are expected to learn to cope with them while managing their routines.
Endometriosis, for example, was classified by the World Health Organization (WHO) as one of the diseases requiring the longest investigation period — from 7 to 10 years — to reach a conclusive diagnosis, being repeatedly dismissed as “normal cramps” or “dramatic”.
The invalidation of female pain goes beyond individual medical error: it is the symptom of a system in urgent need of reform. Transforming this reality requires granting prestige and funding to clinical studies conducted by and for women, investing in research focused on endometriosis and conditions that predominantly affect female bodies.
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The article above was edited by Sarah Pizarro.
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