Why We Need to Address Gender Bias in Healthcare

One of our earliest 2024 projects was with Reckitt, supporting them with their Gender Pain Gap campaign.

Reckitt hosted a talk at the Best Practice Show as part of this campaign. Titled ‘Gender bias in the management of women’s pain’, three healthcare professionals raised a series of pertinent points on how women’s pain is viewed and the impact this has on their treatment. Here’s what was covered in this talk.

Far from suggesting pain is experienced by both sexes in the same way, Professor Katy Vincent, Senior Fellow in Pain in Women and Associate Professor at the University of Oxford proposed that women’s pain is, in fact, different. Here’s what she discussed.

What are the most common causes of pain for women?

From her research, Professor Katy Vincent noted that the following are the most common causes of pain for women:

• Period pain (dysmenorrhoea)
• Painful during or after sex (dyspareunia)
• Chronic pelvic pain

As seen from the above list, women’s pain is often more intimate than males, and is frequently experienced around and due to female reproductive organs. The prevalence of several common chronic pain conditions is also greater for some women than men including fibromyalgia, migraine and chronic tension-type headache, irritable bowel syndrome, temporomandibular disorders, and interstitial cystitis.

The extent to which the lives of women are affected by the pain varies widely, and studies of general practice records showed that despite affecting millions, annually only 4% actually consult a GP for their symptoms.

For many of us (myself included!) we silently accept the taboo or avoid discussing symptoms mainly because, as women, we think this is a normal part of life and ‘get on with it’.

But the talk made clear that just because pain is common doesn’t mean it should be considered normal and, by extension, acceptable.

Take period pain as an example. It’s experienced by 80-90% of women and is a leading cause of absenteeism, with 30-40% of women regularly missing school or work as a result. If the pain is ‘normal’, why should it have such a detrimental effect on our lives?

Interestingly, I also found out that due to longer life expectancies and less time spent pregnant and/or breastfeeding, women in developed countries have four times more periods than women 200 years ago – on average 450 in a lifetime.

However, women in developing countries who may breastfeed for longer and have multiple pregnancies with a lower life expectancy could have an estimated 100 periods throughout their lives.

What then is ‘normal’ if so many different experiences exist? What is the baseline for ‘normal’ pain?

When it comes to healthcare-based gender bias in action, consider these research findings:

• Women are given IUDs without pain medication, but the new male implant contraception ‘ADAM’ is available under local or general anaesthetic.
• Women are often given sedatives rather than painkillers because their pain is seen as a symptom of hysteria.
• Women are  25% less likely to receive pain medication than men.
• Women wait, on average, 26 minutes longer to be prescribed pain relief in A&E.

 Gender biases have serious and sometimes fatal repercussions. One study found that women are up to seven times more likely than men to be misdiagnosed and discharged in the middle of having a heart attack.

Why?  Because medical concepts of most diseases are based on the understanding of male physiology, historically, women have been excluded from clinical trials.  Men were treated as the “medical norm”, and women ‘…in essence, considered small men.’

This is a mad fact for you: It took until 2014 for the National Institute of Health to begin acknowledging a problem with male bias in preclinical trials and until 2016 for it to mandate that any research money it granted must include females. 2016!!!

Led by Professor Rebeccah Slater, Professor of Paediatric Neuroscience at the University of Oxford, the conversation moved on to the effect our words have.

One GP pointed out that drugs used to treat pain are overstated. ‘I say things like pain killer, and then the patient is led to believe what I am giving them will get rid of the pain completely when it doesn’t. I don’t use words like cholesterol combuster or low mood miracle’.

Concerns were raised that using specific terms and words that suggest pain medication will rid one of pain ultimately was detrimental to the patient. They focus too much on pain when the focus should be on quality of life instead.

If GPs are making this mistake, then, as copywriters or creatives, we also have to consider the weight our words can have when devising material for patients.

Some of my key takeaways from the talk were as follows:

Use words wisely 

Whether you’re a marketeer or a clinician talking to a patient, think about the weight of your words. Don’t use phrases like ‘pain killer’. Over-promising the effects of pain medication leaves patients frustrated and disappointed when the pain returns. Ideas offered by the audience for more realistic phrases were ‘pain relief’ or ‘pain management.’

Provide additional support tools

Many HCPs in the audience spoke about the need to educate patients on new technologies. However, for HCPs to do this, they must be aware of what ‘new technologies’ exist. That’s why reaching out to them with education packs could create powerful brand advocates for your brand or service.

Consider language barriers 

Whilst gender is one consideration, within this single characteristic are many variants and assuming all women speak (and read) English in the UK is a mistake. Translating assets into different languages ensures the most vulnerable can advocate for themselves.** 

*Brands like Daye are making waves in this area as well investing in innovation to bridge the gender gap in medical research and innovation.  

**I was delighted to see another client of ours, Breast Cancer Now, had their leaflets translated into numerous languages including Arabic, Urdu and Spanish.

I was encouraged by how many HCPs attended, but it’s concerning that we’re still having this conversation. Below is a list of resources I’ve found helpful lately for anyone wanting to learn more about gender bias and health issues.

Valentina Milanova

Valentina Milanova founded Daye, a gynae health research and development company, with a mission to close the gender pain gap and overcome historical gender biases in medical research and product innovation.

Jane Brearley 

If you want to learn more about health inequalities, Jane Brearley is your person. Her feed is full of valuable insights and she set up Intent Health, a healthcare communications agency focused on reaching forgotten, ignored, or misunderstood communities.

Jo Corral

An old school friend, Jo Corral, has set up a sex education and vulva acceptance campaign, This Is A Vulva, to stem the rise in labiaplasty. She also runs make-your-own vulva workshops/pub quizzes, which are a must!

Book Recommendations on the Gender Pain Gap

• Invisible Women: Data Bias in a World Designed for Men
• Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick

Interesting Research on the Gender Pain Gap

• https://link.springer.com/article/10.1186/s12939-020-01283-4
• A whole heap of papers from the British Medical Journal – https://www.bmj.com/gender
• https://www.gov.uk/government/publications/womens-health-strategy-for-england/womens-health-strategy-for-england

Learn more about this campaign by visiting the Nurofen case study on our website.