| And How to Get the Medical Answers You Need |
| When it comes to medical care, women aren’t just smaller versions of men. They have entirely different medical needs. Yet in the quest to cure what ails you, doctors sometimes don’t account for the health differences between the genders. A number of conditions manifest differently or occur more frequently in women than men, which means sometimes symptoms are ignored, misdiagnosed or treated inappropriately. Several commonly misdiagnosed medical conditions in women are heart disease, thyroid conditions and fibromyalgia. Learn what you can do to protect yourself. Plus, test your smarts with our women's health quiz…
Nausea, shortness of breath and sharp chest pain are common indications of cardiovascular disease. However, when those symptoms present themselves in women, the indicators might be chalked up to anxiety or heartburn.
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Why it’s difficult to diagnose: “Health care for women has traditionally focused on screening for breast, ovarian, cervical, and other cancers,” says Dr. Norma Keller, clinical chief of cardiology at Bellevue Hospital in New York. “But ironically, heart disease is the number one killer of women over 45, killing 1,400 women every day.” That’s more deaths than all cancers combined. (See related article: Medical Myths That Can Kill You)
Most heart attacks are caused by coronary artery disease, usually the result of arteriosclerosis. This buildup of plaque causes arteries to harden and narrow, which prevents the flow of blood and can result in a heart attack. According to the Journal of the American College of Cardiology, women manifest symptoms of heart disease differently than men, particularly if they are suffering from coronary microvascular syndrome (CMS). In women with this condition, plaque collects in small arteries of the heart. The lack of significant blockage in routine angiograms often leads to misdiagnosis.
What you can do to help prevent misdiagnosis: Women who experience symptoms of heart disease, such as pressure or burning in the chest, shortness of breath, irregular heartbeat, dizziness, sweating, fatigue, and nausea, should ask their doctor about a nuclear stress test or stress echocardiogram, Schwartz says. Additionally, just as they do for cancer, women should screen themselves for heart disease and control their risk factors:
- Find out if your parents or grandparents suffered from heart disease.
- Monitor your blood pressure regularly, especially if high blood pressure runs in your family.
- Have your cholesterol measured annually, more often if it is high.
- If you smoke, quit.
- If you are obese, lose weight. Exercise 30-40 minutes at least four times per week.
- If you are diabetic, take your insulin as instructed, eat a balanced diet low in sugar and engage in daily exercise, such as walking.
2. Thyroid Disease
Thyroid disease is one of the most often undiagnosed and misdiagnosed diseases. According to the American Association of Clinical Endocrinologists, up to 27 million Americans may be affected by thyroid diseases. Of this number, more than 50% are undiagnosed. One research study reported that 3% of college-age women studied had a thyroid disorder.
The thyroid gland regulates the pace of the body’s metabolism through the production of hormones. Hypothyroidism (associated with a slow metabolism) occurs when the thyroid fails to produce hormones triiodothyronine (T3) and tetraiodothyronine (T4). Symptoms include weight gain, puffiness of the face, fatigue, depression, dry skin, brittle nails, hair loss, development of a goiter, hoarseness, increased sensitivity to cold, slow heart rate or congestive heart failure, constipation, muscle pains and cramps, and heavy menstrual flow.
Conversely, hyperthyroidism (associated with an overactive metabolism) is the overproduction of the T3 and T4 hormones and can be caused by Graves’ disease (an autoimmune defect) or inflammation of the thyroid. Symptoms include weight loss, hot flashes, nervousness, anxiety, fine or brittle hair, increased sensitivity to heat, rapid heart rate, difficulty sleeping, frequent bowel movements, muscular weakness, and lighter menstrual flow. In the case of Graves’ disease, there may also be bulging of the eyes.
Why it’s difficult to diagnose: “One of the problems with diagnosing thyroid disease is that the symptoms are non-specific and come on gradually,” says Dr. Joseph Rand, a board-certified endocrinologist. “The condition is typically genetic, and there are no other identifying risk factors.” (See related article: Are You At Risk for Hypothyroidism?)
Undiagnosed and untreated thyroid disorders can lead to elevated cholesterol levels, heart disease, high blood pressure and depression. A blood test determines diagnosis, and hormone replacements can be taken in the case of hypothyroidism, Rand says. In the event of hyperthyroidism, doctors typically prescribe anti-thyroid drugs to block the overproduction of thyroid hormone, radioactive iodine to destroy the overactive thyroid tissue, or surgery to remove the thyroid gland.
What you can do to help prevent misdiagnosis: If you think that you might have a thyroid condition, there are several measures you can take to reduce the risk of a misdiagnosis:
- Be aware of risk factors, which include a family history of thyroid disorders and having radiation or neck surgery.
- Perform a self-check for an enlarged thyroid. Drink a glass of water in front of a mirror. If you see a lump on the thyroid location below the larynx (or Adam’s apple) and just above the collar bone, contact your physician for further diagnosis.
- Pay attention to your symptoms.
- Keep a journal to track your progress and note any changes in health you experience.
- Maintain follow-up appointments and an ongoing dialogue with your physician about how you are feeling.
3. Fibromyalgia
An estimated 10 million Americans – mostly young women – suffer from fibromyalgia (FM). It is often referred to as an “invisible” illness or disability due to the lack of outward indications of illness. Symptoms of FM may seem unrelated, and conventional medical tests typically come back normal.
However, fibromyalgia is a chronic condition marked by widespread pain, intense fatigue, heightened sensitivity and needle-like tingling of the skin, muscle aches and spasms, weakness in the limbs, and nerve pain. People with FM may also have problems sleeping and deficits in short-term memory.
The cause of fibromyalgia is unknown, although some experts believe stress or genetics play a role. Pain may worsen as a result of increased stress, excessive physical exertion, lack of deep sleep, and changes in humidity and barometric pressure. One theory suggests that a decreased level of serotonin, a neurotransmitter that regulates sleep patterns, mood, feelings of well-being, concentration, and tolerance to pain, may be a factor.
Why it’s difficult to diagnose: “Difficulty in diagnosis is due to the fact that symptoms vary from person to person. They overlap with other diseases, and there are no definitive blood tests for it,” says Dr. Bart Price, who practices internal medicine in Florida.
FM is diagnosed through the exclusion of other conditions, but it is often misdiagnosed because other disorders, such as chronic fatigue syndrome, depression, Lupus, Lyme disease, and thyroid conditions, can produce similar symptoms. The invisible nature of the illness, as well as its relative rarity (about 2% of the population has been diagnosed with FM) also make a definitive diagnosis difficult.
While there is no universally accepted cure for fibromyalgia, prescription muscle relaxants and nonsteroidal anti-inflammatory drugs are recommended. Some studies suggest that mild exercise and sleep may reduce pain and fatigue. Many people also find temporary relief by applying heat to the painful areas. Physical therapy, massage and acupuncture may also help.
What you can do to help prevent misdiagnosis: Be persistent with your doctor, Price says. Ask questions about your symptoms, request blood tests to rule out other diseases, and seek a second opinion from a rheumatologist if necessary.
If you believe you may have FM, ask your doctor these questions:
- Have you checked for fibromyalgia?
- What can I do to ease my symptoms?
- What medications can I take?
- What drugs, foods or activities I should avoid?
- What alternative therapies or stress management techniques might help me?
- Do you recommend counseling?
- How do I explain my condition to others?
