If you have ever left a doctor’s appointment feeling like your symptoms were not taken quite as seriously as they should have been, a major global review has now put numbers to that feeling. Researchers have found that women with the same heart, kidney or liver conditions as men are consistently less likely to be offered active treatment such as surgery, a stent or a strong painkiller. For anyone managing a long-term condition, or caring for a partner who is, it is a finding worth carrying into the next appointment.
The review, led by researchers at the University of St Andrews, looked at 38 studies covering conditions including heart disease, kidney failure and Parkinson’s. In 33 of those studies, women came out with the lesser option. Where men with a heart attack, heart failure or an irregular heartbeat were more likely to be sent for a coronary bypass or a stent, women with the identical diagnosis were more often managed with medication alone. Women were also less likely to be prescribed statins.
The gap showed up across specialties. Men with Parkinson’s were more likely to be referred for deep brain stimulation, and men with liver failure were more likely to receive a transplant. Women needing dialysis for kidney disease were less likely to be given permanent access for treatment and had to rely on a catheter for longer. Women were also less likely to be given opioids to manage pain.
Not every condition showed the same pattern. Stroke and diabetes treatment did not differ significantly between men and women, and women were actually more likely to be treated for dementia. But across cardiology, surgery and transplant medicine, the gap held firm, and researchers found no clinical guideline anywhere that recommended different treatment by sex.
Dr Andrew O’Malley, who co-led the study, said the findings should prompt doctors to check their own reasoning. “For clinicians, the findings are a prompt to check whether treatment is being offered on clinical grounds rather than assumption,” he said. He pointed to earlier research showing doctors more often put women’s symptoms down to anxiety, and made more diagnostic errors in female patients even when test results came back positive.
Dr Miriam Veenhuizen, an honorary lecturer at the university’s School of Medicine, said it was the consistency of the pattern that stood out. “While the direction of the findings was not a surprise, the consistency was. The same pattern appeared in cardiology, surgery, transplant medicine…” she said.
None of this means the treatment women are offered is wrong, or that surgery is always the better path. It does mean the choice on the table should be the same one a man in the same condition would be given, and that is worth asking about directly.
A simple question at your next check-up – would a man with my results be offered anything different? – costs nothing and may open a conversation your doctor is glad to have.
