Women with certain gynecological diseases who seek help may suffer from symptoms from doctors or nurses, a new study suggests.

Researchers reported on Thursday in JAMA Network Open that disdain and ineffective remarks by health care providers about diseases that affect vulva and vagina can cause damage to women, sometimes causing them to give up seeking help in pain.

The study focused on patients at vulvaginal clinics who are seeking medical care for a variety of conditions that may cause pain, sexual dysfunction, and bowel or bladder dysfunction.

Dr. Ob-gyn, chief author and adjunct professor at George Washington University, said the root of the study is “heard years of experience of patients, and it feels like the wider medical community doesn’t know how painful it is to comment on patients.”

Moss and her colleagues designed a survey that included dismissive comments and frequent behaviors, such as doctors telling women to lose weight, go to treatment, or drink more alcohol to cope with pain.

Survey completed by 447 women Between August 2023 and February 2024. Some survey questions include:

• “How many of the healthcare providers you’ve met make you feel your symptoms are in your mind?’”
• “Have you been told you just need to relax more?”
• “Have you been told that your vaginal opening is just 'too small?'”
• “Have you been told you just 'need a glass of wine' or something like that?”
• “I was told that despite the obvious pain reported on the exam, the pain I had during my physical examination was normal.”

Participants reported that in the past, the average 43.5% of the support was supported by practitioners. However, more than a quarter of providers are derogatory, with about 20% not trusting patients.

Overall, only more than 40% of women were told they only need to relax more, recommending about 20% of women drinking alcohol, while 39.4% said they were being “feeling crazy.”

Many women say they no longer need care because they think their concerns are not met. An estimated 20% of patients were referred to psychiatry without medication.

"The comments 'only one glass of wine' are particularly common recommendations for pain patients reporting very painfully."

The researchers say the finding is important because the dismissed situation may stop seeking medical services and experience delayed diagnosis.

This study has obvious limitations. It is conducted in a clinic and may not represent a diverse population. The researchers did not explore whether there were more questions for male or female caregivers, although Moss said many participants felt that the treatment was different based on the clinician’s gender. The investigation is based on patient recall.

However, Moss believes similar results will be found in other centers.

Dr. Roger Dmochowski, professor of urology, surgery and gynecology at Vanderbilt University Medical Center, said the new report highlights women who frequently experience urinary and pelvic floor complaints.

"It's my impression that women are traditionally untreated and their symptoms are minimized or marginalized," Dmochowski said. "Women are ignored or derogated because of their symptoms."

One important factor in providing care is focusing on what the patient is talking about, Dmochowski said. "A real critical part is listening to the patient," he added. "Many patients have very complex performance: pain, pelvic floor dysfunction, urine problems, sexual problems. Every part of the puzzle is important. Empathy is crucial."

What should women do when the doctor doesn't listen

Dmochowski said patients should go to other providers without hesitation.

"Don't give up," he said. "Several negative experiences should not stop you from seeking care."

Dr. Alessandra Hirsch, assistant professor of obstetrics and gynecology at the School of Physicians and Surgeons at Columbia University Waglos University, was not surprised by the findings of the study.

“In the medical community, there is a history that can compete with providers who don’t believe in women’s pain,” she said. “It’s hard for me to read the patient’s accounts, especially those with chronic pain syndrome, such as endometriosis, which is usually not diagnosed for many years.”

Hirsch hopes that doctors who read the study “try to avoid falling into these habits.”

Hirsch said that for doctors, that is important.

“There is a chronic pain study that shows that they feel that patients with providers are attentive and are being scored for symptom severity,” she said.

A large part of the problem, Hirsch said, is that doctors don’t train much on pelvic pain. The health care system makes doctors anxious for exams.

Her advice for women: If the exam is uncomfortable, keep moving forward and realize that gas is a form of disrespect.