For people with chronic gynecological pain conditions, the pain can be persistent, and it is very uncomfortable to perform daily activities such as sitting, cycling or even wearing underwear. For many of them, most are considered female-sexual intercourse and routine pelvic examinations are unbearable.

Endometriosis and vulvar or chronic genital pain are common gynecological diseases that can cause severe pain. They each influence one in ten American women.

However, many women face doubt and light in health care settings when seeking this painful care.

We understand this well through research on social perceptions and how people who misunderstand health conditions manage difficult conversations with doctors and families, and by volunteering with people with these conditions.

We have been finding that medical gases surrounding chronic gynecological pain are a complex social problem driven by holes in medical research and training.

'It's all in your mind'

A 2024 study of patients who went to a clinic for vulvaginal pain – pain experienced by external female genitals and vaginas – found that 45% of these patients were told they “just need to relax more” while 39% felt they were “crazy.” A staggering 55% are considering giving up seeking care.

These results echo one of us (Elizabeth Hinz) found in our 2023 metasynthesis: Female patients with chronic pain conditions often hear the doctor's "all in your head".

Another study followed patients in two different major U.S. cities who were seeking care for vulvaginal pain. The researchers found that most patients have met multiple clinicians but have never been diagnosed. Given the challenges of seeking medical services, many patients turn to social media sources, such as Reddit for support and information.

These studies include those who seek care and are told that the clinicians who often spend years often spending their time in clinicians seeking care is psychological, or even real. Given these experiences, why do patients continue to seek care?

The patient with vulvaginal pain told her doctor: "Let me describe the pain that would prompt me to try many different doctors, test and treat." To her, sex "is like grabbing the most sensitive area and trying to tear it apart."

“I can wear any pants or underwear I want now without pain,” said another patient after the successful treatment. “I never realized how much damage the pain caused to my body every day until it disappeared.”

[embed]https://www.youtube.com/watch?v=OUWXZTBMM6I[/embed]

Medical gas

Many patients around the world experience medical airflow – a social phenomenon in which patients’ health problems are not properly evaluated for medical treatment, but are understateed, misunderstood or completely fired.

Medical gas light originates from gender bias in medicine for hundreds of years.

Women’s reproductive health problems have long been considered psychological or “hysterical.” Genital and pelvic pain is especially misattributed to psychological causes rather than biological causes: A century ago, Freudian psychoanalysts mistakenly believed that female sexual pain came from psychological complexes such as Penis Envy.

These historical perspectives help to clarify why these symptoms are not taken seriously today.

Consequences of medical gas lamps

In addition to physical losses due to untreated pain, medical air can also cause psychological damage. Women may become isolated when others do not believe in their own pain. Some people internalize this suspicion and may begin to doubt their own views on pain and even rationality.

This cycle of qi light increases the burden of pain and can lead to long-term psychological effects such as anxiety, depression, and post-traumatic stress symptoms. For some, repeated experiences of being fired by clinicians have eroded their sense of trust in the health care system. They may hesitate to seek medical care in the future, fearing they will be fired again.

Although certain chronic gynecological pain conditions, such as endometriosis, are attracting public attention and becoming better understood, these dynamics remain.

Funding Crisis

Part of the reason for misunderstandings around chronic gynecological pain conditions is the lack of research on them. A report from January 2025 found that studies on diseases in women were disproportionate compared to diseases that had a disproportionate impact on men.

As time goes by, this problem becomes worse. The NIH funding ratio has actually declined over the past decade. Despite these known differences, the Trump administration threatened to end funding for Women’s Health Program, a long-running Women’s Health Research Program, further exacerbated the issue.

Without ongoing federal women’s health research funding, diseases like endometriosis and vulvar disease will remain under-understanding, leaving clinicians in the dark and patients in trouble.

Differences in nursing

It is difficult for any female patient to believe and treat pain, and it is even harder for those facing discrimination based on class or race.

A 2016 study found that half of white medical students had at least one false belief about the biological differences between blacks and white patients, such as blacks with thicker skin or sensitive nerve endings than whites. Medical students and residents who recognize these false beliefs also underestimate the suffering of black patients and provide them with less accurate treatment advice.

Studies have shown that women are more likely to develop chronic pain conditions and report more frequent and severe pain than men. However, women are considered emotional and therefore more reliable than men in describing their own pain. Therefore, female patients who describe the same symptoms as male patients are considered less painful and are unlikely to be relieved even in emergencies and female clinicians. Female patients are more likely to receive psychological care than pain medications than male patients.

These misconceptions about gender and race are key reasons why patients’ pain is ignored, misunderstood and overlooked. Very realistic consequences for patients include delayed diagnosis, treatment and even death.

Actual steps to destroy medical gas lamps

Correcting these issues will require changes in clinical training to challenge biased perceptions about pain in women and ethnic minorities and to educate clinicians about common pain conditions such as vulvar. Research shows that medical training requires teaching students to better listen to patients’ life experiences and acknowledge when they don’t know the answer.

Meanwhile, people driving the health care system can take practical steps when encountering dismissive care.

They can educate chronic gynecological pain conditions by reading books like “When Sexual Injury: Understanding and Healing Pelvic Pain” or educational information from sources of trust, such as the International Society for Women’s Health Research, the International Society for Pelvic Pain, and the International Research on Vulvovaginal Diseases.

Although these steps do not address the root causes of medical gaslight, they can enable patients to better understand the medical conditions that may cause symptoms, thus helping to counteract the effects of gaslight.

If someone you know has experienced a medical atmosphere and wants to provide support, there are resources available.

Organizations such as the Endometriosis Society and the National Vulva Association provide support networks and information such as how to find knowledgeable providers. In addition, connecting with patient advocacy groups such as tight lipsticks can provide patients with opportunities to change their healthcare systems.