Underdiagnosis in Older Women and How Research Gaps Impact Healthcare

Did you know that older women are often misdiagnosed or underdiagnosed for conditions like chronic pain, autoimmune disorders, and heart disease? That’s right—it’s all in your head, Missy!

Underdiagnosis is a growing concern in healthcare for older women, primarily due to gaps in medical research. These gaps contribute to missed or delayed diagnoses, leaving women vulnerable to untreated conditions. In this post, we’ll discuss the reasons behind underdiagnosis in older women and what steps you can take to ensure better healthcare outcomes.

Why Underdiagnosis Happens More in Older Women

Indeed, despite improvements in healthcare, older women still suffer from incorrect diagnoses disproportionately because many medical conditions present differently in women than men, yet diagnostic criteria and treatment guidelines are often based on decades of studies that were conducted using predominantly male, much younger test subjects.

As a result, this wide discrepancy in care has left us with diagnostic and treatment lacunae for many of the problems that midlife and older women face, such as heart disease, autoimmune disorders, and chronic pain.

Common Conditions Often Underdiagnosed in Older Women

Heart Disease

Consider the fact that heart disease in women can present with feelings of weakness, nausea, or shortness of breath, symptoms that are much less familiar than the chest pain (an ad or a commercial depicting a man grabbing his chest) commonly associated with heart attacks in men, thus leading to a misdiagnosis or a costly delay in receiving potentially life-saving care.

Autoimmune Disease

Likewise, autoimmune diseases, such as lupus and rheumatoid arthritis, are more common in women, especially older women. Because such conditions often have vague symptoms and mimic other illnesses or diseases of aging, they are frequently missed or misdiagnosed.

Chronic Pain Conditions

Similarly, some chronic pain conditions are not taken seriously or are associated with being ‘all in your head’ (a common diagnosis for women experiencing chronic pain), leading women to receive inadequate care, experience prolonged suffering, and experience conditions that could have been managed or diagnosed (or better yet resolved) sooner.

Mental Health (Brain Health)

Mental health (I prefer the term brain health) is a significant challenge for older women. They often wait longer for diagnoses and frequently have their symptoms dismissed, with many attributing them to psychological issues instead of underlying physical ailments. This leads to older women being told their symptoms are “all in their heads,” which can result in delayed or missed diagnoses.

This situation becomes particularly dangerous when serious conditions, like heart disease, are misinterpreted as anxiety or depression. For instance, a woman experiencing chest pain and fatigue might be told she’s just anxious when, in fact, she could be having a heart attack. Such misdiagnoses can have fatal consequences, as the necessary treatment for the actual condition is postponed or never provided.

The implications of this trend are severe. Women who do not receive timely and accurate diagnoses face a higher risk of severe health complications and even death. This underscores the critical need for healthcare providers to listen to women, take their symptoms seriously, and approach both physical and mental health in a comprehensive manner.

So yes, this means whole body health, including the brain, as mentioned in a prior post, Compartmentalizing the Brain and the Stigma Attached to the Term Mental Illness. If your body is not healthy, of course, you will experience depression! Your brain is not a separate entity.

And these sex-related differences underscore the urgent need for more inclusive research and awareness regarding women’s and older women’s health. Healthcare providers need to address these disparities to prevent misdiagnosis, morbidity, and a diminished quality of life for older women.

And I’m not referring to older women who happen to be 90+. This is for anyone, especially those aged 55 and over.

How Research Gaps Cause Underdiagnosis in Older Women

A significant reason for the underdiagnosis of older women is the considerable gap in medical research that targets this group. For many years, clinical trials have often excluded women, especially older women, due to worries about hormonal changes and reproductive health.

Consequently, diagnostic guidelines, treatment protocols, and even lists of symptoms are frequently based on studies conducted primarily on younger men.

This absence of gender-specific research has profound implications:

Inadequate Diagnostic Tools: Diagnostic criteria are typically developed based on how conditions present in men. For instance, heart disease in women often shows up with subtler symptoms, such as fatigue or shortness of breath, which do not align with the “classic” symptoms used in male-focused diagnostic tools. This oversight can lead doctors to miss or misdiagnose these conditions in older women.

Bias in Symptom Recognition: Numerous conditions that disproportionately impact older women, like autoimmune disorders and chronic pain syndromes, are under-researched. Without adequate studies that examine how these illnesses affect women, healthcare providers may not recognize the nuances in symptom presentation, resulting in misdiagnosis or dismissal of women’s concerns.

Delayed Innovation in Women’s Healthcare: The lack of inclusive research also hinders advancements in creating more effective diagnostic tests and treatments that cater to the specific biology of older women. This leads healthcare systems to rely on outdated or generalized methods that do not meet the unique needs of older women.

How You Can Take Charge and Advocate for Your Health

Dealing with the healthcare system can be daunting, particularly when it feels like your worries are being overlooked. However, it’s important to remember that you are your own best advocate. By being proactive, you can ensure your health gets the attention and seriousness it deserves. Here are some ways to take charge:

Keep a Symptom Journal—Your Health Story

Think of your symptom journal as your personal health story. Doctors see you for only a short time, but your body is with you every day. Write down your symptoms and the details: when you felt the pain, what you were doing, and how long it lasted. This health diary can help your doctor connect the dots and see the bigger picture.

But don’t forget to associate what you ate with how you feel.

Ask Tough Questions—Be Curious About Your Care

Don’t be afraid to ask your doctor direct questions about your diagnosis. “Is this diagnosis based on research that includes women my age?” or “What else could explain these symptoms?” By being curious, you open the door to a deeper conversation about your care and push for the answers you deserve.

Speak Up for Testing—Don’t Settle for ‘It’s Just Aging’

You know your body best. If something doesn’t feel right, and your doctor brushes it off as “just aging,” push for more testing or referrals. Demand that every avenue is explored—sometimes a second opinion or additional tests can be the key to unlocking a proper diagnosis.

Seek Second Opinions—Your Health, Your Choice

If something doesn’t sit right with you, there’s nothing wrong with getting a second opinion. Another healthcare provider might have the fresh perspective or expertise that leads to a diagnosis missed by the first. Remember, it’s your health, and you have every right to keep your options open.

Arm Yourself with Knowledge—Stay Informed

The more you know, the more empowered you are. Keep up with the latest research on women’s health, especially for conditions like heart disease, autoimmune disorders, and brain health. When informed, you can have more meaningful conversations with your healthcare provider and take control of your care.

Final Thoughts

Writing this brings me back to a somber chapter in my life. I was finally pregnant. It took six years for this miracle to happen. Hubby and I were ecstatic! Then I had a miscarriage.

I was very young and thought I would pop right back into my old self. My body felt messed up. My mind felt messed up. Everything felt messed up. I was exhausted, mentally and physically drained.

So, I visited my doctor. The recommendation was to “Just go home and bake a cake or take a run.” This was a mega-warning I’ll never forget! I felt odd and displaced, with the startling realization that I must become my own advocate and do everything in my power to take care of myself. But how…

Don’t let your symptoms be dismissed or overlooked. You have the power to advocate for yourself by asking the right questions, staying informed, and pushing for the care you deserve. It’s time to ensure your voice is heard and your health is prioritized. It’s not ‘all in our heads.’

Have you ever felt dismissed or misdiagnosed by a healthcare provider? Share your story in the comments below. By raising awareness, we can beat that drum harder toward better healthcare for all older women. Let’s get sassy!

In our next post, we’ll explore how research gaps impact screening guidelines and why early detection of chronic conditions is often delayed in older women. Stay tuned!

Disclaimer: The content provided on this blog is for general informational purposes only and should not be construed as medical advice, diagnosis, or treatment. This information is not intended to replace professional medical guidance from a qualified healthcare provider. Always consult your physician or another qualified healthcare professional before making changes to your health, diet, or wellness routine. Never disregard professional medical advice or delay seeking it because of the information you have read on this blog. Use of this blog and reliance on any information provided is solely at your own risk.