It has recently been reported after a major study that medical misogyny is leaving women with serious illnesses undiagnosed for years. The study found that one in three women with autoimmune diseases have their symptoms dismissed as being psychological, indicating that historical gender biases may be impacting the route to diagnosis and causing avoidable delay in diagnosis and treatment.

Research has found that women were 50% more likely than men to have their symptoms attributed to a psychiatric disorder and 75% more likely to be told they were caused by stress or anxiety. Men were slightly more likely to be misdiagnosed with another physical illness than being misdiagnosed with a psychiatric illness.

The study also found that women faced longer delays between their first symptoms and diagnosis, sometimes lasting up to two years, and attended more medical appointments than men before reaching diagnosis.

Autoimmune diseases occur when the immune system mistakenly attacks healthy tissue instead of fighting off infections. Examples include rheumatoid arthritis, lupus, multiple sclerosis and type 1 diabetes.

Diagnosing these conditions can be difficult because early symptoms including fatigue, pain, low mood and sleep problems are often vague and can have many possible causes. Symptoms may also be mistaken for hormonal changes in women.

Dr Melanie Sloan, from the University of Cambridge, said: “Our findings highlight that psychological or mental health explanations can be given too soon, and this is true for both sexes, but our study suggests that females may be particularly vulnerable to these types of misdiagnoses”.

Dr Sloan has acknowledged that autoimmune diseases can be particularly difficult to diagnose, especially when specific blood tests are needed to confirm the condition.

Professor David D’Cruz, Consultant Rheumatologist at Guy’s Hospital in London, said it was important not to assume that psychological symptoms could never be linked to autoimmune disease. He says “people can have both autoimmune and psychiatric conditions, and it is increasingly understood that psychiatric symptoms can be part of an autoimmune disease, especially in diseases like lupus which can directly affect the brain”.

He went on to say, “the important message is that when symptoms persist, evolve or involve multiple systems, clinicians must be open minded and consider whether there is an underlying autoimmune disease that has not yet been recognised and to listen to patients”.

Sarah’s Story

In one case, Sarah Bassra, 36, experienced a delay in diagnosis of antiphospholipid syndrome (APS – also known as Hughes Syndrome), which is an autoimmune condition that causes the blood to clot too easily, increasing the risk of blood clots, strokes, heart attacks and pregnancy complications.

Sarah’s symptoms began in June 2022 when she noticed her toes were red and feeling hot. Soon after, her ankle also became swollen and inflamed, leading Sarah to be concerned about a blood clot, particularly as she had recently been on long haul flights.

In spite of Sarah having a close family history of antiphospholipid syndrome, Sarah revealed how doctors dismissed her swollen foot as a plantar fasciitis, rather than suspecting a blood clot. She also reported extreme fatigue, which was attributed to a vitamin D deficiency, bouts of vertigo which were attributed to anxiety and joint pain, for which she was offered physiotherapy and steroid injections.

Sarah did in fact have a blood clot which remained undiagnosed and untreated. When this is the case, the blood clot can travel from the leg and cause a blockage of an artery in the lungs, which can be fatal. This is indeed what happened, as 2 months later, Sarah was rushed to hospital with a pulmonary embolism.

In spite of this, there was a further delay with diagnosis. Sarah said, “even after suffering this horrendous event, they were still reluctant to test for Hughes syndrome, despite my dad having it”.

When Sarah was eventually diagnosed, she says she was not prescribed blood-thinning medication to prevent further clots. It was only after she suffered a second pulmonary embolism in March 2023 that she received the treatment. Sarah has since been told her lungs will never fully recover from the damage caused by the clots.

Sarah went on to say, “before any of this, there were signs that something wasn’t quite right, I just feel like someone should have looked through my records and pieced it together”. Sarah now takes her partner with her to GP appointments to get her health taken seriously.

If you have been affected by a delayed diagnosis of an autoimmune condition, or indeed any condition, in which your symptoms were previously misdiagnosed and this has resulted in harm to you, we may be able to help. Please call our Clinical Negligence Department on 01482 323697 for a confidential discussion.