For many women, it's the same story.

Something starts to feel off, you're experiencing a new physical pain, but when you go to a doctor for treatment, they can't pinpoint what's wrong. Some might dismiss or misdiagnosis it. Others might even claim it's all in your head.

The experience itself can almost be as agonizing as the pain itself.

There's a growing body of research supporting the claim that women in pain are often not taken as seriously as men in similar positions. Fromheart problems andstroke toreproductive health and chronic illness, gender bias toward womens pain can affect their treatment for a number of health issues

"Women aren't listened to in a lot of different ways," said Dr. Mona Prasad, a women's health doctor with OhioHealth. "Every bad story I've heard from a woman, she tells me, 'I told them; they didn't listen. I told them; they didn't listen.'"

While there are still a lot of questions as to how why these differences exist, doctors say the best way women can get the care they need is to advocate for themselves. But what exactly does that look like?

The Dispatch spoke with three local doctors about how patients can best advocate for themselves and their medical treatment.

The first step to knowing if something is wrong is paying attention to your body, Columbus Public Health Commissioner Dr. Mysheika Roberts said.

"Man or woman, you need to know what's normal for you," Roberts said. "You know your body."

Roberts said paying attention to and knowing what feels normal for you will help you realize more quickly when pain feels different. That can also include knowing your family history, allergic reactions and how certain physical activity affects you.

It's also a good idea to know how some health conditions can affect men and women in different ways, Roberts said.

A 2013 study by the Pain Research and Intervention Center of Excellence at the University of Florida found that women are alsomore sensitive to painthan men and are more likely to express it. The result is that women's pain is more often seen as an exaggeration than a reality.

Strokes, heart attacks and even acne can present differently in women than in men. That can mean some women don't notice they're experiencing symptoms before it's too late, Roberts said.

Take heart attacks, for instance.

Like men, womens most common heart attack symptom is chest pain. But according to the American Heart Association, women may also experience other symptoms typically less associated with heart attacks, including shortness of breath, nausea, vomiting and back or jaw pain.

"Doctors and patients need to take different presentations seriously," Roberts said.

One of the best ways to advocate for yourself is having a primary care provider you trust.

Not only is it an excellent prevention method, Roberts said having a longstanding doctor who knows your history and with whom you feel comfortable can make the difference between being heard and potentially overlooked.

"You need to see someone who respects you. You need to have that open relationship," Roberts said. "You should take it as seriously as a marriage or a dating relationship."

Prasad said primary care physicians can do more in many cases in the long run than turning to emergency room visits.

"Primary care can make more sense because you can establish that relationship," Prasad said. "If you go to the ER with concerns, you're starting at square one."

Prasad said she recently started seeing a new primary care physician herself.

"It's so nice to see someone who knows you," she said.

But that doesn't mean your relationship with your primary care physician is infallible. Roberts said mutual trust is a must with your doctor, and if that's not there, then it's time to find someone new or get a second opinion.

Dr. Whitney Luke, an Ohio State University Wexner Medical Center physician specializing in pain medicine, physical medicine and rehabilitation, agreed that sometimes the best way to advocate for yourself is getting another opinion. She likened it to finding the right therapist or hair dresser.

"You should be able to discuss your symptoms and feel heard. Sometimes that takes one or two tries to find someone you feel comfortable with," Luke said.

Prasad said it can be helpful to bring a family member or trusted friend along to appointments. Not only can they support you, they can also help you remember your treatment plan.

"They can be a second set of eyes and ears to know what your next steps are," she said.

Keeping diaries or logs of your health history and previous visits can also aid your physician, Prasad said, especially in cases of chronic pain or instances where you don't have a clear diagnosis.

Not having the answers you want can be frustrating, but patients should speak up if they feel confused, unclear or unheard, Roberts said. That might look like asking to speak to another provider or manager in the ER or being explicit with your doctor.

"There's nothing wrong saying, 'I don't feel comfortable leaving here until I have answers or next steps,'" Roberts said.

Prasad said there's no shame in asking questions, sharing symptoms that might seem irrelevant or making suggestions.

"The ego in medicine is presumed more than it exists. It's fine to ask, 'Have you thought of this?'" Prasad said. "There's a saying you hear in medical school: If you let the patient talk long enough, you'll figure out what's wrong."

shendrix@dispatch.com

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Gender bias can affect women's medical treatment. Here's how you ... - The Columbus Dispatch