'Bikini physical' keeps women from getting comprehensive medical care

Too many women believe that simply seeing their OB/GYN is enough to protect their health.

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/ Source: TODAY
By Meghan Holohan

When Carol Sauvageot was 59, she started feeling anxious. Soon, she noticed she struggled to write and her handwriting had become smaller and smaller. The normally healthy and active Sauvageot felt worried. She thought she had Parkinson’s disease and visited seven different doctors for answers. They recommended she see a psychiatrist.

“I had told them I thought I had Parkinson’s and they totally, basically dismissed it,” she told TODAY. “They just didn’t think that was it.”

Doctors prescribed medication for her anxiety and physical therapy. But she kept pushing for answers. After 11 months, she was diagnosed with Parkinson’s disease.

“It was frustrating. We wasted a lot of time, a lot of money. I’m not sure all that was necessary if they had just listened a little bit more,” she said about her encounter six years ago.

Sauvageot’s experience is not unique. Women often tell their doctors about concerning symptoms only to be ignored. NBC News special anchor Maria Shriver explored the bias against women in health care in a segment for TODAY’s series Dismissed.

“We know that women have a higher rate of misdiagnoses, later diagnoses. Their symptoms are often under-recognized,” Dr. Fiona Gupta, a neurologist at Mount Sinai in New York City, told TODAY. "And then I have a lot of patients who were told that their experiences were psychosomatic or in your head."

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Shriver found there are several reasons women’s illnesses go unnoticed. Doctors often do not detect illnesses in women because they often put their health second. Too often, women often think that visiting their OB/GYN for a mammogram and Pap smear — what’s colloquially known as a “bikini physical” — means they’re healthy. For many, that’s the only medical care they receive. A study of more than 45,000 women found more than half only visit their OB/GYN. Less than 6% visited a primary care physician.

“A comprehensive health checkup really should encompass a regular gynecology checkup and an internal medicine... well woman exam that's expanded beyond the bikini area,” Dr. Chrisandra Shufelt, director of the Women’s Hormone and Menopause Program at Cedars-Sinai, told TODAY.

The American College of Obstetricians and Gynecologists also recommends women visit a primary care physician to help them detect and manage other health conditions, including:

  • Heart Disease
  • Cognitive and mental health
  • Cancer risk
  • Diabetes risk
  • Bone density
  • Vaccinations
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Regular checkups remain extremely important for spotting and treating illnesses, especially when doctors already struggle to diagnose women. A study from the University of Copenhagen found Danish women received a diagnosis about four years later than men for diseases such as cancer and diabetes.

“Women make up half of the U.S. population,” Gupta said. “Yet when it comes to their health, women are not being treated equally.”

Doctors sometimes overlook women's symptoms because they can present in other ways than men’s do.

“Even the diagnostic tools that we use for, let’s say, heart health, symptoms we know are different,” Shufelt said. “Women are not little men. Every cell in our body is different. It has different genetic makeup.”

What's more, women do not explain their symptoms like men might.

“There’s a lot to learn about gender and sex differences on how we present ourselves, even to the doctor,” Shufelt said.

But there are things women can do to become advocates for their health. The experts recommend that women try the following:

  • Keep a health journal: This comprehensive log should include days and times of symptoms.
  • Send the journal before appointments: that way the doctor has all important prior to appointments.
  • Stick to your gut: Question your diagnosis or treatment if it does not feel right.
  • Seek a second opinion: If you feel ignored, seek another opinion or find a new doctor.