Weyand Angela C, James Paula D
Department of Pediatrics University of Michigan Medical School Ann Arbor MI USA.
Department of Medicine Queen's University Kingston ON Canada.
Res Pract Thromb Haemost. 2020 Dec 13;5(1):51-54. doi: 10.1002/rth2.12468. eCollection 2021 Jan.
Sexism has been an issue in bleeding disorders for centuries. Women with bleeding disorders have been underrecognized and underdiagnosed. Those who are diagnosed often experience delays in diagnosis and feel that their symptoms are dismissed or minimized. Several factors contribute to this sexism. Historically, the clinical and research focus within the bleeding disorder community has been on men and hemophilia. Von Willebrand disease, a disease that has long been recognized as affecting women, is much more common than hemophilia, yet has significantly fewer resources devoted to it. The lack of knowledge and comfort that patients and health care providers have regarding menstruation compounds the issue, as heavy menstrual bleeding is one of the most common symptoms seen in women with bleeding disorders. Stemming from the universal stigmatization of periods, this lack of comfort and knowledge results in fewer women seeking care, fewer health care providers addressing the issue, and fewer women getting the care they deserve. Progress has been made, with many organizations dedicating resources to improving the care of these women. The road is long, and much more work is needed to ensure that women with bleeding disorders receive the care they deserve.
几个世纪以来,性别歧视一直是出血性疾病领域存在的问题。患有出血性疾病的女性一直未得到充分认识和诊断。那些被确诊的患者往往经历诊断延迟,并且感觉自己的症状被忽视或轻视。造成这种性别歧视的因素有几个。从历史上看,出血性疾病领域的临床和研究重点一直是男性和血友病。血管性血友病这种长期以来被认为会影响女性的疾病,比血友病更为常见,但投入到该疾病研究的资源却少得多。患者和医疗服务提供者对月经缺乏了解且感到不自在,这使问题更加复杂,因为月经过多是患有出血性疾病女性最常见的症状之一。由于对经期普遍存在污名化,这种不自在和知识的匮乏导致寻求治疗的女性减少,处理该问题的医疗服务提供者减少,以及得到应有的治疗的女性减少。目前已经取得了一些进展,许多组织投入资源来改善对这些女性的治疗。道路漫长,还需要做更多工作以确保患有出血性疾病的女性得到她们应得的治疗。