7 Diseases Doctors Miss

February 3, 2015
7 Diseases Doctors MissPhotograph by Thomas Barwick/Getty Images

In her early 40s, Pamela Serure was the epitome of health. An energetic New York City marketing executive who'd grown tired of the rat race, she'd moved out to the Hamptons, started a juice business, and written a guide to yoga and fasting that catapulted her onto an international book tour.

Celebrities including Alec Baldwin and Barbra Streisand swore by Serure's detox diet. Yet even her own regimen couldn't ease the puzzling symptoms Serure suffered: a burning in her chest, fatigue, neck pain, and a tendency to sweat profusely after just a short workout.


Over the previous 10 years, at least a dozen doctors had labeled Serure's chest pain heartburn, her sweating a prelude to menopause, and her exhaustion chronic fatigue. They x-rayed her lungs, looking for pneumonia and bronchitis. "If they couldn't find anything, they would dismiss the whole chest thing," she says.

When the 47-year-old Serure told yet another doctor about her symptoms, he said, "You don't have pneumonia. You have angina." "That's ridiculous," she retorted. The doctor made her promise to take nitroglycerin pills to forestall a possible heart attack. A few days later, she went to see a cardiologist. All the usual tests came back normal, but in the hallway as she was leaving, she felt a burning in her chest and returned to the doctor. In a matter of minutes, heart monitors were hooked up: She was about to have a heart attack. Serure's main artery was 98% blocked; two others were only marginally better. "We don't know how you're walking around," the chief cardiologist told her as she was prepped for bypass surgery. "You must have one hell of a spiritual life."

Heart problems aren't the only disease that doctors often overlook in women. Below, you'll read more about this and six others that have subtle or confusing symptoms and are frequently missed by women and their doctors. By learning the risk factors, symptoms, and treatment, you can better protect yourself against some of life's nastier surprises.

1. Heart Disease
One in three women has cardiovascular disease; it claims more lives than all forms of cancer combined. More women than men die of heart disease every year, yet they are six times more likely than men to be mistakenly sent home from emergency rooms by unsuspecting doctors.

Partly, that's because women often don't have the classic male sign of cardiac failure: severe chest pains. Women tend to experience symptoms such as nausea, shortness of breath, indigestion, and fatigue—and even they don't know that they're experiencing a heart attack. As a result, women often take longer to seek emergency care. And because doctors miss the symptoms, they are slow to take action, delaying emergency surgery to reopen clogged blood vessels and restore blood flow to the heart.

A University of Michigan study found that women must wait 13 minutes more on average than men for emergency heart surgery. Add to that another 13 minutes they waited before seeking help, and the result is almost a half hour of potentially deadly heart damage. Not surprisingly, female victims are twice as likely as their male counterparts to die within two weeks of a heart attack.

Pamela Serure is now working on a memoir about her long journey to diagnosis. "Finally, someone found why I felt so bad," she says. "Now I feel great. I feel like I'm 20 again."

What You Need to Know
Gauge risk. Smoking, high cholesterol, inactivity, stress, and obesity can weaken blood vessels. African Americans, diabetics, women with a family history of heart disease, or those who are older than 65 are also at increased risk. (Check out these 7 more surprising ways you're increasing your risk of heart attack.)

Recognize symptoms. If you are experiencing shortness of breath, fatigue, nausea, pressure in your chest, or gastric pain, seek emergency care. Most women have symptoms prior to their heart attack, several times a week, which mimic the sensations of the actual attack 1 week to 6 months later. Pay attention—and make sure your doctor does, too.

Get tested. Ask for an exercise echo-cardiogram in addition to standard tests. It's an ultrasound of the heart performed after using a treadmill or stationary bike. If that's inconclusive, and you're still having symptoms, ask for a CT (computed tomography) scan or an MRI. Your doctor may also suggest an angiogram. For more information, visit The American Heart Association's Go Red for Women.

MORE: 6 Simple Steps That Can Lower Your Heart Disease Risk 92%

2. Ovarian Cancer
This aggressive cancer strikes one out of 57 women, and though it can be effectively treated in its early stages, it's usually caught too late—when tumors have spread throughout the abdomen and to other parts of the body. Ovarian cancer is tricky to catch because most women have few distinctive symptoms during its initial stages, or doctors attribute the symptoms to irritable bowel syndrome, menopause, or aging.

What You Need to Know
Gauge risk. Incidence rises sharply after age 50. Women with a family history of ovarian, breast, or colon cancer are more likely to get ovarian cancer—and at an earlier age. Those who have never had children are also at increased risk.

Recognize symptoms. Recent studies have reached a startling conclusion: This so-called silent killer isn't quiet after all. Nearly 90% of women with early-stage ovarian cancer have a cluster of identifiable symptoms several months before their diagnosis: most commonly, abdominal and pelvic pain, urinary urgency, and a bloated sensation. Other signs are abnormal vaginal bleeding, constipation, and fatigue. If women alert doctors to a sudden onset of these ailments, they may catch the disease early, when it's 90% curable.

Get tested. Women should get a pelvic/rectal exam from their gynecologist every year. It's not comfortable, but it does a far better job than a simple vaginal exam at assessing the health of your ovaries—which in some women are tucked behind the uterus. If the exam raises any questions, your doctor should follow up with a transvaginal ultrasound. And if any abnormal masses are found, a CA-125 blood test may be used to determine if they are malignant.

Find the right treatment. It can range from removing the ovaries and uterus to taking out the omentum (thin tissue covering the stomach and large intestine) and lymph nodes in the abdomen. Chemotherapy may be given to destroy any cancer cells remaining after surgery.

MORE: 6 Symptoms To Never Ever Ignore

3. Celiac Disease
Celiac Disease
This condition is a genetic inability to digest gluten, a protein found in wheat, rye, and barley. Gluten damages the lining of the small intestine, making it difficult to absorb nutrients such as calcium, vitamin D, folic acid, and iron. Left untreated, the disease can cause osteoporosis, anemia, infertility, miscarriages, and lymphoma. (Could you have celiac disease? See When Your Gut Screams No.)

Mostly, celiac disease is left untreated. It takes about 6 to 10 years to diagnose. In many cases, a person is symptom-free even while the illness destroys the intestinal lining.

Until a few years ago, the disease—which strikes women three times more often than men—was thought to be rare. But research reveals that it affects 3 million Americans, 10 times more than previously estimated. Worse, as many as four out of five people with celiac disease are undiagnosed. A study of women with osteoporosis found that celiac disease was 17 times more prevalent among this group than in women with healthy bones. And the more severe the disease, the worse the bone loss was.

Celiac disease may be causing other health problems as well, says Peter Green, MD, a professor of clinical medicine at Columbia University Medical Center and director of the university's Celiac Disease Center. "The question is: Where are all these people with celiac disease? They're not getting diagnosed. It may be hiding behind other diseases—irritable bowel syndrome, infertility, and anemia."

What You Need to Know
Gauge risk. Only 1 in 133 Americans are estimated to have celiac disease, but if one family member has it, the risk jumps to 1 in 22, even if they show no signs of it. Relatives who already have an autoimmune disease are 25% more likely to get celiac disease. Recognize symptoms. They can include chronic diarrhea, abdominal bloating and pain, weight loss, foul-smelling stool, seizures, edema, and a painful skin rash.

Get tested. Your doctor can give you a panel of blood tests to assess the levels of certain antibodies that are typically high in people with celiac disease. If the tests are positive, he may perform a biopsy to sample tissue in your small intestinethe only sure way to diagnose the problem. This biopsy is done with an endoscope, a long thin tube that's eased through the mouth and stomach into the small intestine. Hospitalization is not usually required.

Find the right treatment. Only one approach works: Eliminate gluten. You'll need to permanently eliminate gluten sources from the diet, including cereals, pasta, flour products, bread, cold cuts, prepared foods, and soy sauce.

MORE: 5 Weird Signs You Have Celiac Disease

4. Lupus
Lupus is a degenerative autoimmune disorder in which the body attacks brain and organ tissue as if they were hostile invaders like viruses or harmful bacteria. The disease is incurable and only minimally treatable. Lupus can manifest in a bewildering cycle of symptoms: bruising, rashes that look like scars, joint pain, sores, and severe fatigue are just a few of the possibilities.

What You Need to Know




5. Hepatitis C
Hepatitis C is the most common chronic bloodborne virus in the United States. It first grabbed headlines all the way back in 1991 when Naomi Judd, the country-western singer, announced that the disease had forced her retirement. As a young woman, Judd had worked as an intensive care nurseand accidentally nicked her finger with an infected needle. Yet 24 years later, sufferers are still going undiagnosed.

What You Need to Know
Gauge risk. Hepatitis C lives in blood. Shared intravenous drug needles, unprotected sex with infected partners, tainted blood transfusions or organ transplants (before 1992), health care work, and—potentially—tattoos and body piercing can put you at risk.

The Centers for Disease Control and Prevention (CDC) estimates that 3.2 million Americans carry the virus. And every year, 16,000 more join their ranks. Hepatitis C is a leading cause of liver disease and the major reason for liver transplants. About 5% of infected mothers transmit the virus to their babies in the womb. Hepatitis C is also present in breast milk, and though doctors say it's too small a dose to worry about, an infected mother with cracked nipples should express her milk rather than breastfeed.

Recognize symptoms. The disease can remain hidden for decades. As many as 70% of those infected are unaware that they carry the virus. Early onset is often asymptomatic, but the few signs that emerge look like the flu—fatigue, sore muscles, headache, nausea, and loss of appetite. Occasionally, the virus yellows a person's eyes, skin, and mucous membranes. But those symptoms quickly disappear, lulling up to 85% of hepatitis C sufferers into inaction—and chronic disease. If left unchecked for more than 6 months, hepatitis C can chronically inflame the liver. Left untreated for many years, the virus can cause cirrhosis (scarring that leads to liver failure), edema, muscle wasting, and death.

Get tested. Within 50 days of exposure to the virus, most people infected with hepatitis C will exhibit elevated levels of liver enzymes on a routine blood test. That test should be followed up with a specific hepatitis C antibody test, which is highly accurate. A liver biopsy can assess the severity of disease and need for treatment.

Find the right treatment. Newer drug treatments are often successful in clearing the virus from the body in two to three months. Older treatments carried more severe side effects and were unsafe for pregnant women, so discuss the latest treatments with your doctor.

MORE: Your Guide To STDs Over 40

6. Chlamydia
Chlamydia is one of the most commonly reported infectious disease in the United States—and one of the most dangerous sexually transmitted diseases among women. But 75% of infected women have no symptoms at all—and only one in four young women at risk for the disease is getting tested for it, according to the CDC.

Those are scary statistics, doctors say, because an estimated 4 million Americans unknowingly contract—and spread—the disease each year. When detected early, chlamydia is easily treated and causes no long-term problems. Ignored, it can cause pelvic inflammatory disease (PID), infertility, ectopic pregnancies, and miscarriage. (Of the estimated 1 million cases annually of PID, half may be caused by chlamydia.) Babies who are exposed to chlamydia in the birth canal are at risk for pneumonia; conjunctivitis (leading to blindness); and ear, nose, and throat infections.

What You Need to Know
Gauge risk. Three of every four reported cases occur in people younger than 25. By age 30, one in two sexually active women probably has had chlamydia.

Recognize symptoms. Contact a health professional immediately if you experience painful urination, cloudy urine, abnormal vaginal discharge or bleeding, lower abdominal pain, genital itching, or swollen glands around the vaginal opening. Symptoms, if they emerge at all, usually surface 1 to 3 weeks after exposure to an infected person.

Get tested. A urine test provides quick results without swabbing genital secretions. Annual screening is recommended for all sexually active women younger than 25, as well as women who engage in high-risk sexual behavior. The government, for some reason, has not issued recommendations urging routine screening for men.

Find the right treatment. The cure can be as simple as a single-dose antibiotic. But be warned: Treatment doesn't protect you against future infections. Be sure to stay vigilant: Women with chlamydia who are exposed to HIV are 3 to 5 times more likely to become infected compared to women who don't have chlamydia.

MORE: Is Your Doctor Making You Sicker?

7. Multiple Sclerosis
Multiple sclerosis, a degenerative nerve disease, is more than twice as common among women as men. One reason: women are more likely to have a gene variant that promotes inflammation and tissue damage. But MS is elusive to diagnose because it appears, disappears, and imitates several other conditions before ultimately dropping its veil.

Much remains unknown about MS, except its often relentless course. In healthy people, nerve fibers are coated in a protective sheath, called myelin. Multiple sclerosis attacks the myelin, destroying nerves and building up scar tissue (or sclerosis) in the brain and spinal cord. Without myelin, the brain's electrical signals are scrambled: It can neither send nor receive messages, and the patient gradually loses muscle control throughout the body. Speech, motion, vision, memory, concentration—even swallowing—are affected.

No two cases are the same, which makes diagnosis particularly tricky. Some experience a gradual decline; others won't notice any symptoms until late-stage disease. In the United States, about 400,000 people are known to have the disease; an unknown number may have it and not know it.

What You Need to Know
Gauge risk. People whose parents have MS are more likely to develop it themselves. Having a mother with MS may be one of the strongest risk factors of all—although whether the link is genetic, viral, or environmental remains a mystery. MS is most pronounced in colder climates, especially in northern Europe.

Recognize symptoms. Most people get their first signs of the disease between the ages of 20 and 40: blurred or double vision, fatigue, tingling, dizziness, lack of coordination, tremors, and diminished concentration.

Get tested. No single test is yet available to accurately diagnose MS, although MRI scans are 90% effective at spotting lesions in the brain or spinal cord. Spinal taps can reveal other abnormalities that are associated with the disease, such as high levels of white blood cells or proteins. Doctors will also test nerve responses to visual, auditory, and electrical stimuli, looking for MS damage. Researchers are working on blood tests to diagnose the disease much earlier in its onset because studies suggest that early intervention can dramatically slow MS.

Find the right treatment. Corticosteroids and plasma exchange can help manage severe attacks; there are seven federally approved medications that can help slow the progress of MS.

MORE: 10 Cancer Symptoms Most People Ignore

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