Heard+ Log

Knowledge base

Conditions that disproportionately affect women and people assigned female at birth (AFAB), are regularly misattributed in primary care, and are easier to discuss when you have data on your side. This is education, not diagnosis.

  1. Endometriosis

    Avg diagnostic delay: ~7.5 years

    On average it takes 7–10 years to be diagnosed with endometriosis in the UK, and 1 in 10 women of reproductive age is affected.

    Symptoms commonly dismissed
    • severe period pain
    • pelvic pain outside of period
    • pain during or after sex
    • heavy or irregular bleeding
    • bowel pain during period
    • fatigue around period
    Often misdiagnosed as
    IBSPIDanxietynormal periods
    Tests to ask about
    • Pelvic ultrasound (transvaginal where appropriate)
    • Pelvic MRI
    • Specialist gynaecology referral
    • Diagnostic laparoscopy (gold standard)
    Questions to bring to your clinician
    • Could endometriosis explain my symptom pattern?
    • What is the next step if hormonal therapy doesn't help?
    • Can you refer me to a gynaecologist with an endometriosis specialism?
    Why this is a gender-equality issue

    Period pain is still routinely normalised in clinical encounters, delaying diagnosis by years and shaping a generation's beliefs about what bodies 'should' tolerate.

    Source: Endometriosis UK

  2. PCOS (Polycystic Ovary Syndrome)

    Avg diagnostic delay: ~2 years

    Up to 70% of people with PCOS worldwide are undiagnosed, despite it being one of the most common endocrine conditions.

    Symptoms commonly dismissed
    • irregular periods
    • acne
    • weight changes
    • excess hair growth
    • fatigue
    • low mood
    • insulin resistance
    Often misdiagnosed as
    depressionlifestylestress
    Tests to ask about
    • Pelvic ultrasound
    • Free testosterone, SHBG, LH, FSH
    • HbA1c / fasting glucose / fasting insulin
    • Lipid panel and TSH
    Questions to bring to your clinician
    • Can we test for PCOS given my symptom cluster?
    • Should I have my insulin and androgens checked?
    • What lifestyle and medical options are appropriate for me?
    Why this is a gender-equality issue

    PCOS sits at the intersection of metabolic, reproductive, and mental health — but is too often reduced to a 'cosmetic' or weight problem and the metabolic risk goes unmonitored.

    Source: WHO — PCOS fact sheet

  3. Adenomyosis

    Avg diagnostic delay: ~6 years

    Adenomyosis affects an estimated 1 in 5 women but is often missed in routine ultrasound and conflated with fibroids.

    Symptoms commonly dismissed
    • very heavy periods
    • severe cramping
    • enlarged tender uterus
    • pelvic pressure
    • pain during sex
    Often misdiagnosed as
    fibroids alonestressnormal periods
    Tests to ask about
    • Transvaginal ultrasound
    • Pelvic MRI
    Questions to bring to your clinician
    • Could adenomyosis be contributing to my heavy periods?
    • Is a transvaginal ultrasound or MRI appropriate?
    Why this is a gender-equality issue

    Adenomyosis is rarely taught in depth in medical curricula; many people live with debilitating periods for decades before being taken seriously.

  4. Heart disease in women

    Women are around 50% more likely than men to receive an incorrect initial diagnosis after a heart attack.

    Symptoms commonly dismissed
    • shortness of breath
    • fatigue
    • jaw or back pain
    • nausea
    • pressure or burning in chest
    • anxiety-like episodes
    Often misdiagnosed as
    anxietypanic attacksindigestionmuscle strain
    Tests to ask about
    • ECG
    • High-sensitivity troponin
    • Echocardiogram
    • Stress test
    • Lipid panel and HbA1c
    Questions to bring to your clinician
    • Can we rule out cardiac causes for my symptoms?
    • Is an ECG, troponin or stress test appropriate?
    • Are my cardiovascular risk factors being assessed?
    Why this is a gender-equality issue

    Cardiac research has historically been built on male physiology. Women's atypical presentations are still routinely missed, and the misdiagnosis gap costs lives.

    Source: European Society of Cardiology

  5. ADHD in women & AFAB adults

    Avg diagnostic delay: ~20 years

    Diagnostic criteria for ADHD were built primarily from studies of boys; many women are first diagnosed in their 30s or 40s, often after their child is diagnosed.

    Symptoms commonly dismissed
    • brain fog
    • executive dysfunction
    • rejection sensitivity
    • chronic overwhelm
    • burnout cycles
    • time blindness
    • PMS-like crashes that worsen ADHD symptoms
    Often misdiagnosed as
    anxietydepressionburnoutperfectionismpersonality
    Tests to ask about
    • Structured ADHD assessment (DIVA-5 / ACE+)
    • Specialist psychiatry referral
    Questions to bring to your clinician
    • Could ADHD explain my long-term pattern of overwhelm?
    • Can I be referred for an adult ADHD assessment?
    • How does the menstrual cycle interact with ADHD symptoms?
    Why this is a gender-equality issue

    Decades of under-diagnosis have left a generation of women masking executive dysfunction as personal failure. Recognition is the first step to support.

    Source: ADDitude — Women & ADHD

  6. Autoimmune disease (Lupus, MS, Hashimoto's, RA)

    Avg diagnostic delay: ~4 years

    Around 80% of people with autoimmune disease are women, yet diagnosis takes an average of 4+ years and 5+ doctors.

    Symptoms commonly dismissed
    • joint pain
    • fatigue
    • rashes
    • brain fog
    • hair loss
    • cold intolerance
    • muscle weakness
    Often misdiagnosed as
    anxietyfibromyalgia (alone)low iron
    Tests to ask about
    • ANA, anti-dsDNA
    • TSH, free T4, TPO antibodies
    • ESR / CRP
    • Vitamin D, B12, ferritin
    • Rheumatology referral
    Questions to bring to your clinician
    • Given my symptom cluster, can we screen for autoimmune disease?
    • Can I have ANA, thyroid antibodies and inflammatory markers checked?
    Why this is a gender-equality issue

    Symptoms common in autoimmune disease are often filed as anxiety in female patients. Quantifiable, time-stamped symptom data is one of the most reliable ways to break that pattern.

    Source: AARDA

  7. PMDD (Premenstrual Dysphoric Disorder)

    Avg diagnostic delay: ~12 years

    PMDD affects up to 1 in 20 menstruators and is regularly mistaken for bipolar disorder or BPD because of its dramatic cyclical mood pattern.

    Symptoms commonly dismissed
    • severe mood crash before period
    • rage / irritability
    • suicidal ideation cyclically
    • insomnia premenstrually
    • physical pain in luteal phase
    Often misdiagnosed as
    bipolarBPDdepressionanxiety
    Tests to ask about
    • Daily Record of Severity of Problems (DRSP) over 2 cycles
    • Specialist gynae or psychiatric referral
    Questions to bring to your clinician
    • Could my symptoms be PMDD rather than (or alongside) depression?
    • Can I track for two cycles to confirm the pattern?
    • What treatment options exist beyond standard antidepressants?
    Why this is a gender-equality issue

    PMDD is one of the clearest examples of cyclic, hormone-linked illness being pathologised as personality. Cycle-anchored data changes the conversation.

    Source: IAPMD

  8. Perimenopause

    Avg diagnostic delay: ~3 years

    1 in 10 women in the UK leaves their job because of perimenopause symptoms — most after years of being told it was anxiety.

    Symptoms commonly dismissed
    • brain fog
    • anxiety surge
    • sleep disruption
    • joint pain
    • irregular periods
    • heart palpitations
    • low mood
    Often misdiagnosed as
    anxietydepressionburnoutthyroid alone
    Tests to ask about
    • Symptom-led assessment (NICE: not blood-test based >45)
    • Thyroid function and ferritin to exclude overlap
    • Cardiovascular risk review
    Questions to bring to your clinician
    • Could my symptoms be perimenopausal?
    • What are my options including, but not limited to, HRT?
    • Can my cardiovascular risk be re-baselined now?
    Why this is a gender-equality issue

    Perimenopause sits at the intersection of women's health, work, and economic equality — and remains one of the most under-diagnosed life stages in medicine.

    Source: Fawcett Society — Menopause and the Workplace

  9. Long COVID / ME/CFS

    Avg diagnostic delay: ~2 years

    Women are roughly twice as likely as men to develop Long COVID, and post-exertional malaise is still routinely mistaken for deconditioning.

    Symptoms commonly dismissed
    • post-exertional malaise
    • brain fog
    • fatigue
    • POTS-like symptoms
    • unrefreshing sleep
    • temperature dysregulation
    Often misdiagnosed as
    anxietydeconditioningdepression
    Tests to ask about
    • Active stand / NASA lean test
    • Long COVID clinic referral
    • Iron studies and B12
    Questions to bring to your clinician
    • Could this be Long COVID or ME/CFS?
    • Are there pacing and POTS pathways available locally?
    Why this is a gender-equality issue

    ME/CFS and Long COVID disproportionately affect women and have a long history of being dismissed as psychosomatic — exactly the pattern Heard is built to interrupt.

    Source: ONS — Prevalence of self-reported long COVID