Why women may be more prone to health anxiety

Hannah White often gets lumpy boobs around the time of her period. Though she knows this is nothing to worry about, it makes her feel anxious to the point of catastrophising. “I do a lot of checking: ‘Is it getting better? Is it getting worse?’,” she says. “But equally, I can have [anxiety] over something in my eye. I’d worry it would be something toxic.”

Also known as illness anxiety or hypochondriasis, people with health anxiety experience a constant conviction that they have a physical illness. This means they will often take harmless physical symptoms, such as a dry mouth, as signs of a serious illness.

In clinical settings, health anxiety is grouped on the obsessive-compulsive disorder (OCD) spectrum and, much like OCD, is commonly treated with cognitive behavioural therapy (CBT) and/or antidepressants. Episodes can lead to panic attacks: for Hannah, “the feelings can be so unpleasant that it takes me a couple of days to recover.”

Women in the UK are almost twice as likely to be diagnosed with anxiety disorders than men,¹ yet there is little evidence for how people of different genders are affected by health anxiety. Where evidence does exist, it is contradictory: one study found that female gender was a risk factor for health anxiety,² but another found no correlation between these factors.³

However, there is a growing body of research suggesting that, due to certain social factors and experiences, women are in fact more likely than men to experience health anxiety.

Sexual violence

Sexual violence has long been a gendered issue,⁴ and there is evidence for a link between sexual violence and health anxiety. In one study of 219 former female military veterans, those who had experienced sexual assault (43.9%) were much more likely to show health anxiety symptoms.⁵ Another notes that the prevalence of anxiety disorders is significantly higher in survivors of sexual violence — and that survivors are most likely to be women.⁶

Survivors may feel a sense of grief for their body that they feel they have lost due to the violent experience

Rachel An Vu, a psychotherapist, suggests that this may be due to the way anxiety is linked to the body for survivors. “The body can remember violence or an act of abuse”, she explains. “[A survivor’s] body is a crime scene, they have to face it every day – so anxiety would affect them even more.”

She explains that a survivor’s anxiety can persist long after signs of physical violence have left the body. This is due to the body’s “memory”. “It’s like when you have a burn or a cut. Even though it is healed, your body remembers it,” she says. Additionally, survivors may feel a sense of grief for their body that they feel they have lost due to the violent experience, which Vu suggests can worsen a survivor’s anxiety.

Pregnancy

Pregnant people, who are mostly women, are another group that may have an increased risk of health anxiety. While research has been conflicting — some find that hypochondria rises during pregnancy⁷ and some do not⁸ — the psychological and physical impacts of pregnancy can be long-lasting and difficult to deal with.

Those who have experienced pregnancy complications, or an unrelated health condition while pregnant, are especially likely to develop health anxiety later in life.⁹ This was the case for Joanna Rennie, who experienced health anxiety and ongoing trauma following the birth of her son. She would seek medical advice for minor symptoms, even when they could be explained by what she was going through. “I found myself getting tested by the doctor for things, but a lot of the symptoms were things I could have from just being a new mum,” she says. “Exhaustion, that kind of thing.” Joanna thinks that this was a way of her seeking an explanation for her depression, anxiety, and exhaustion after giving birth.

“For women who can’t get pregnant or are struggling with fertility, it almost becomes your whole world or your whole focus”

Since, Joanna has found smear tests and Covid tests anxiety-inducing and “incredibly uncomfortable” – despite never finding the former painful before childbirth.

Fertility

Health anxiety can affect people trying to get pregnant, too. Sunita Thind experiences anxiety around her fertility following a second ovarian cancer diagnosis. Having had her ovaries removed and eight of her eggs frozen, Sunita says not knowing whether she’ll be able to get pregnant exacerbates her health anxiety. “In terms of the health anxiety, my worst fears have been realised,” she says. “I’ve been told I couldn’t keep my ovaries, and what it meant for me.”

Robyn Clinton, a psychotherapist who specialises in fertility counselling, explains that fertility issues can spur health anxiety because they become overwhelming. “For women who can’t get pregnant or are struggling with fertility, it almost becomes your whole world or your whole focus,” she says. “Hand in hand with that is your health. How your body’s working, are you getting monthly cycles, is everything doing what it’s supposed to do?”

As with so much pertaining to the health of women and people with vaginas, more research is needed to fully understand these effects. Along with sexual violence and pregnancy, there are no doubt many other risk factors for health anxiety that are barely recognised or understood.

What the evidence does show, again and again, is that social experiences and physical health absolutely do impact mental health. It’s vital that healthcare professionals address this if health anxiety in women is to be quickly detected and adequately treated.
 
 
Featured image is an illustration of a woman holding a magnifying glass over her right hand, as if trying to find something wrong with it. The background is a moody purple colour
 
Page last updated May 2021