Why Women Are So Often Misdiagnosed—And What We Miss When We Rush Care

Many women experiencing fatigue, brain fog, or hormone-related symptoms aren’t misdiagnosed because their issues are vague—they’re misdiagnosed because our healthcare system rarely allows the time it takes to be thorough. At TrueCare DPC, I take a different approach—one that makes space to understand the full picture.

Most of the women I see at TrueCare DPC don’t show up with clear-cut answers. They show up with complex, multisystem symptoms that don’t fit neatly into a diagnosis.

They’ve been told things like:

• “Your labs look fine.”

• “That’s just part of aging.”

• “You’re probably just anxious.”

• “It’s probably hormonal—maybe birth control will help.”

None of these are necessarily wrong. They’re just incomplete.

The truth is: women are often misdiagnosed or dismissed—not because their symptoms are subtle or exaggerated—but because our system isn’t built to ask the right questions.

The body doesn’t speak in organ systems. It speaks in patterns.

Many women dealing with unexplained fatigue, bloating, and brain fog start to wonder why their labs are normal but they still feel off. They experience:

• Fatigue that doesn’t resolve with rest

• Intestinal issues with no clear cause

• Menstrual cycle changes, weight gain

• Palpitations, headaches, pain flares

• A sense that something is off—even when everything “checks out”

These are often labeled as hormonal, psychosomatic, or “stress-related.” But few clinicians actually have the time to ask:

What kind of stress are we talking about?
What has this person been carrying? For how long?
How has her nervous system adapted to survive?

If we don’t ask those questions, we miss the diagnosis entirely.

Stress illness is real—and physiologic

Let me be clear:

Stress is not psychological, it is physiological. That means, that it is something that happens in the body. In fact, stress is not what we feel, it’s the physical response that our body goes through when we experience all kinds of different stressors. These stressors can be inside or outside of the body. They can be physical or they can be psychological.

But I never tell patients “it’s just stress.”
What I explain is that chronic stress—especially the kind we repress—can cause real, measurable changes in the body.

We’re not talking about “feeling stressed.” We’re talking about:

• Dysregulated cortisol and autonomic tone

• Impaired immune signaling

• Persistent muscle tension, intestinal motility changes, and hormonal feedback loops

• A nervous system that’s been stuck in survival mode for so long, it forgot how to turn off

This can lead to everything from chronic pain to inflammation to cardiovascular risk—and if no one’s trained to recognize it, it’s often mistaken for anxiety, fibromyalgia, IBS, or “hormonal imbalance.”

Hormones are often affected—but rarely the root

It’s true that many women experience hormonal shifts, especially during perimenopause or postpartum. But getting hormone labs and prescriptions is not the same as treating the cause.

Hormones are secreted in the body in response to things. Hormones can reflect how safe or unsafe the body feels.

• If your body’s in a state of constant alarm, it can downregulate reproductive signaling.

• If you’re undernourished, under-rested, and emotionally overloaded, your progesterone may drop.

• If your sleep and blood sugar are unstable they can drive up cortisol—one of the most overlooked causes of anxiety, fatigue, and hormone disruption.

That doesn’t mean you need to “optimize” your hormones. It means we need to understand the conditions that your body is responding to with hormonal changes.

Why women are misdiagnosed: because no one is asking the right questions

Not because the symptoms aren’t real. Not because women are “too complex.” But because:

• The average visit doesn’t allow time for nuance

• Most training doesn’t include the physiology of chronic stress

• And our culture teaches women to tolerate symptoms until they’re severe

Here in Fayetteville at TrueCare DPC, I start with the same foundational tools every clinician should:
A thorough history - Every first visit is 50 minutes long. This gives my patients plenty of time to share their story and me time to digest the story and ask important questions.

A head-to-toe physical exam - In a time where more and more practitioners are drawn to rely on expensive fancy tests, I still believe in the value of physically examining my patients to look for clues of disease. It also gives me the opportunity to apply certain therapies with my hands that may provide relief.

Clinically useful labs - Not all labs are created equal and ordering the wrong ones can create unnecessary health anxiety. But it is simply the case that some things need a lab study in order to be properly diagnosed.

Imaging - Whenever necessary, I order the ultrasound or the x-ray or CT scan.

And specialist referrals when appropriate - I don’t know everything and I care more that my patients get proper care than that I be the one to solve all their problems.

But if and when those results all come back normal—or inconclusive—and the symptoms persist, I don’t stop there.

That’s where I ask the questions most systems overlook:

• What has your body been carrying that no one has named?

• How long have you been pushing through?

• Could your nervous system be stuck in survival mode?

I never assume your symptoms are just caused by stress—but after a full workup, I often find that the chronic stress response has been quietly disrupting everything from hormones to digestion.

I land there after ruling other things out—and when I do, I treat it as a real, biologically valid contributor to dysfunction. Because that’s exactly what it is.

If you’ve been dismissed, misdiagnosed, or told it’s all in your head—this is your reminder that your body is speaking for a reason. If you’ve been told everything looks fine but you still don’t feel well, the next step is finding a provider who listens—and understands how stress, hormones, and history interact.

That’s what I do right here in Fayetteville, NC at TrueCare DPC.

Text (910) 758-1769 today to learn how membership works or go ahead and click enroll when you’re ready to experience care that finally makes space for the whole you.