If you’re a woman (or someone assigned female at birth) who has sat on a crinkly paper sheet in a doctor's office, clutching a scratchy hospital gown closed with one hand while describing debilitating pain, only to be asked, “Are you sure you’re not just stressed?”, you’ve met the ghost of hysteria.

For centuries, the medical establishment has viewed women’s bodies through a lens of skepticism. When male bodies malfunction, it is viewed as a mechanical failure requiring a fix. When female bodies malfunction, it is often viewed as a failure of the mind or a defect of character. This phenomenon, often called medical gaslighting, is not new. It is the modern echo of a diagnosis that dominated women's health for nearly 4,000 years: hysteria.

To understand why more than half of patients see more than one doctor to receive a PCOS diagnosis, or why autoimmune diseases (more common among women) are frequently misdiagnosed as anxiety (see also), we have to look back at the history of this catch-all diagnosis and how it continues to shape the way women’s health is treated today.

The "Wandering Womb"

The term “hysteria” comes from the Greek word hystera, meaning uterus. The concept, however, predates the Greeks. Ancient Egyptian medical texts from c. 1900 BCE described a condition where the uterus, believed to be a living, animal-like entity, would become bored or unhappy and detach itself to wander around the female body. If it migrated to the chest, it caused breathlessness; to the head, headaches or dizziness. 

Hippocrates, the father of modern medicine, formalized this in the 5th century BC (read more). He argued that the uterus was prone to drying out and wandering if it wasn't kept "moist" through regular intercourse and pregnancy. Thus, the prescription for nearly every female ailment from seizures to sadness was marriage and motherhood.

For millennia, this was the prevailing medical wisdom. A woman’s biology was inherently unstable, ruled by a reproductive organ that could supposedly strangle her other organs at will. This foundation set a dangerous precedent: the belief that a woman’s physical symptoms are almost always tied to her reproductive status or her emotional state, rather than a distinct physiological pathology.

The Victorian Catch-All

By the Victorian era, the "wandering womb" theory had evolved, but the dismissal remained. Hysteria became the dustbin diagnosis for everything doctors couldn't explain or didn't want to deal with.

Symptoms of "hysteria" in the 19th century were comically broad. They included fainting, nervousness, sexual desire, lack of sexual desire, fluid retention, irritability, and "a tendency to cause trouble." It was a diagnosis used as much for social control as for medical treatment. Women who were too loud, too independent, or too unhappy were labeled hysterical.

The treatment was often the "rest cure," famously critiqued in Charlotte Perkins Gilman’s “The Yellow Wallpaper,” where women were confined to bed, forbidden from working or writing, and force-fed until they were "calm." The message was clear: your pain is a product of your fragile mind, and the cure is silence.

The Modern Shift: From Hysteria to "Just Anxiety"

In 1980, the American Psychiatric Association finally removed "hysterical neurosis" from the DSM (read more). But while the word was erased, the bias remained deeply embedded in medical culture. Today, "hysteria" lives on whenever a woman’s symptoms are dismissed as being "psychosomatic," "stress-related," or, most commonly, "anxiety" without any additional follow-up or exploration. To be clear, anxiety and stress can affect health, but when a doctor points to those as being the only causes of what a woman knows to be physical pain (especially without any testing), that’s where the problem lies.

This is where the intersection with autoimmune disease becomes critical. Autoimmune diseases—conditions where the body attacks its own healthy tissue—disproportionately affect women. Approximately 80% of those with autoimmune conditions like lupus, multiple sclerosis (MS), and rheumatoid arthritis are women.

These conditions are notoriously difficult to diagnose. According to the American Autoimmune Related Diseases Association (AARDA), the average time for diagnosis is 4.5 years, and during that period, a patient typically sees four doctors.

One reason it can take so long is that autoimmune conditions often present with invisible symptoms: fatigue, brain fog, migratory pain, and weakness. In a male patient, these symptoms might trigger a battery of neurological or blood tests. In a female patient, they often trigger a referral to a therapist or, even worse, an outright dismissal of symptoms as being “hormonal”. 

Research consistently shows that women wait longer for diagnoses than men. In fact, one study from 2023 found that, among 112 acute and chronic diseases, women experience longer lengths of time between symptom onset and disease diagnosis than men for most diseases regardless of metric used, even when only symptoms common to both genders are considered. 

This delay isn't just frustrating; it can be dangerous. In the years a woman spends being told it’s “all in her head,” her disease is often progressing, sometimes causing irreversible damage.

The Mental Health Scapegoat

The tragedy of the hysteria legacy is that it has created a false dichotomy between mental and physical health. Women are told their physical symptoms are mental, while their actual mental health needs are often overlooked or attributed to hormonal "moodiness."

When a woman with undiagnosed autoimmune encephalitis or a thyroid disorder is treated for depression instead of the underlying physical cause, she suffers twice—first, from the untreated disease, and second, from the gaslighting that erodes her trust in her own reality.

Conversely, the chronic stress of living with undiagnosed pain does cause anxiety and depression. When a patient is told for the tenth time that her labs are "normal" while she can barely get out of bed, she may indeed become anxious. But this anxiety is a symptom of the medical system's failure, not the cause of her illness.

Reclaiming the Narrative

The history of hysteria teaches us that medicine is not only objective; it is also cultural. It reflects the biases of the time. For thousands of years, the bias has been that women are unreliable narrators of their own bodies.

Changing this requires a two-pronged approach. First, the medical system must acknowledge its own history. Medical schools are beginning to teach "sex-specific" medicine, e.g., recognizing that symptoms of heart attacks, strokes, and immune responses manifest differently in women than in men.

Second, women must arm themselves with data. Resources like patient advocacy groups, symptom-tracking apps, and wearable tech like Petal that can track changes to your body in real-time are tools of rebellion. They allow women to walk into appointments not just with "complaints," but with quantitative evidence.

The "wandering womb" may have been debunked, but its ghost still lingers in the exam room. Exorcising it requires us to trust women’s voices, validate their pain, and finally accept that a woman’s biology is not a mystery for doctors to dismiss but a complex system we must seek to understand.

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If you enjoyed this article, we also recommend the book It’s Not Hysteria by Dr. Karen Tang.