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Women’s symptoms are often interpreted through emotional regulation.

Nineteenth-century hysteria and modern care share a persistent diagnostic pattern.

Clinical authority shapes what counts as real and what is dismissed.

Dismissal leads to delayed care, mistrust, and patients leaving treatment.

Nearly two hundred years and different diagnoses separate these two cases: One patient was advised to rest; the other patient was advised to relax. One’s symptoms were attributed to heightened sensitivity to stimuli and failure to regulate emotion; the other’s symptoms are often dismissed as signs of stress, anxiety, and heightened bodily awareness. One’s treatment focused on limiting what might provoke an emotional response; the other’s clinical experience shifts attention from symptoms toward the patient’s responses to them.

The first case is about 19th-century hysteria and the second is about contemporary vulvovaginal disorder, but they nonetheless share a pattern of interpretation: When women’s physical symptoms resist easy explanation, they are often understood in terms of emotional regulation and management.

From “Just Rest” to “Just Relax”

In 1853, Robert B. Carter attributed a woman’s hysteria to a failure of willpower. Fainting, trembling, and unable to regulate her responses to the shocks of the world, the hysterical woman was, he argued, simply too impressionable (1). In mid-19th-century hysteria discourse, physicians understood a woman’s sensitivity to her environment as her constitutive vulnerability—the condition that made her susceptible to illness in the first place. As Marshall Hall argued, women were, by their nature, “far more sensitive and susceptible than the male,” and it was this constitutional fact, rather than any identifiable pathology, that explained their suffering (2).

Within this framework, emotional responsiveness itself became explanatory. A woman’s symptoms were understood as expressions of her inherent susceptibility. The cure was clear: remove her from exciting circumstances,........

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