There is no woman on earth who isn’t familiar, intimately, with pain. We grow up experiencing it, whether it’s through menstrual cramps and muscle aches or through childbirth, menopause and old age. This lifelong experience leads to major side-effects throughout a woman’s lifetime. Most women take pain to be a regular part of life and learn to suffer it in silence. This leads to us sometimes underreporting our symptoms, delayed diagnosis of diseases and inappropriate treatment. Even when we do report pain to doctors, there are times when we are not taken seriously.
This is the major reason why women must understand the connection with pain. Not only can this understanding lead to better healthcare options, but also better quality of life. Here’s everything you need to understand about your connection with pain and how it manage it throughout your life.
What Causes Differences In Pain Perception & Sensitivity?
A 2017 study published in PLOS One explains that the prevalence of chronic musculoskeletal pain is much higher among women. A lot of factors play a role here. Another study, published in 2021 in the journal Pain And Therapy, explains that these factors are anatomical, physiological, neural, hormonal, psychological, and socio-cultural in nature. A number of pain perception studies based on controlled experiments also suggest that women have a lower threshold for pain, therefore being more exposed to perceive pain or have less tolerance for intense pain stimuli.
But perhaps the easiest to understand of all these factors is the hormonal one. Our gender determines the types of hormones we produce more. A 2019 study published by the Oxford University Press explains that sex steroid hormones like estrogen, progesterone and testorterone and peptide hormones like prolactin, oxytocin and vasopressin all are linked to pain. Healthy production of progesterone (a female sex hormone) and testosterone (the primary male sex hormone) have protective effects against pain. On the other hand, estrogen (the primary female sex hormone) exacerbates pain. Prolactin triggers pain, while oxytocin and vasopressin protect against pain.
A woman’s hormone production does vary greatly due to the menstrual cycle, pregnancy and reproductive health issues. These can lead to imbalances in our hormone production, making us more vulnerable to pain. One of the best ways to map this is to consult your gynaecologist, get hormone tests done, and understand better which hormones are causing pain for you. Your doctor can also suggest hormone replacement or other therapies to manage pain.
Gender Differences In Pain Coping Strategies
In a study published in the British Journal of Anaesthesia in 2013, researchers explain that gender differences exist not only in pain perception and sensitivity, but also in pain coping strategies. The study says that men use behavioural distraction and problem-focused tactics to manage pain, while women use a range of coping strategies like social support, positive self-affirmations, emotion-focused techniques, etc. The study also explains that there are basically two constructs that impact pain responsivity are catastrophizing and self-efficacy. Catastrophizing refers to magnifying the pain-related information and constantly ruminating about its impacts. Self-efficacy refers to a problem-focused attitude which involves performing certain tasks or developing habits that can relieve the pain in the short and long terms.
This study and others show that catastrophizing about pain not only makes the experience worse but also leads to greater pain-related disability. Higher levels of self-efficacy, on the other hand, is a better coping mechanism when it comes to pain. And catastrophizing, as this study shows, is something women engage in more often than men. Does this sort of catastrophizing response to pain make the overall outcomes for women worse? Perhaps it does. Recent studies on mental health show that getting psychological counselling while suffering from a disease that leads to debilitating pain, like cancer or arthritis, actually helps reduce catastrophizing and improves self-efficacy. So, this, ladies, is a definite method we too can use to learn to manage pain better.
The Medication & Research Gender Gap
A leading factor that leads to mismanagement of women’s pain has nothing to do with our anatomy, mental makeup, hormones, etc. It has to do with medical science and the gender gap therein. A 2017 report by Harvard Health Publishing suggests that women’s pain is often dismissed as psychological in origin. Women in pain are also more likely to receive prescriptions for sedatives rather than painkillers for their illnesses than men. In fact, a 1989 study even suggests that women going through coronary bypass surgery are only half as likely to be prescribed painkillers as men who have had the same surgery.
Most medical concepts of diseases are based on studies done on men and their physiology. While 70 per cent of the people impacted by pain, as per the Harvard report, are women, 80 per cent of pain studies ate conducted on male mice or human men. However, it is very well known that women have altogether different symptoms than men for major issues like heart attacks! So, this medical discrepancy in understanding women’s pain and administering the right dosage of painkillers to us does impact how we handle pain throughout our lives.
So, as a woman, understanding that all of these factors together play a role in how we perceive, cope with and treat pain is critical because gender differences still do exist. Knowing your own body and response to pain is certainly going to help in this regard, but so is getting a good doctor you can communicate openly with. For more on how to manage pain and other health issues, head to the Help section on Her Circle to connect with medical professionals who can guide you.