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Victorian Womens Health Atlas

CHC: Women and pain

Women and pain

Clearinghouse Connector – September 2016


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Introduction

A number of biological and psychosocial factors contribute to women’s different experience of pain. Pain is a complex and subjective experience that is often not visible.1 Women report more pain-related conditions than men and are the majority of those presenting with chronic pain.2 Studies show that women have a higher sensitivity to and lower tolerance of pain than men.2 3 Women report clinical pain as more intense and with more frequent episodes compared to men as well as having greater sensitivity to painful stimuli in clinical experiments.4

Women’s overrepresentation in pain conditions could arise from the interaction of biological, psychosocial and sociocultural factors.5 Emerging research suggests that women may process pain through different immune cells from men.6 7 Psychosocially, women are also more likely to have higher levels of depression and anxiety which is linked to increased risk of pain.7

Gendered norms play a role in reporting bias, as learned masculinity encourages stoicism and is associated with higher reported pain thresholds.4

Studies confirm that women’s pain can be normalised by health professionals and as a result, they are less likely to have their pain taken seriously.3 8 9 The absence of diagnosis and a desire to conceal pain can lead to isolation.8

Drug trial exclusion, discussed in our previous Connector, has led to a lack of research on effective treatment for women’s pain.10


Overview

Genders experience pain differently, and women have it more The Conversation, 2015

Gender and the pain experience Practical Pain Management, 2016

Sex differences in pain : a brief review of clinical and experimental findings British Journal of Anaesthesia, 2013

A massive dataset settles it : concerning pain, men and women are different Pain Research Forum, 2012

Gender role affects experimental pain responses : a systematic review with meta-analysis European Journal of Pain, 2012

Sex differences in pain and pain inhibition : multiple explanations of a controversial phenomenon Nature Reviews Neuroscience, 2012


Pelvic pain

Managing chronic pelvic pain in girls and women Medicine Today, 2013 Australian study

The association of inflammation with premenstrual symptoms Journal of Women’s Health, 2016

Localised provoked vestibulodynia (vulvodynia) : assessment and management Royal Australian College of General Practitioners, 2015

Chronic pelvic pain [Factsheet] Women’s Health Queensland Wide, 2014


Childbirth

Why labour is such a pain : and how to reduce it The Conversation, 2015

Birth wars : the politics of childbirth New Statesman, 2016

Pain relief in labour : a qualitative study to determine how to support women to make decisions about pain relief in labour BMC Pregnancy and Childbirth, 2014

Joint RANZCOG/ANZCA Position statement on the provision of obstetric anaesthesia and analgesia services RANZCOG, 2015


Breast pain

Breast pain / mastalgia Family Planning NSW, 2016

Managing cancer pain : for women living with advanced cancer [Webinar] BreaCan, 2014

Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer British Journal of Cancer, 2012


Head and neck pain

Migraine headaches, menopause and HRT Australian Menopause Society, 2014

Overview of orofacial pain : epidemiology and gender differences in orofacial pain Pocket Dentistry, 2016


Fibromyalgia and pain comorbidities

Chronic pain epidemiology : where do lifestyle factors fit in? British Journal of Pain, 2013

The link between chronic pain and depression: which comes first? The Conversation, 2016

Hidden and unexplained : feeling the pain of fibromyalgia The Conversation, 2015

The science of fibromyalgia Mayo Clinic Proceedings, 2011


Medical care and treatment bias

Beating pain Jean Hailes Magazine, 2016 Australian article

Chronic pain in women Best Practice Journal (NZ), 2015

Perspective : equality need not be painful Nature, 2016

Why women are living in the discomfort zone Wall Street Journal, 2014

How sexist stereotypes mean doctors ignore women’s pain The Independent [U.K.], 2016


Women’s experiences

How different cultures experience and talk about pain The Conversation, 2015

What I live with : the silent suffering of one in 10 Australian women with endometriosis Huffington Post Australia, 2015

When a tampon feels like a knife : living with chronic pelvic pain SBS News, 2016

How doctors take women’s pain less seriously The Atlantic, 2015


International policy development

Chronic pain in women : neglect, dismissal and discrimination : analysis and policy recommendations [Direct download] Campaign to End Chronic Pain in Women. Overlapping Conditions Alliance [U.S.], 2010

Impact of chronic overlapping pain conditions on public health and the urgent need for safe and effective treatment : analysis and policy recommendations Chronic Pain Research Alliance [U.S], 2015


Australian policy development

Pelvic pain report : the $6 billion dollar woman and the $600 million girl Pelvic Pain Steering Committee (Australia), 2011

National pain strategy : pain management for all Australians Pain Australia, 2011

NSW Pain management plan 2012-2016 NSW Ministry of Health, 2012


Related websites

Pelvic Pain Foundation of Australia Pelvic pain in women

Jean Hailes for Women’s Health Search for >100 pain resources

The Conversation Pain series

American Society of Anesthesiologists Women’s pain update

Queensland Health Persistent pain resources : for clinicians


Footnotes

  1. Jean Hailes (2016). Beating pain. Jean Hailes Magazine 2016(1):13-16. Accessed on 12/08/2016.
  2. Mogil, JS (2012). Sex differences in pain and pain inhibition : multiple explanations of a controversial phenomenon. Nature Reviews Neuroscience 13(12):859-66. Accessed on 12/08/2016.
  3. Bartley EJ, Fillingim RB (2013). Sex differences in pain: a brief review of clinical and experimental findings. British Journal of Anaesthesia 111(1):52-8. Accessed on 12/08/2016.
  4. Alabas OA, Tashani OA, Tabasam G, Johnson MI (2012). Gender role affects experimental pain responses : a systematic review with meta-analysis. European Journal of Pain 16(9):1211-23. Accessed on 12/08/2016.
  5. Olson KA (2016). Gender and the pain experience. Practical Pain Management 16(2):1-3. Accessed on 12/08/2016.
  6. Mogil JS (2016). Perspective : equality need not be painful. Nature 535(7611):S7. Accessed on 12/08/2016.
  7. Della Volpe K (2016). Sex and gender differences in the pain experience. Practical Pain Management 16(2):1-2. Accessed on 12/08/2016.
  8. Toye F, Seers K, Barker K (2014). A meta-ethnography of patients' experiences of chronic pelvic pain : struggling to construct chronic pelvic pain as ‘real’. Journal of Advanced Nursing 70(12):2713-27. Accessed on 12/08/2016.
  9. Woolston C (2016). Pain : another gender gap. Consumer Health Daily (Jan. 20). Accessed on 12/08/2016.
  10. Evans S (2015). Genders experience pain differently, and women have it more. The Conversation (Dec. 10). Accessed on 12/08/2016.

How our Clearinghouse can help you

Women’s Health Victoria’s Clearinghouse has a wealth of information on gender in health in various forms. Our experienced health and information professionals can assist you to access this information.


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