As I put it in my book The Painful Truth, “Pain is an unbidden guest, humanity’s shadow companion down through the ages. It is an interloper, a despoiler of dreams, a thief.” The “thief,” however, does not treat all persons equally. Chronic pain affects one group of people more frequently than any other—women.
A study published in a 2009 issue of the Journal of Pain found that women are “twice as likely to have multiple sclerosis, two to three times more likely to develop rheumatoid arthritis and four times more likely to have chronic fatigue syndrome than men. As a whole, autoimmune diseases, which often include debilitating pain, strike women three times more frequently than men.”
Several factors account for this disparity, including environmental, hormonal, and genetic influences. Estrogen appears to play a role in pain for women. Stages of the menstrual cycle also appear to affect women’s susceptibility to pain.
Regardless of why women experience pain more than men, it’s a fact that they have a different experience than men when seeking care. Women are consistently prescribed less and treated less for pain than are men. Studies show that women are often passed up for surgeries and medications despite presenting the same symptoms as men. Men are 22 times more likely to be recommended a knee surgery when having chronic knee pain than women. Additionally, a 2008 study found that men who showed up to a hospital to receive treatment for acute abdominal pain were between 15 and 23 percent more likely to receive opioids than were women, and women were less likely than men to get any medication at all. Furthermore, women are more likely than men to be prescribed a sedative instead of an analgesic for acute pain.
The gender difference in pain perception and treatment is real. Unfortunately, members of the medical community are largely either unaware of these differences or indifferent to them. Even our family and friends unknowingly contribute to the gender disparity in treatment for pain by discounting or dismissing pain complaints from women as being emotional. My profession must commit to rectifying this problem. Meanwhile, as individuals, we can begin a conversation about how women can get the compassionate response they deserve when they are in pain.
In a past blog post, I talked about the difference between empathy and sympathy and the impact that the former can have on healing. In my next blog post, I will discuss how medical professionals and caretakers use empathy to support women who are experiencing pain.
Purchase my book The Painful Truth: What Chronic Pain Is Really Like and Why It Matters to Each of Us (available on Amazon) or read a free excerpt here.
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One anecdote I will always remember (this was about 17-18 years ago). A woman was admitted for intractable pain yet the only medication ordered was lorazepam. I called the doctor to see if there had been a mistake. He said there hadn’t as he thought it was mostly emotional and wanted to see if the lorazepam would help first . He knew I was a pain management nurse. I told him I couldn’t ethically give her an antianxiety medication only when she was admitted for pain and got a pain medication order from him. It wouldn’t have worked with a lot of other doctors even though this was the equivalent of giving a placebo which is against the ANA standard of care.