Gender And Pain: Women More Susceptible, Researchers Say

Men and women experience chronic pain differently, an increasingly large body of research into the area of gender and pain says. Women are more likely to experience chronic pain and related conditions, such as fibromyalgia.

However, when it comes to pain after surgery or minor procedures, the picture is more nuanced, according to research conducted by Austrian researchers and presented at an industry meeting in Stockholm, with the experience depending both on gender and the type of treatment.

Over the last 2 decades, researchers have become increasingly interested in the intersection of gender and pain, and the findings are influencing how doctors treat that pain.

The Austrian researchers decided to focus on pain related to surgery because research in that particular area has been more limited than in other areas. Dr. Andreas Sandner-Kiesling, of the Department of Anaesthesiology and Intensive Care at the Medical University of Graz, notes that:

“The influence of gender and (pain) is a key issue of today’s research in medicine. Our aim was to analyze a large population to find differences in post-operative pain perception in females and males.”

Over the course of 4 years, the Austrian researchers interviewed 10,000 people—42% male and 58% female—24 hours after undergoing surgery. Participants answered questions on a specially designed questionnaire, describing the surgery and providing information related to well-being and the amount of pain they experienced.

The findings intrigued scientists. Although males and females felt roughly the same amounts of pain when the data was analyzed as a whole, the picture changed when researchers examined specific types of procedures. Gender influenced how much pain any given patient felt after undergoing a minor procedure versus a more extensive surgery.

For example, 27% more men reported higher levels of pain following major vascular and orthopedic surgery while women experienced more pain after minor surgeries such as biopsies and other diagnostic procedures.

How much pain will you feel after surgery? The answer depends on gender, scientists say.

Despite the large amount of data, researchers said they still couldn’t draw unequivocal conclusions regarding gender and pain. “Our data do not definitely clarify this issue,” the study says. However, scientists said the results support the view that gender plays a significant role in how much pain patients feel following surgery.

The evidence surrounding this area is growing, and earlier studies came to opposite results, revealing that women may feel a greater intensity of pain following operations or minor procedures, according to a scientific review of studies on the topic published in The Journal of Pain.

The review showed that in addition to feeling more pain after surgery, women are more likely to experience other types of pain, including chronic pain or fibromyalgia, or suffer from multiple pain conditions.

Women report pain more frequently than men, although scientists aren’t sure if the pain is worse.

Although women experience pain more frequently, researchers say it’s difficult to tell whether gender impacts the severity of pain, according to a review of studies published in the British Journal of Anaesthesia. While some studies show that women do experience more severe pain, others have found no difference based on gender. Researchers say it’s difficult to reach an answer because it’s likely that patients without much pain are not represented as well in the studies as those experiencing higher levels.

Just as the Austrian researchers tried to gauge if women or men fared worse after surgeries or other procedures, the British scientists reviewed a body of literature for insight on this matter.  Their inquiry yielded mixed evidence: some studies showed women fared worse, others determined men did, and still others found no difference at all.

Taken as a whole, scientists say women tend to feel worse pain after invasive procedures than men.

Of the approximately 5 million U.S. adults with fibromyalgia, up to 90% are women, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. 3 out of 4 migraine sufferers are women, according to the Office on Women’s Health, and estrogen may play a role in some of those headaches. Researchers aren’t sure why women tend to experience pain more frequently than men, but they’re hot on the trail.

Women may experience more pain then men because of differences in how men and women process pain, according to research conducted at the University of California, Los Angeles (UCLA). Scientists focused on people with IBS, a common condition that results in stomach pain.

Study subjects were given pain stimuli and then researchers watched how their brains reached. Women’s brains were more active in the limbic region, an area governing emotion, while pain affected men in the areas of their brains related to analysis and rational thought. Anticipating pain led to the same centers being activated.

Researchers hypothesized that the difference results from humans’ primitive days when men and women had more defined social roles. Pain in a logical area of the brain could trigger a man’s instinct to figure out a way to protect the home, while in women, the emotion of fear would lead them to protect their children.

“The brain is a powerful force in dictating how the body responds to pain and stress,” says Dr. Lin Chang, a UCLA processor who co-authored the study. Researchers said future pain medications may focus on working with the areas of the brain most implicated in pain processing to change patients’ experiences.

Women are also more in tune with the emotional aspects of pain than men, often worsening their experience of it, researchers say.

Psychologists say that because women react more strongly to the emotional experience of pain, they may experience more of it. Rheumatologist Dr. Mark Borigini says:

“Men tend to focus on the physical sensations experienced. Women may actually experience a greater degree of pain due to the negative emotions associated with pain.”

Borigini says this knowledge about gender and pain should impact how doctors talk to patients about pain, presenting it as a problem that can be surmounted instead of 1 that’s insurmountable. Learning coping strategies and ways to manage the emotions surrounding pain can vastly improve a patient’s quality of life, he says.

In your experience, do women or men experience more pain?

Photo by David Amsler via Flickr