Why Do Women Suffer Chronic Pain More Than Men?

We've known it for some time.  We're much better at handling pain than men.  But a new study has found that not only do we deal with it better, but women have more chronic pain than men.

Writes Judy Foreman at the Wall Street Journal, "Women are 'allowed' to be emotional about their pain, and men often aren't, so perhaps women's pain gets noticed more. There are complicated hormonal factors too. There are research biases at work as well, including the absurd fact that most basic neuroscience work on pain pathways is done not only in rats but in male rats. Go figure."

But she also notes that women's pain is more complex and women and men react so differently to both pain and pain medications.  Recently, when I broke my wrist -- clearly the most painful injury I've ever had! -- I almost passed out when the doctor tried to jam the bone back into place in my wrist. Not once but many times. My husband said he, in that situation, would have had to be put out.  This is the man, a medical professional himself, who fainted when the opthamologist flipped up his eyelid to check something. (He actually needed smelling salts to come around.)

Here's how Foreman puts it: "Clinically, women are both more likely to get chronic painful conditions that can afflict either sex and to report greater pain than men with the same condition, according to studies over the past 15 years." She points out that women also have more acute pain than men even after the same surgeries, such as wisdom tooth extraction, gall bladder removal, hernia and hip and knee surgeries.

In a 2008 study, Foreman relates, in a sample that included more than 85,000 people, "They discovered that the prevalence of any chronic pain condition was 45% among women, versus 31% among men."

In a 2009 review, researchers found that, all over the world, "women get more irritable bowel syndrome, more fibromyalgia, more headaches (especially migraines), more neuropathic pain (from damage to the nervous system itself), more osteoarthritis and more jaw problems such as TMD, as well as more musculoskeletal and back pain. A 2012 study confirmed this.

Canadian researchers have found that men and women have comparable thresholds for cold and ischemic pain but that women have lower pain thresholds for pressure-induced pain than men. It's unclear why. With tolerance, there is strong evidence, the team found, that women tolerate less heat and cold pain than men, but that tolerance for ischemic pain is comparable in men and women. Again, it isn't clear why.

Women are three times less likely to get the hip or knee replacement they need, according to researchers, and when they do finally have the surgery, they often don't do as well as men, Foreman adds.

So we have more chronic pain and less treatment?  Hmmm....  I, like a lot of women, just suck it up. I've had major cancer surgery, went through a C-section and surgery a week after that, and what do you do?  You do what you have to, I've learned.  (I came home from the hospital after the second surgery, with a seven-day-old baby, barely able to move, only to be asked by my mother-in-law for more ice for her drink!)

But maybe it's a little our fault, too.  Part of the problem is that women usually wait longer to have surgery, while men (the big babies!) tend to seek surgery before their pain becomes extreme. Because a woman typically has more advanced disease by the time she gets surgery, the result often isn't as good (though my husband, again, who could use a knee replacement, refuses and still plays tennis, then can't walk for a week).

So what are we to do?  Maybe listen to our pain more.  Put our bodies first.  When we feel that twinge or ache, honor it.  And, for once, let the men do the caring.  

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