As the song goes, “Everybody hurts,” but not everybody gets the same treatment. As with pay and promotions, women get short shrift when it comes to their pain being taken seriously. Women in pain get less treatment, wait longer for doctors, and generally get treated as second-class citizens. We believe it’s time for women in pain to be taken seriously and to get the treatment they deserve.
Women in pain – The numbers
A recent survey from the National Pain Report cited disturbing statistics regarding women in pain. Of the nearly 2,600 female respondents to the survey, just over 56% said they were sometimes treated differently because they were women. Another 27.5% felt that they were usually or always treated differently because of their gender. A full 65% felt that their doctors took them less seriously because they were women.
These anecdotal statistics are supported by hard numbers. Women feel more pain, more severe pain, and more frequent pain, but their pain is treated less aggressively than men’s. This is borne out by statistics cited in a 2001 study titled “The Girl Who Cried Pain: A Bias Against Women In The Treatment Of Pain.” The authors looked at whether or not women actually experience pain differently, why they are treated differently from men, and what changes need to occur to fix that.
These questions matter. Women are disproportionately affected by chronic pain. Around 50 million women in the U.S. are living with chronic pain. Some conditions grossly affect women in ridiculous proportions. Women are seven times more likely to suffer from fibromyalgia than men, and 90% of lupus cases in the U.S. are women.
Societal beliefs about pain
Given these numbers, one would expect more time and attention would be spent on finding treatments geared towards women. This is not the case. At the most basic level, the emergency room, men presenting in the E.R. with abdominal pain wait an average of 49 minutes for pain medicine. Women wait an average of 65 minutes for any pain relief, often being told that their pain isn’t that bad or that they are overreacting.
This may be due to the societal belief that women have higher pain thresholds than men. Childbirth is often used a joking “evidence” of this belief, but researchers at Bath University have found that women experience pain both physically and emotionally, making it worse.
Lead researcher Dr. Ed Keogh, a psychologist at the pain management unit at Bath University, believes that both the quantity and quality of women’s pain is greater than men’s. He also notes that traditional pain management advice may not help women cope with pain, saying:
“Women who concentrate on the emotional aspects of their pain may actually experience more pain as a result, possibly because the emotions associated with pain are negative…women experience a greater number of pain episodes across their lifespan than men, in more bodily areas and with greater frequency. Our research has shown that whilst the sensory-focused strategies used by men helped increase their pain threshold and tolerance of pain, it was unlikely to have any benefit for women.”
Medication research in women
Researchers from the Bath study believe that these differences in pain between men and women mean that more women-centered treatments are needed. This opens up a whole other area of sexism in pain: medication. In research and clinical trials, women are excluded from virtually all phases of drug development and testing.
A review of major medical journals in 2014 found the following discrepancies:
- Cell research: Only 17% of research animals were female, and only 21% of cells studied were female.
- Predominantly female disease: Fewer than half of the studies examined mentioned the sex of animals used, and when they did, only 14% of the studies on predominantly female illnesses used female cells. In studies of depression, a disease which occurs twice as often in women than in men, researchers used only 45% female animals.
This basic discrimination in research is one thing, but when it comes to clinical trials, this discrepancy could kill. Women are routinely left out of clinical trials of medications, a habit left over from a ban on using women of child-bearing age as clinical trial subjects that was in place from 1977 to 1993. In these 16 years, over 1,500 drugs were approved for use, tested only on men.
This may be one of the main reasons why so many women in pain find so little relief from commonly accepted prescription pain relievers. If they haven’t been developed on female cells or tested on female animals or put into clinical trials with women, there is no evidence that they will work in the same way as they do with men. Further, side effects and dangerous reactions may be heightened due to the manner in which these drugs react with the different hormones in a woman’s body.
Blame the hormones, when it comes to women in pain
Many researchers will use the excuse of hormone fluctuations as justification for why they cannot test their drugs on women. Hormone fluctuations throughout a woman’s life (and throughout the month) are very real, and (predominantly male) researchers just don’t want to take that into consideration.
Hormones and the perception of overreaction because of them is also the reason that physicians in the emergency room as more likely to dismiss symptoms of heart attack in women as simply anxiety.
In the National Pain Report cited above, women report hearing one or more of the following during their treatment for chronic pain:
- The pain is all in your head: 44.8%
- You look good, so you must be feeling better: 51.4%
- You’ll have to learn how to live with your pain: 75.1%
Become a health advocate
For women in pain, there are concrete steps to take to become a health advocate for themselves.
- Step one: Know that your pain is real, valid, and deserves to be treated.
- Step two: Know your rights as a patient to be treated with respect, dignity, and equality.
- Step three: Take a trusted female friend with you to help advocate for you if you are in pain.
- Step four: Visit Women in Pain’s website to read more about the campaign to end discrimination in pain treatment.
- Step five: If you aren’t being heard, change doctors and tell your previous doctor why you are leaving.
As the researchers in “The Girl Who Cried Pain” concluded:
“There are gender-based biases regarding women’s pain experiences. These biases have led health-care providers to discount women’s self reports of pain at least until there is objective evidence for the pain’s cause. Medicine’s focus on objective factors and its cultural stereotypes of women combine insidiously, leaving women at greater risk for inadequate pain relief and continued suffering.”
Women in pain need to be strong advocates for themselves and other women. Have you ever felt discriminated in your treatment due to gender? How did you handle it?