“Women are born with pain built in. It’s our physical destiny: period pains, sore boobs, childbirth, you know. We carry it within ourselves throughout our lives; men don’t.” (Fleabag, Series Two, Episode Three)
Ask any woman, and she will likely have a packet of ibuprofen or paracetamol at the ready—perhaps even an antihistamine for those summer afternoons spent in the Meadows. Sometimes, it really does feel like women are born with pain built in, with monthly period pain doses accompanying us throughout uni. Yet many men will lament discomfort, like a headache, but refuse medication. Is this reluctance merely out of fear of building a tolerance against pain relief, or does it reflect a deeper sociological force, the enduring archetype of the strong male, expected to endure pain in silence? Beyond these cultural patterns, is there a clinical difference in how men and women experience and manage pain?
Scientific research has established notable differences between men and women in pain perception and management, shaped by biological, psychological, and social factors. Women generally report higher pain sensitivity and lower pain thresholds than men, with a greater prevalence of chronic conditions such as migraines, fibromyalgia, and musculoskeletal pain (note: there is some sick irony in women living longer yet having more long-term illnesses!). Hormonal fluctuations, particularly oestrogen, influence pain modulation, while societal norms can shape how individuals express and tolerate pain—women’s pain is often dismissed, whereas men are expected to endure discomfort stoically.
Advances in pharmacogenomics reveal that genetic variations significantly impact pain responses, highlighting the need for personalised treatment. However, accessibility remains a challenge, as genetic testing, while economically feasible, is not yet widely available. Additionally, women tend to use more pain medication and may experience enhanced opioid analgesia (the inability to feel pain) but also increased adverse drug reactions. The growing field of genome-wide association studies promises further insights, yet gender disparities persist in pain research, limiting optimal care. To improve treatment outcomes, future research must integrate sex- and gender-specific analyses, ensuring equitable and effective pain management strategies for all individuals.
In addition to this, one study examining sex bias in emergency department pain management shows that women receive less pain treatment than men, despite reporting similar pain levels. An analysis of electronic health records from Israel and the US, along with a controlled experiment, found that women’s pain is taken less seriously, leading to undertreatment and longer wait times. Psychological biases, influenced by stereotypes, contribute to these disparities. This research underscores the need for policy reforms, improved education, and standardised protocols to ensure equitable pain management.
Pain indeed makes us human, but it shouldn’t have to affect one gender more than others. With female-specific conditions such as endometriosis affecting one in ten women, while diagnosis takes between six and twelve years, we must advocate for policy changes and support organisations dedicated to reducing gender bias in healthcare, fostering an environment where everyone can access the pain relief they deserve.
Photo by Myriam Zilles on Unsplash