Pain is likely the most common reason people seek medical help. For a long time, however, treatments have been applied in a standardized manner, without considering differences between the sexes.
Only in recent decades have some specialists begun to recognize that women experience pain differently from men and that, in many cases, traditional treatments are not as effective for them.
This discovery has major implications for medicine, especially for women. Studies indicate that women tend to feel pain more intensely than men and are more susceptible to chronic conditions such as migraines and fibromyalgia.
Despite this, their complaints are often underestimated by healthcare professionals, leading to delayed diagnoses and inadequate therapies.
A review of 77 scientific articles, published in 2018, examined sex differences in chronic pain treatment. Scientists found that when reporting this symptom, men were more likely to be prescribed painkillers, whereas women were more often given sedatives. Although pain complaints are more prevalent and intense in women, medicine does not take them as seriously.
A report on the topic, published in February by National Geographic magazine, highlights that before 1993, researchers were not required to include women in clinical studies funded by the National Institutes of Health (NIH), the main U.S. agency for medical research funding.
“This was based on the notion that women’s menstrual cycles distorted test results and the fear of harming a potential pregnancy. Instead, researchers assumed that if a drug was safe and effective for men, it would also be for women,” states the article by Katie Camero.
However, this premise is false. “The main issue is that we still know very little about female biology and its relationship with pain,” said Elizabeth Losin, a neuroscientist at Penn State University, in an interview with the magazine.
Hormonal Differences and Drug Responses
One explanation for this disparity lies in sex hormones. Estrogen, which is present in higher amounts in women, influences how the body processes medications. The hormone slows gastric emptying, increases body fat, and reduces the proteins that transport drugs in the bloodstream. These factors make painkillers less effective for women.
Additionally, the female immune system is more active, which can lead to stronger inflammatory responses, according to the National Geographic report. This may explain why women often require higher doses of medication for longer periods. However, this need is not always met, exacerbating suffering and prolonging recovery time.
The lack of female representation in clinical studies also means that many drugs have poorly studied side effects for women. A 2020 study revealed that women metabolize 86 drugs, including morphine and prednisone (a corticosteroid), more slowly than men, resulting in higher blood concentrations and adverse effects such as nausea, headaches, and seizures.
The Impact of Untreated Pain
Untreated chronic pain can have devastating consequences for women, affecting their quality of life and increasing the risk of medical complications. Moreover, the burden of domestic and family responsibilities can worsen their suffering.
Chronic pain is also linked to mental health issues such as anxiety and depression, as well as the misuse of medication. NIH data shows that while more men die from opioid overdoses, deaths among women have increased by 642% since 1999, compared to 439% among men, according to National Geographic.
Experts advocate for more research focused on gender differences in pain treatment. In the meantime, self-advocacy and seeking information are crucial for women dealing with pain.
“It’s not that this should be our responsibility, but the more research you can do in advance to participate more actively in your treatment, the better it will be for you,” Elizabeth Losin told the magazine.
