Friday, April 1, 2011

Gender and Pain

In the April 2011 issue of More magazine, Alice Lesch Kelly writes a brilliant article entitled “The Male-Female Pain Gap” which explores why men often receive better pain relief from their doctors than women. In her article, Kelly uncovers three disturbing statistics ...

1) Women are less likely to be treated for pain and or/pain disorders than men. Kelly gives several examples of studies which show that women are treated less often for pain than men. Kelly explains that one reason for this is that women tend to describe their pain with more emotion than men, which has led many doctors to believe, consciously or unconsciously, that women tend to exaggerate their pain. As a result, the myth that women make up pain that doesn't exist or that they experience pain that is only 'in their heads' continues to circulate within the medical community. These biases often mean that women are more likely to have their pain dismissed or ignored by medical professionals than men.

2) Women experience more pain than men. Kelly explains that despite the fact that women are treated less frequently for pain, they are much more likely to suffer from long-term conditions that cause pain such as fibromyalgia, osteoarthritis, and irritable bowl syndrome, and are also more likely to to suffer from more than one painful condition at a time. There is also evidence that female hormones like estrogen can diminish women's ability to tolerate pain, and can also affect the effectiveness of many painkillers. Kelly also reveals that although there is a general belief that women can handle pain better than men because of their ability to handle childbirth, women tend to have lower pain tolerance thresholds than men. The result? Women tend to experience more pain in their daily lives than men do.

3) Women are less likely to be prescribed adequate pain medication. Despite the fact that women experience more pain than men, Kelly reveals that women are significantly less likely to be prescribed high-potency painkillers and that physicians are often more apprehensive about prescribing potentially addictive drugs to women. She also found that African American women were less likely to receive proper pain medication than white women with the same condition.

So what does all of this mean for patients with Hypermobility Syndrome? Well, although HMS affects both men and women, the condition is more commonly seen in women, and many of the gender biases described above help explain why many female HMS patients spend months and even years trying to get a proper diagnosis. Like fibromyalgia, HMS is often seen as a 'women's disease,' and as such its seriousness and ability to affect a patient's quality of life are often downplayed because of gender biases that suggest that women exaggerate their pain symptoms. Fighting these gender biases within the medical community is one way to ensure that HMS patients of both genders will their voices heard and their health-care needs met.

So, what can I do to make sure my pain is properly treated? Kelly gives some great suggestions for anyone seeking medical assistance for pain. Try following these tips at your next doctors visit to help ensure that your pain symptoms are properly addressed.

1) Use clinical language when describing your pain - when describing your pain symptoms to your doctor try to not get emotional, instead, try to use objective language and give your doctor concrete examples of how the pain is affecting your life. When describing the severity of your pain, use the ten-point scale, with 0 representing no pain and 10 representing the most pain imaginable. For example, instead of telling your doctor 'my back really hurts' try explaining your symptoms like this - 'three days this week I experienced back pain that was a six out of ten, I was forced to take a half-day off of work, and was unable to attend to my household duties so I had to call a friend to watch my children and have my husband cook diner.' Describing your pain this way, by giving specific information about its intensity, duration, and impact on your daily function will give your doctor important medical information, and encourage them to look at your pain more objectively. Remember, pain is a subjective experience, you can't measure it or see it, but doctors like to treat conditions where their are objective tests that can show them there is something wrong. By being more clinical and objective when describing your pain, you are translating your personal experience into language a doctor can better understand and is more likely to respond to.

2) Keep a pain journal - one great way to convey your pain symptoms to your doctor is to keep a pain diary. Be as specific about your symptoms as possible - what type of pain did you have, was it burning, stabbing, aching, crushing? When did the pain occur, was it triggered by something specific? How long did it last, did it respond to anything you did? Did your pain affect your appetite or ability to perform daily tasks? Try going to or to download a free template that you can use as your daily pain journal. Each time you visit your doctor, bring your pain dairy. This will give your doctor information that will help them spot patterns in your symptoms and make it easier for them to recognize the presence of an underlying condition or stimulus for your pain. A pain diary will also help you understand your pain better, help you to spot triggers and the treatments that work best for you, which will help you handle your pain better.

3) Find the right doctor - some doctors are more experienced and more comfortable treating pain disorders than others, so if you feel your doctor is not the right fit or if they downplay your pain and/or accuse you of making it up, find a new doctor! Try looking for doctors in your area who have either studied pain management or have experience with pain patients, or try visiting a pain management center. You deserve to have your concerns listened to and respected, so if you find yourself in a situation where you think you are being doubted or disrespected, you have the right and the duty to yourself to seek medical help elsewhere. In her article, Kelly found that female doctors are often more likely to treat pain symptoms than male doctors, especially if the patient is female. So try finding a sympathetic female doctor who will listen to your concerns with true interest and respect.

4) Know that pain management and treatment is often a long term process - even if you find a doctor who is willing and eager to treat your pain, its important to know that pain management is not an exact science. Pain medications work differently in different people, and even if you are prescribed one, there is only a 40-60% chance that it will be the right one. Its important that you understand this when you are going into your doctors appointment and that you ask your doctor about the benefits and risks of different treatment options and leave with a plan already in place for the next treatment option you would like to try if your doctor's first attempt at treating your pain does not work. Try to be open to different types of treatment - antidepressants are often prescribed for chronic pain because they help block pain-communication pathways in your brain, so don't let the stigma of being prescribed an antidepressant deter you from giving that treatment option a try. While you are working with your doctor to find the right pain treatment for you, it is great to try out alternative pain relieving techniques, which can help you get by while you are waiting for a more formal treatment plan. Acupuncture, message, certain types of yoga, meditation, hypnosis and guided relaxation, biofeedback, and other relaxation techniques are often wonderful at treating pain without the need for medication and can teach you skills you can apply at home to help you treat your own pain.

I hope these tips will help you navigate the tricky process of pain management. Just remember that you deserve the best treatment possible and if you don't feel like you are getting that currently, you have the right to seek treatment elsewhere. Keep your chin up and know that there is a solution to your pain problems out there, you just have to have the perseverance to find it!


  1. this is such a well written post, I'm going to link to it. All the best, Helen x

  2. Ha, I'm a 20 year old dude and I couldn't get a doctor to believe I had hypermobility syndrome even after I shoved the damn book in his face. Most doctors haven't even heard of JHS or HMS (I literally had a doctor asked me what Harvard had to do with my pain). When I told him that I also thought I had fibromyalgia, he practically started laughing. It's been about 9 months and I've learned to live with it. Honestly, I couldn't afford to continue treatment even if my ex-doctor wasn't a blithering idiot.
    What I really hate, though, is when people downplay my pain or discriminate against me because of my age and gender. People assume that because I'm a young man I'm not allowed to talk about my pain unless I can't walk or have a full body cast on. I get woman telling me that "men have no long term pain tolerance" and other such things. I'm an ex-boxer, and I can tell you that no fight I've ever been in has hurt the same way one bad day with HMS does. The emotional trauma is what really does it, I think. Knowing that you can never get away, and the feeling that the constant dull, burning ache is eroding away at your nerves and cartilage. Point is, don't forget that men have their own specific hurdles to jump, especially when dealing with a condition like HMS.

    Sorry for the banal ranting, I'm just really tired of it.

  3. Joseph, you make an excellent point! While women face certain prejudices because of their gender when it comes to discussing pain, men do as well. Cultural influences and ideas about what a man should be can discourage men from speaking up about their pain for fear of being accused of being 'weak' or 'un-masculine.' Many men may also be told they must simply 'deal with' their pain, that instead of talking about it or seeking proper treatment for it, that they should just 'man up' and find a way to tolerate it. While women may face problems having people believe them when they say they are in pain, men may often find it harder to speak up about their pain in the first place. It may also be harder for men to speak up about or find someone willing to listen to their emotional pain caused by HMS. Thank you for bringing up this important point and giving us a masculine perspective on HMS! HMS is a disorder that affects both men and women, and it is important to acknowledge and understand how both genders experience HMS differently.

  4. I was suffering from chronic pain and tried a clinic. I think its good to share it here. Celiac Plexus Blocks Houston.

  5. Use therapeutic communication techniques to determine the client's experience of pain before going to any infertility center