Understanding Gender Disparities and Hormonal Factors in Chronic Pain

Embracing a Compassionate Approach

If someone doesn’t look or act like they’re in pain, it can’t be that bad. Right?

Wrong.

Because chronic pain is an invisible demon, a lot of people both in and outside of the medical profession have told me, ‘It’s all in your head’, or, ‘I heard you were sick, but you look fine to me.’ To be in constant pain and at your lowest point, and not be believed by doctors and loved ones, is one of the hardest things I’ve had to face. This is just one of the complexities of living with chronic pain.

And let’s not forget that I am a woman.

For women dealing with chronic pain, there's an added layer of complexity – gender disparities and hormonal factors. Let’s take a closer look at this issue from the perspective of someone who has two decades of lived experience with chronic pain – me, Michelle, and draw upon medical journals and research findings to provide valuable insights that reinforce what I have to say on the matter.

Gender Disparities in Chronic Pain – A Personal Perspective

I have lived with chronic pain for over twenty years now. Since the day I fell from a balcony and sustained life-changing injuries right through to the present day, I have witnessed (and continue to witness) gender disparities in pain management.

I have also seen how women’s health has progressed during this time – via funding, research, innovation, and education – there is a more open conversation about these disparities, women are speaking out and shifts are occurring, but there is still a long way to go.

Studies have shown that women experience and report more pain than men, yet they often receive less intensive and effective treatment. Gender differences in pain prevalence emerge during adolescence, and rates of pain conditions increase as girls pass through puberty. Despite this, women’s pain is more often dismissed and sometimes talked about as ‘emotional’, ‘hormonal’, or ‘hysterical’. It is not always taken seriously, even when it could indicate a serious health problem. For example, stomach pain or abdominal pressure can be a signal of a heart attack for women. These are sometimes mistaken for heartburn, indigestion, or a stomach ulcer, leading to delays in diagnosis and treatment, which can have serious and sometimes fatal consequences.

Unfortunately, the normalization of pain in women’s lives has also played a role in this treatment gap. The French saying “Il faut souffrir pour être belle” (“one must suffer to be beautiful”) has been repeated to generations of girls, almost making pain a female ‘condition’, drilling women to accept it as necessary. I know that to be true when I look back over my journey.

Gender disparities started to appear during my school years; I was told that I talked too much, that I daydreamed, and that I lacked focus at school. I struggled academically for many years under the illusion that I was just a low achiever. Only in later life did I discover that I have ADHD. Had this been diagnosed earlier, I am sure my academic experience would have been very, very different. Looking back, many of my male peers were diagnosed with ADHD during those school years; it was considered a condition that largely affected boys, so it’s hardly surprising that my diagnosis got missed. I also remember the terrible period pains I endured throughout adolescence; again, this was dismissed as ‘time of the month hormonal stuff’ until I wanted to have children. I then discovered I had endometriosis and adenomyosis. I had spent years just sucking up the pain and powering through.

As both a peer support specialist and a woman living with chronic pain, I feel passionate about making bigger and bolder strides towards ensuring that women can access information about appropriate pain management options and treatments. Untreated pain negatively affects mental health, and chronic pain is often associated with mental health conditions such as anxiety and depression, resulting in a low quality of life. I have been there. I still go there.

We must therefore take women’s pain management seriously and provide the necessary tools to address it. End of.

To close the gap in pain management, a multifaceted approach is needed – knowledge about pain, the ability to talk about symptoms with an appropriate lexicon to aid diagnosis, and the motivation to treat.

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??I’m Michelle, Founder & CEO of Moving Through Chronic Pain

???Supporting patients & providers navigate chronic pain with grace

??Providing PEER? Support Training and Provider Consultation

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