Despite medical progress, pain management continues to be a woefully neglected area of women’s health, leaving gaps in both the scientific literature and our collective knowledge. Unfortunately, the persistent and false belief that women’s pain is ‘normal’ further perpetuates this issue.
Although women are more likely to experience chronic pain – be it endometriosis, migraines, or severe menstrual cramps – their pain is often trivialised and overlooked (1), leading to what is now known as the `The Gender Pain Gap.’
The implications of The Gender Pain Gap can be catastrophic: unconscious medical discrimination, dismissal of symptoms, misdiagnosis, and a continued lack of research, which often means women suffer in pain for years, even though they live longer than their male counterparts.
In this article, we shed light on this overlooked aspect of healthcare, exploring why The Gender Pain Gap exists and strategies for dismantling it.
What is The Gender Pain Gap?
The Gender Pain Gap is the phenomenon in which women’s pain is misunderstood and mistreated due to widely held, unconscious biases.
In a recent report commissioned by Nurofen in 2023, which surveyed over 5,000 individuals, it was found that women experience pain more frequently and intensely than men. Shockingly, the report revealed that 1 in 2 women feel their pain has been disregarded simply because of their gender. Even more alarming, 1 in 6 women endure severe pain daily (2).
The report also highlighted a concerning trend: there has been an 11% increase in the number of women who believe their pain has been disregarded or dismissed, compared to just 7% in 2022, indicating The Gender Pain Gap is only getting bigger.
Unfortunately, women who live in pain without proper medical treatment are more likely to experience sleep issues, challenges exercising, and dips in their mental health, highlighting the severity of the issue.
The ‘male by default’ perspective
The Gender Pain Gap has its roots in a patriarchal bias, where the health care system was built by men for men. Consequently, there has been – and continues to be – a lack of funding to study women’s health and bodies.
The ‘male by default’ perspective is widespread across clinical research. Most pain studies are conducted on males. As a result, we know less about how pain impacts men and women differently, as well as the pain conditions that mainly affect women.
Although women make up 51 per cent of the population, scientific findings are rarely disaggregated by sex, missing the vital opportunity to expand our knowledge of women’s health and experiences of pain.
For instance, there has been more scientific research on erectile dysfunction, which affects 19 per cent of men, than on premenstrual syndrome, which impacts almost 90 per cent of women (3).
Regrettably, without sufficient funding, data, and statistics, a burgeoning gap remains, hindering efforts to acknowledge and treat women’s pain effectively.
Why is female pain often ignored?
Besides the ‘male as default’ approach, The Gender Pain Gap can be attributed to a number of erroneous beliefs and stereotypes.
Firstly, there’s the idea that women can naturally endure pain because they experience menstruation and childbirth. In fact, one study revealed that 51 per cent of women and 52 per cent of men think period pain is something women ‘have to deal with’ (4).
The notion that women are ‘emotional’ or more likely to exaggerate pain for ‘attention’ also perpetuates The Gender Pain Gap, as does the misconception that women’s pain is simply ‘psychological’.
Indeed, a 2018 review of 77 pain studies globally reported that healthcare professionals were more likely to view men in pain as ‘brave’ and women in pain as ‘hysterical’ (5). For context, the word ‘hysteria’ derives from the Greek word for uterus. Historically, doctors thought a woman’s uterus could lead to mental health disorders – a belief that, perhaps, still lingers today.
The Gender Pain Gap can be even more detrimental for women of colour, who face additional discrimination about pain tolerance due to their race.
These stereotypes, coupled with the ‘male as default’ approach in medicine, fail to give female pain the gravitas it deserves, leaving women undiagnosed and untreated for years.
Closing The Gender Pain Gap
While the Women’s Health Strategy for England in 2022 promises to address the ‘male as default approach’ in research and trials, systemic change takes time (6).
That said, there are still many ways to advocate for yourself at a grassroots level, break down stigma, and bring women’s pain to the fore.
Rethink your GP appointments
Consulting healthcare professionals about pain can often be a frustrating and emotionally draining endeavour, particularly when you sense your concerns are not being fully heard. With that in mind, here are some practical tips to get better treatment.
Come with a loved one: Bringing a close family member, partner, or friend to medical appointments can offer valuable support. They can ask questions, speak up on your behalf, and witness your experience.
Have your notes ready: Keeping an account of your symptoms can help you get straight to the point and maximise your appointment. These notes could also outline what you’ve already done to manage your pain, as well as your family history.
Use pain words: Describing pain can be difficult, but it’s important to convey the severity accurately. Using terms like stabbing, burning, cramping, sharp, aching, dull, pinching, tingling, gnawing, pulsing, and sporadic can help communicate with your doctor effectively.
Consider how pain affects your daily life: Explaining your everyday experience of pain can help healthcare professionals better understand what you’re going through. Use a scale ranging from 1 (minimal pain) to 5 (severe pain) to articulate the intensity of your discomfort If you’re a number 3, this may suggest that you’re struggling more than usual and need help from others. If, however, you’re a number 5, this could indicate you’re unable to carry out your normal tasks altogether.
Get a second opinion: Remember, your pain is valid, and you’re entitled to ask for help. If you feel your concerns have been dismissed based on your gender, don’t hesitate to request a second opinion.
Educate yourself
Educating yourself on pain management can empower you in the face of The Gender Pain Gap. This might involve delving deeply into your condition, conducting your own research, and becoming somewhat of an 'expert'.
Of course, as mentioned, finding adequate scientific research on women’s pain can be a challenge. However, you can still glean valuable insights from forums, many of which have been set up by fellow women in response to gender pain discrimination. Besides education, these online spaces can provide a sense of solidarity and validation, which is equally important.
Charities such as Pain Concern can also offer plenty of information and guidance on navigating your pain management journey.
Make small, manageable lifestyle changes
While you can’t dismantle The Gender Pain Gap overnight, you have the power to change your diet and lifestyle. Tweaking your daily habits means you can take matters into your own hands, buffer against pain, and support your overall health.
Embrace a plant-focused diet
Following a plant-centred diet, rich in fruits, vegetables, whole grains, legumes, nuts,seeds, herbs and spices, can be extremely helpful for pain management as it may help reduce inflammation.
Inflammation is a natural response by the body to protect itself from harmful stimuli and begin the healing process. However, when inflammation becomes chronic and low-grade, it can contribute to various health issues, including pain (7).
Firstly, a plant-based diet reduces animal-based products, like butter, cheese, and milk – foods that may cause inflammation in the body.
Plants are also packed with powerful antioxidants, phytochemicals (plant chemicals), and omega 3 fatty acids, which can lower inflammatory markers in the body and support general health.
Finally, a plant-focused diet is high in fibre. Fibre not only promotes healthy digestion but also nurtures the gut microbiome, which plays a significant role in modulating inflammation and supporting immune function.
The connection between the gut and the brain, also known as the |gut-brain-axis//B1336//target="_blank"|, further highlights how a healthy gut can positively influence pain perception and overall wellbeing.
Keep moving
If you live with pain, it can be tempting to avoid all movement to prevent further discomfort. However, studies suggest inactivity can often exacerbate pain (8). Gentle exercise reminds your body that movement is safe, normal, and nothing to be feared.
Exercise also releases feel-good hormones called endorphins, which are known to block pain signals from reaching the brain (9).
With this in mind, try to keep moving as much as possible, even if it’s a gentle walk around the block.
Manage stress
Psychological stress and anxiety can aggravate and even cause pain, so taking the time to decompress can help manage symptoms. There are many ways to reduce stress – from walks in nature to journaling to connecting with loved ones.
Mind-body practices like meditation can be particularly useful. In a 2018 study, researchers found that a long-term meditation practice changed the cortical thickness in some areas of the brain, which can make you less pain-sensitive (10).
Deep breathing can also quickly downregulate the stress response. Deep belly breathing activates the parasympathetic nervous system, responsible for the ‘rest and digest’ state. Spending a few minutes consciously breathing will communicate to your body that it’s safe, and this may positively adjust your experience of pain.
Practice self-compassion
When you’re stuck in the pain-fear cycle – experiencing pain, worrying about pain, and feeling more pain – it can be easy to get frustrated with yourself. But this only keeps the cycle going.
Practising self-compassion enhances your ability to self-soothe and lower the threat response triggered by pain. Here are some simple ways to incorporate more of it into your daily life.
Talk to yourself gently, as you would to a small child or loved one. You could even use diminutives, like “darling” or “sweetheart”.
Ask yourself: “What would I do if this was a friend?”.
Use soft self-touch, such as giving yourself a massage or gently placing a hand on top of the painful area.
Get outside
According to environmental research, spending time in nature and green spaces can improve pain outcomes (11).
There are many reasons for this: exposure to sunlight, physical exercise, social interactions, and the sights and sounds of nature, all of which downregulate the nervous system and support wellbeing.
Just 10 minutes in a natural setting can help lessen the effect of physical and emotional stress, often associated with pain (12).
Prioritise sleep
Unfortunately, women who experience chronic pain often find themselves in a self-perpetuating cycle of anxiety, low mood, pain, and insomnia (13). Fortunately, there are plenty of ways to break this negative feedback loop and optimise your sleep hygiene.
Ensure your bedroom is cool, quiet, and dark.
Invest in a comfortable mattress, pillow and bedding.
Get plenty of natural morning light to calibrate your 24-hour circadian rhythm.
Enjoy a relaxing wind-down routine one hour before bed.
Disconnect from your electronic devices before bed or, even better, leave them outside your bedroom.
Have a strategy to help you get back to sleep if you wake in the middle of the night
Consider supplementing with magnesium,theanine and lemon balm, and tart cherry juice
Read more tips on improving sleep on our dedicated Sleep Health Hub.
Think about targeted support
Besides adjusting your diet and lifestyle, the following formulas can provide targeted support for physical discomfort.
|NEURO-B//P165//target="_blank"|
Designed with healthy nerves in mind, |Neuro-B//P165//target="_blank"| contains relevant amounts of vitamin B1 for the nervous system, vitamin B6 (as PSP) for normal red blood cell formation, and B12 for normal neurological and psychological formation, making it a great choice.
PEA
A member of the N-acylethanolamine (NAE) family, PEA is found in almost every cell and is vital for chemical signalling in the body. PEA is a popular alternative to CBD and helps tackle any discomfort that might hold you back.
Want to find out more?
It’s easy to feel powerless in the face of The Gender Pain Gap. However, there are still many ways to advocate for yourself, including speaking up at doctors’ appointments, self-education, and changing your diet and lifestyle to reduce symptoms.
For more guidance and advice, please get in touch with our team of expert Nutrition Advisors, who provide free, confidential advice.
References:
www.cdc.gov. (2020) "Chronic Pain and High-impact Chronic Pain Among U.S. Adults, 2019." Available online: https://www.cdc.gov/nchs/products/databriefs/db390.htm.
www.nurofen.co.uk. (2023) "Nurofen | See My Pain." Available online: https://www.nurofen.co.uk/see-my-pain/.
The Independent. (2016) "One in five men have erectile dysfunction. 90% of women experience PMS. Guess which one researchers study more?" Available online: https://www.independent.co.uk/news/science/pms-erectile-dysfunction-studies-penis-problems-period-pre-menstrual-pains-science-disparity-a7198681.html.
Bodyform Global V Taboo Tracker: https://libresse-images.essity.com/images-c5/592/309592/original/gvttfinal.pdf.
Samulowitz A, Gremyr I, Eriksson E, Hensing G. (2018) "‘Brave Men’ and ‘Emotional Women’: A Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain." Pain Research and Management 2018(1):1-14.
GOV.UK (2022) "Women’s Health Strategy for England." GOV.UK. Available online: https://www.gov.uk/government/publications/womens-health-strategy-for-england.
Fang XX, Zhai MN, Zhu M, He C, Wang H, Wang J, Zhang ZJ. (2023) "Inflammation in pathogenesis of chronic pain: Foe and friend." Mol Pain.
Anders Pedersen Årnes, Christopher Sivert Nielsen, Audun Stubhaug, Mats Kirkeby Fjeld, Johansen A, Morseth B, Bjørn Heine Strand, Wilsgaard T, Ólöf Anna Steingrímsdóttir (2023) "Longitudinal relationships between habitual physical activity and pain tolerance in the general population." PLOS ONE 18(5): e0285041–e0285041.
Pilozzi A, Carro C, Huang X. (2020) "Roles of β-Endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism." Int J Mol Sci. 22(1):338.
St. Marie R et al. (2018) "Neurological evidence of a mind-body connection: Mindfulness and pain control." Psychiatry 13: 205.
White MP et al. (2019) "Spending at least 120 minutes a week in nature is associated with good health and wellbeing." Sci Rep. 9: 7730.
Psychology Today. (2022) "Fun with Fractals?" Available online: https://www.psychologytoday.com/gb/blog/codes-joy/201209/fun-fractals.
Tang NK, Goodchild CE, Sanborn AN, Howard J, Salkovskis PM. (2012) "Deciphering the temporal link between pain and sleep in a heterogeneous chronic pain patient sample: a multilevel daily process study." Sleep. 35(5):675-87A.
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Olivia
Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.
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