Women feel pain more than men: Study

By Dr. Ananya Mandal, MDJan 24 2012

A new study showed that women experience more intense pain than men. The study published in the Jan. 23, 2012 issue of the Journal of Pain, further suggests that greater effort is needed to recruit women into studies in order to determine the reasons for this gender difference. The Stanford University School of Medicine investigators examined pain scores from tens of thousands of patients in the United States.

For the study, the researchers analyzed electronic medical records to examine more than 160,000 pain scores reported for more than 72,000 adult patients. The results showed higher pain scores for women in virtually every disease category. The differences were both statistically and clinically significant, the authors noted. The study found that when asked to rate their pain on a scale of 0 to 10 - with 0 being no pain at all, and 10 being the worst pain imaginable - women on average scored their pain 20 percent more intense than men.

“In many cases, the reported difference approached a full point on the 1-to-10 scale. How big is that? A pain-score improvement of one point is what clinical researchers view as indicating that a pain medication is working,” study senior author Dr. Atul Butte, a professor of systems medicine in pediatrics, said in the Stanford news release.

Authors feel this is in corroboration with earlier studies and findings, such as the fact that women with fibromyalgia or migraine report more pain than men with those conditions. But the study also identified previously undocumented gender differences. For example, pain intensity among patients with acute sinusitis or neck pain is greater in women than in men.

Butte noted that there are numerous studies showing that women report more pain than men for a number of diseases. “We're certainly not the first to find differences in pain among men and women. But we focused on pain intensity, whereas most previous studies have looked at prevalence: the percentage of men versus women with a particular clinical problem who are in pain,” he said. “To the best of our knowledge, this is the first-ever systematic use of data from electronic medical records to examine pain on this large a scale, or across such a broad range of diseases,” Butte added.

The study doesn't explain the reason for the difference, and researchers say it could include social, psychological or biological factors. Men may be more reluctant to confess intense pain to a female nurse, for example. Women are more likely than men to suffer from depression and anxiety, two psychological conditions that can increase susceptibility to pain. Or it could be hormonal - women may indeed experience greater pain than men because of some not yet understood biological response. Either way, the results need further study, researchers said.

“Why the pain responses are at the higher level in females, we really don't know. Is it completely psychologically based? Is it related to hormones? We are really not clear,” said Dr. Prasad Movva with Kaiser San Jose's chronic pain program. “But this report is a good start definitely.”

There is an epidemic of chronic pain: Last year, the Institute of Medicine estimated that it afflicts 116 million Americans, far more than previously believed. But these latest findings, believed to be the largest study ever to compare pain levels in men and women, raise new questions about whether women are shouldering a disproportionate burden of chronic pain and suggest a need for more gender-specific pain research.

Melanie Thernstrom, a patient representative on the Institute of Medicine pain committee from Vancouver, Wash., said the newest research “really highlights the need for more treatment and better treatment that is gender-specific, and the need for far more research to really understand why women’s brains process pain differently than men.”

Sources

http://www.americanpainsociety.org/

https://med.stanford.edu/