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Women more pain sensitive, new study reports

Robin Wulffson MD's picture
pain, gender difference, pain perception, chronic pain

PALO ALTO, CA - Women have been dubbed “the weaker sex,” and now a new study reports that they are the more pain sensitive sex. Researchers at Stanford University (Palo Alto, CA) reported that women feel more pain than men.

Childbirth is an area of pain unique to women; studies have reported that 18% of women who undergo a cesarean section and 10% who deliver vaginally report pain from the event one year later. Also, certain pain-related conditions, such as migraine headaches, irritable bowel syndrome, and fibromyalgia are more common in women than in men.

The new study by the Stanford researchers reported that even when men and women suffer from the same medical condition (i.e., arthritis, low back pain, or a sinus infection) women were found to experience greater pain.

The researchers analyzed adult records from the electronic medical records (EMRs) of 72,000 patients whose pain scores were recorded as a routine part of their care; they arrived at more than 160,000 pain instances, ranging across approximately 250 different disease categories, in which a pain score had been reported.

To obtain a pain score, a physician asks a patient to describe his or her pain on a scale from 0, for no pain, to 10, “worst pain imaginable.” A pain score difference of 1 point indicates that pain medication is effective. The researchers found higher pain scores for female patients “practically across the board.” The reported differences were not only statistically significant but also clinically significant. In many instances, the reported difference approached a full point on the scale.

The study authors noted some cautionary notes. First, the researchers made the assumption that patients’ pain had not already been treated (i.e., self-medication with an over-the-counter analgesic (pan reliever) before they appeared at a physician’s office, outpatient health clinic, or emergency room).

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In addition, the researchers could not determine whether more men than women had already been treated. Other possibly limitations of include the setting in which pain was reported.

For example, Dr. Butte noted, “Will an 18-year-old male report the same pain intensity with or without his mom present, or in the presence of a male vs. a female nurse? We can’t be sure.” He added that the large patient sample reduces the chance of confounding factors to some extent.

Another caveat expressed by the study authors was noted by them to be perhaps the most controversial. “It’s still not clear if women actually feel more pain than men do,” said Butte. “But they’re certainly reporting more pain than men do. We don’t know why. But it’s not just a few diseases here and there, it’s a bunch of them — in fact, it may well turn out to be all of them. No matter what the disease, women appear to report more-intense levels of pain than men do.”

According to the Institute of Medicine, chronic pain is of epic proportion in the United States. In 2011, the instituted estimated that 116 million Americans suffer from chronic pain. However, the Stanford study indicates that women may be enduring a greater proportion of chronic pain than men.

Dr. Butte and colleagues note that stronger efforts should be made to recruit women subjects in population and clinical studies in order to find out why this gender difference exists. His team plans to search EMRs to see if they can find some objective measurement (i.e., an already commonly measured blood-test variable) that correlates highly with reported pain. He explained, “We want to find a biomarker for pain.” The finding shows women are more sensitive to pain than are men, but the reasons why are unclear.

Reference: Stanford School of Medicine

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