Chronic Pain: Does Sex Matter?

Reprinted with the kind permission of Celeste Cooper


September is chronic pain awareness month and a perfect time to recognize that when it comes to chronic pain, women are treated differently than men.


As reported in my article Women, Pain, Bias, and Discrimination, written for Health Central, there is a century’s old bias against women, and I am sorry to say not much has changed in the twenty-first century. Our pain remains misunderstood, mistreated, undertreated, and oftentimes, untreated all together—simply because we are women.

The Wandering Womb = Wandering womb was the belief that a displaced uterus was the cause of many medical pathologies in women. The belief originates in the medical texts of ancient Greece, although it persisted in European academic medicine and popular thought for centuries. Wikipedia (accessed, September, 2018)

The National Pain Strategy tells us bias, stigma, and discrimination exists, and women exhibiting pain from chronic fatigue syndrome, fibromyalgia, and other conditions are among the vulnerable. So, why might that be?


There are specific factors that influence pain in women that are different from men. Researchers (2016) propose this is because of genetic, anatomical, physiological, neuronal, hormonal, psychological, and social factors.

Gender matters because:

  • We experience pain from disorders that are gender specific.
  • Our language patterns are different.

“Women do not want to appear “too strong or too weak, too healthy or too sick, or too smart or too disarranged and struggle for the maintenance of self-esteem or dignity as patients and as women.”

  • The character of our pain is different.
  • Our cellular responses are different.
  • Our opioid receptors interact differently
  • Our risks for chronic pain are significantly different and higher.
  • The effect of pain on our brain is different.

Evidence is mounting.

“Medical researchers recently found that a specific manipulation of receptors in the nervous system for the neurotransmitter dopamine impairs chronic pain in male mice, but has no effect on females.” Science News (March 6, 2018, accessed September 2018)

There are biological differences in pain processing between the sexes.


I think it is imperative that we understand the differences in the way pain is experienced, reported, and treated as women. We desperately need more research on women’s health that focuses on intractable pain.

However, everyone is vulnerable when it comes to chronic pain. We all share the threats to our self-esteem and well-being when bias is present.

“Although pain is known to be prevalent across society, reliable data are lacking on the full scope of the problem, especially among those currently underdiagnosed and undertreated, including racial and ethnic minorities; people with lower levels of income and education; women, children, and older people; military veterans; surgery and cancer patients; and people at the end of life; among others.”

Institutes of Medicine Report, 2011, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research

That report was in 2011. It’s unfortunate, but the dialogue in 2018 has not improved, in fact, it has gotten much worse. Now everyone is discriminated against…


I always like to end on an encouraging note. It is out of adversity that opportunity exists. Use this time to raise awareness. Send a note, tag the CDC, NIH, and your congressional representatives in a tweet. You can find contact information and other helpful information in the Advocates Corner tab at the top of this page.

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