Chronic Pain: Does Sex Matter?

SIMPLY BECAUSE WE ARE WOMEN

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.

DISCRIMINATION

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 often times, 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? 

GENDER INFLUENCE

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:

1.     We experience pain from disorders that are gender specific.

2.     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.” https://www.ncbi.nlm.nih.gov/pubmed/12927471

3.     The character of our pain is different.

4.     Our cellular responses are different.

5.     Our opioid receptors interact differently.

6.     Our risks for chronic pain are significantly different and higher.

7.     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.

DISCRIMINATION IS NOT LIMITED TO WOMEN

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…

SIMPLY BECAUSE WE LIVE WITH CHRONIC PAIN

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.

"A bird doesn't sing because it has an answer,

it sings because it has a song."

~MAYA ANGELOU

Additional Reading:

Fact or Fiction: Chronic Pain Affects Everyone the Same

Coming soon: Brain Under Siege: Centralization, Chronic Pain, and Fibromyalgia (watch for it here.)

In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

http://www.CelesteCooper.com

~ • ~ • ~ • ~ • ~ • ~

Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

Women, Men, Autoimmune, Neurological disease, and Fibromyalgia: Meeting Gender Bias Head On

The women to men ratio affected by fibromyalgia are 7:1 or 8:1, but are these statistics accurate?  

We once thought more men were affected by heart disease than women and we now know that is not the case, and even more alarming, women’s heart attacks are twice as likely to be fatal. So we ask, “Why the disparity in diseases between male and female?”  And an even bigger question, “Why are we not paying closer attention?”

Statistically, fibromyalgia is a leading female syndrome, and therefore, few studies are done on men.  Men typically do not report their symptoms, do not receive the right emotional support (though women many times don’t either), and suffer gender bias, leaving them undiagnosed and untreated. Females dominate other autoimmune and neurological diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), scleroderma, Hashimoto's thyroiditis, chronic fatigue syndrome, migraine, and multiple sclerosis   This by no means suggests that men do not also have any one of these syndromes or diseases.  So I ask,  “Why are men so frequently left out when evaluating fibromyalgia?” 

Since women seem predisposed to neuro-endocrine-immune disorders, their is a theory that hormones play a role. However, ankylosing spondylitis (another autoimmune disease) affects more men than women, so that theory is purely speculative, in my opinion. 

Men are more likely to keep their symptoms to themselves. Many do not understand the co-occurrence of myofascial pain syndrome and that it can cause male related issues, such as impotence, testicular pain, and male pelvic dysfunction, which men are less likely to discuss with their doctor than women, and often overlooked on exam for both men and women.  

Historically men avoid seeking healthcare, because of the long tradition that one should “buck up” and “take their lumps,” which could be a factor in under diagnosis.  Personally, my own husband would be dead had it not been for my insistence that I accompany him to the doctor to report his symptoms, which he wanted to dismiss as GERD and a pulled muscle. 

It is my opinion that more men are affected by fibromyalgia than what the statistics show, because of the factors I just mentioned, and I believe that men are not represented in proportionate numbers in clinical trials.  Like studying women in heart disease separate from men, the same should be true for fibromyalgia.  Women do tend to have a greater affinity toward autoimmune diseases, but believe me, if you are a man and suffer with fibromyalgia, MS, migraine, disordered sleep, restless leg syndrome, or any of the other overlapping neuro-endocrine-immune disorders, it is just as real. 

Gender bias must hit the road, it is immoral, counterproductive, and unethical for men and women. 

In healing and hope, Celeste

All blogs, posts and answers are not meant to replace medical advice.

Want to know more about Celeste’s books?  (click on the title)

BrokenBody Wounded Spirit: Balancing the See Saw of Chronic Pain. (co-author, Jeff Miller, PhD)

IntegrativeTherapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: TheMind-Body Connection (co-author, Jeff Miller, PhD)

Contributing author to Fibromyalgia Insider Secrets: 10 Top Experts, Kindle Ed.