Despite significant healthcare advances in recent years, the gender pain gap – the phenomenon in which women’s pain is more poorly understood and mistreated compared with men’s due to systemic gaps and biases – is well and truly alive in 2023. Although women in the UK live, on average, almost four years longer than men, studies have found that women spend more of their lives in ill health in comparison with men. A startling one in six women experience severe pain every day, according to Nurofen’s Gender Pain Gap Index Report. What’s more, their pain is often overlooked in healthcare and underrepresented in research. While women make up the majority of chronic pain sufferers, they have historically been excluded from clinical drug trials.
Here in the UK, the government’s first ever Women’s Health Strategy for England, published last year, announced plans to tackle the gender health gap by confirming that all graduating medical students and doctors would receive mandatory specific teaching on women’s health. This won’t, however, come into place until 2024.
The news left many scratching their heads, stunned at the lack of mandatory training for healthcare professionals around women’s conditions in the first place. The strategy also acknowledged the “male as default” approach that exists in research and clinical trials, meaning far less is known about specific conditions that predominantly affect women, or about how different conditions can affect men and women separately. For example, women have been shown to be 50% more likely to receive the wrong initial diagnosis for a heart attack (especially worrying since an incorrect diagnosis, for both men and women, can increase risk of death after 30 days by about 70%, according to the British Heart Foundation).
Perhaps unsurprisingly, this combination of gender bias and lack of medical research on women has contributed to 56% of women feeling they have had their pain ignored or dismissed, compared with 49% of men, according to the report. And for those who felt that way, one in four women said no one took their pain seriously, and that includes family, friends and workplaces, not just healthcare professionals. In fact, a number of studies have found that not only is women’s physical pain regularly underestimated, but it’s also much more likely to be attributed to psychosomatic causes – for example, being told “it’s in your head” or that “emotions” or “hysteria” are to blame. One study in particular found that middle-aged women with coronary heart disease symptoms were twice as likely as men with the same symptoms to be diagnosed with a mental health condition as the most likely cause of their symptoms.
It’s something Lucia, 28, can relate to. “In 2018 I was diagnosed with endometriosis – a long-term condition where tissue similar to the lining of the womb grows in other places, like the ovaries and fallopian tubes. It is an extremely painful condition, cited by the NHS as one of the top 20 most painful illnesses, yet it took me four years to be given an official diagnosis, despite me suggesting it to my GP at my very first appointment. Instead, I was told: ‘Periods could be painful’ and given unhelpful, patronising suggestions like ‘try placing a hot water bottle on your stomach’ and to ‘take a warm bath’. It meant when I was finally given the official diagnosis years later, part of me felt relieved rather than angry – it hadn’t all been in my head.”
Sadly, Nurofen’s Gender Pain Gap Index Report – commissioned as part of its See My Pain campaign – shows Lucia is far from alone. Almost one in five (18%) women surveyed who suffered endometriosis pain experienced pain for three to five years in total. In fact, on average it takes eight years from the onset of symptoms to get a diagnosis for endometriosis.
Similarly, Catherine McNally-Hughes, 38, discovered how dismissive attitudes can be to women’s health after a caesarean section in 2021 led to severe adhesions (where scar tissue joins two internal body surfaces that are not usually connected). “After my C-section, I knew something wasn’t right, experiencing symptoms including awful pain, heavier periods and an inability to exercise long after the typical recovery period. I first visited my doctor about it in January 2022 and was told it was ‘normal’ and I ‘needed a stronger core’.” It took four more visits until she was finally referred for an MRI. “There, they diagnosed not only adhesions, but endometriosis and ovarian cysts too. Because adhesions can bind internal organs together (they fused my womb to my ovary and fallopian tube) it could present significant problems if I become pregnant again. Keyhole surgery finally removed the adhesions, endometrial tissue and ovarian cysts, but the mental effects will stay with me for a long time.”
As these women’s stories highlight, the impact of pain not being taken seriously or treated properly can prove incredibly detrimental in terms of quality of life. Nurofen’s Gender Pain Gap Index Report highlighted that 41% of women living with pain experience trouble sleeping, with 39% reporting they are less able to exercise as a result, too. Almost a quarter of women report that the pain they experience has led to them feeling depressed (compared with fewer than a fifth of men). Hardly surprising, when you consider that almost every aspect of women’s lives – from work to relationships – is negatively impacted because of this colossal inequality. In 2023, surely enough is finally enough?
If you want to learn more about the Gender Pain Gap and read the full Gender Pain Gap Index Report commissioned by Nurofen, visit nurofen.co.uk/see-my-pain
Nurofen 200mg Tablet for short-term, mild to moderate pain. Contains ibuprofen. Always read the label. RKT-M-22289.
