Chronic pain has the power to put lives on hold and affect every aspect of a sufferer’s wellbeing, from mental health to relationships. And while pain conditions can impact anyone, studies have shown that women experience more pain, more often, than men, yet the Nurofen Gender Pain Gap Index Report, commissioned by Nurofen, found that 63% of women feel their pain is taken less seriously than men’s due to their gender.
But what are the risk factors, and where are the treatment disparities that make the gender pain gap a reality? Here, we drill into the detail and take a closer look at some common pain-causing conditions, their symptoms and how men and women are typically impacted by them. Along the way, we’ll hear from women who have been affected by some of these debilitating health issues and how they often struggled to get a diagnosis or be taken seriously.
Heart attack
Men are more likely to experience a heart attack, but coronary heart disease – its main cause – is the single biggest killer of women worldwide. Despite this, cardiovascular disease is still widely considered as a man’s disease.
Both in prevention and treatment, there is evidence that women are undertreated, compared with men. According to the British Heart Foundation (BHF), women are 50% more likely than men to receive an initial wrong diagnosis after a heart attack. This may be because their symptoms present differently. For example, while chest pains apply to both men and women, women are much more likely to get less common symptoms such as indigestion, shortness of breath and back pain, sometimes even in the absence of obvious chest discomfort.
Research from the BHF reveals that unequal care resulted in more than 8,000 women dying of heart attacks during the course of 10 years, with women also having more than double the rate of death in the 30 days following their heart attack than men. Researchers believe that this may be down to the gender disparities in treatment.
Endometriosis
Endometriosis is an incurable condition where tissue similar to the lining of the womb grows elsewhere in the body. This leads to inflammation, fatigue, extreme pain, especially during periods, and can cause infertility. It affects 1.5 million in the UK, approximately one in 10 women. On average it can take as long as eight years from the onset of symptoms to get a diagnosis, restricting access to treatment. The condition is most active from puberty to menopause, although the impact can be felt for life.
Sarah experienced symptoms from when she was 12 years old, but didn’t get a diagnosis until she was 19:
“Endometriosis has impacted every single aspect of my life. I’ve been in continuous pain for over five years, on top of the other symptoms such as sporadic bleeding, mood swings etc. It’s also set me back in almost every aspect of life too. It took me twice as long to complete both my degrees. I can’t work a normal nine-to-five job because I can’t commit to anything knowing I have no control over my health. I’ve lost friends, it has affected relationships. I don’t remember the last time I felt like I had control over either my body or my life. Even though I’ve got my diagnosis, I still feel like I’m constantly having to battle to get my pain taken seriously. I know there’s no cure, but it sometimes feels like no one truly understands how devastating this disease is.”
Migraine
Migraine attacks can be debilitating and last for hours or days, with pain typically on one side of the head. The pain can be accompanied by nausea, extreme sensitivity to sound and light, and sometimes vomiting, and there are a variety of different types. According to the NHS, women are three times more likely to experience migraine than men, with one in every five women affected, and according to studies the frequency, duration and disability of attacks tend to be higher in women. There is evidence that sex-based hormonal differences contribute towards this, especially those linked to the menstrual cycle.
Jennie has lived with chronic migraine for nearly eight years:
“I have tried every form of medication and treatment – both medical and alternative – under the sun, spending a fortune in doing so. It has affected every aspect of my day-to-day life from friendships to my social life. There isn’t enough awareness around the effects, which means it is hard for people to truly understand how it impacts my life. I suffer with both anxiety and depression because of being in constant pain. When I have asked the multiple neurologists and specialists that I have seen about the cause, they dismiss my migraines as hereditary.”
Stomach or peptic ulcer
A stomach or peptic ulcer is an open sore that develops in the lining of the stomach or small intestine; they are more common in men than women. Stomach pain is the most common symptom, usually presenting as a gnawing pain inside your stomach, although other symptoms such as referred pain, indigestion, heartburn and acid reflux may occur. Treatment for peptic ulcers may include medication to reduce stomach acid, antibiotics and lifestyle changes.
Annelise Levy didn’t know she had a stomach ulcer until it perforated:
“I had been having a lot of stomach problems for a while, which I was told was IBS by the GP. The night it happened I was out at the pub with some friends, I had a burger and some wine … I started to get abdominal pain that got worse and worse. I managed to get the bus home but by this time I was bent over with pain, and it had spread to my shoulder … The next morning I went to the GP, they sent me straight to A&E. I spent a long time in A&E while they tried to figure out what was happening. They eventually diagnosed the perforated ulcer, but one of the reasons they didn’t think I had one is that apparently I “didn’t fit the profile”, and normally people are brought in screaming by an ambulance, they don’t come in on the bus. I was about 30 then but I think I looked a bit younger – I wondered if that factored into how I was treated by some health professionals.”
Shingles
Shingles is a condition caused by the virus responsible for chickenpox and leads to sharp, burning pain accompanied by a blister-like rash usually on the chest and stomach (but can appear elsewhere). According to the National Institute of Aging, the risk of developing shingles increases with age, and the chance of getting shingles becomes much greater by the age of 70, or in people with a weakened immune system. According to one study, women are more likely to develop shingles than men, accounting for about 60% of cases. The exact reason for this is still unknown, but menopause and hormonal changes have been suggested as possible reasons for the disparity.
Fibromyalgia
Fibromyalgia is a chronic pain condition that causes widespread pain all over the body, as well as fatigue, sleep issues, headaches and muscle stiffness; it is often comorbid with a range of conditions including migraine, IBS and chronic fatigue syndrome. Fibromyalgia is vastly more common in women than men, with 80-90% of those diagnosed being women. The reasons for this gender gap are not fully understood. Studies have linked fibromyalgia to how the body processes pain signals, and often occurs after emotional trauma, infection, psychological stress or surgery.
Hannah, 29, was diagnosed with fibromyalgia aged 21 after nearly eight years of investigations:
“My symptoms began at 14 and swiftly developed from intermittent pain to debilitating, widespread body pain. Getting diagnosed was a trial by fire. From my very first doctor’s visit, I was not believed, and multiple doctors over the years said that my symptoms were likely all in my head. Fibromyalgia is typically diagnosed through the exclusion of all other possibilities, so physicians took years exploring countless possible diagnoses before settling on fibromyalgia. Receiving a diagnosis was equally reassuring and devastating. I finally had a name to put to the constant pain I live with but there is no cure, so no end in sight. I am still in constant pain and that has been true since my very first stab of pain in my living room at age 14. However, I am far more capable of dealing with the high levels of pain and fatigue thanks to years of therapy, physiotherapy, and the practices of mindfulness and meditation.”
Frozen shoulder
A frozen shoulder is where you experience a painful or tender shoulder that can cause stiffness in the shoulder joint. According to the Journal of Orthopaedics, women suffer from a frozen shoulder at a greater rate than men, with particular risk factors such as breast cancer surgery. Treatment for frozen shoulder usually involves exercises and pain relief, and most get better within three years.
Bone fracture
A bone fracture, or a broken bone, is a common injury known for its severe pain, with the bone being completely or partially fractured in any number of ways. Some medical conditions, such as osteoporosis, can increase your risk for experiencing certain types of breaks, such as wrist, hip or vertebrae fractures. Women are more at risk of osteoporosis than men.
Complex regional pain syndrome
Complex regional pain syndrome (CRPS) is a chronic pain condition that usually affects one limb after an injury, though the pain can spread. According to the NHS, the skin of the affected body part can become so sensitive that a slight touch, bump or even a change in temperature can cause intense pain. CRPS tends to be more common in women than men, but the exact cause is unknown and it’s thought that many cases go undiagnosed or are misdiagnosed.
Slipped disc
A slipped disc is when a soft cushion of tissue between the bones in the spine is pushed out through a weak area in the outer wall, which can be extremely painful and irritating on nearby nerves, resulting in pain, numbness, weakness in an arm or leg, or even sciatica. Slipped discs are more prevalent in people over 30, and are about twice as common in men as they are in women.
Arthritis
Arthritis is characterised by inflammation in the joints, which can then lead to pain and stiffness. According to the NHS, in the UK millions of people have arthritis or other similar conditions that affect the joints. Arthritis affects people of all ages, including children, with women being affected more than men.
Kidney stones
Kidney stones are a common condition, with one person in 10 affected, and are a result of waste product in the blood forming crystals. Large kidney stones, in particular, can be extremely painful, and you’re more likely to develop them if you don’t drink enough fluid, are taking some types of medication or have a medical condition that raises the level of certain substances in your urine. While men are nearly twice as likely to develop kidney stones compared with women, the prevalence in women is increasing.
Gout
Gout is a form of arthritis that develops in people with high levels of uric acid in the blood, causing sudden, severe pain and inflammation. An attack of gout usually lasts around five to seven days, and the condition often runs in families. According to the NHS, gout is more common in men, especially as they get older.
Post-surgical pain
Post-surgical pain occurs after a variety of surgical procedures. While women seem to be at higher risk of developing severe postoperative pain, the pain strongly depends on the type of procedure.
Cluster headaches
Cluster headaches cause excruciating pain on one side of the head, often around the eye, and affect approximately one in 1,000 people. Symptoms include a red and watery eye, drooping and swelling of one eyelid, or feeling restless and agitated, with pain peaks lasting between 15 minutes to 3 hours, up to eight times a day. According to the NHS, they’re more common in men than women. Treatment options include medication, oxygen therapy and nerve stimulation.
Unconscious bias in healthcare has led to lifetimes of suffering and under-treatment for countless women. As the above conditions show, chronic pain illnesses and conditions occur in women more frequently than men, yet oftentimes women’s pain is taken less seriously by healthcare providers, workplaces and wider society, resulting in them feeling ignored and dismissed. We see this across the board, whether it’s female-only diseases such as endometriosis, which can take years to diagnose and has very few effective treatment options, or life threatening conditions such as heart attacks, in which women are 50% more likely to be misdiagnosed than men. This is the gender pain gap laid bare.
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.
