Many women’s health conditions are associated with pain, for example dysmenorrhea (period pain), endometriosis, adenomyosis, interstitial cystitis (IC), vulvodynia, chronic pelvic pain, UTIs and more. This pain is often debilitating, with profoundly negative impacts on quality of life, affecting relationships, career, education and earnings due to missed school and work. Chronic pain is also associated with mental health impacts.
Some of these health conditions are only experienced by women, like dysmenorrhea and endometriosis. Others are also experienced by men but may present differently in women compared to men, such as heart attacks. Of these, some disproportionately affect women, such as chronic pain conditions1. Regardless of the condition, the narrative is the same: women’s pain is more likely to be dismissed and not recognised by healthcare professionals. This limits access to treatment and hampers further research.
The gender pain gap
The gender pain gap refers to the systemic lack of funding, understanding, recognition and awareness of women’s pain, and the profound impact this has on so many women’s lives.
Several factors feed into the gender pain gap: a historical lack of research and the resultant lack of understanding and training, and societal gender biases.
A further complicating factor is that pain is a subjective experience. This subjectivity means that for a patient to receive treatment, healthcare providers must first recognise this pain before they can then decide if that pain is clinically relevant. This is not made easier by the fact that the mechanisms driving pain are complex, underpinned by multiple molecular pathways, and the perception of the pain can be affected by mental state.
Societal attitudes
The gender pain gap may in part be explained (although not excused!) by ingrained societal attitudes.
As an example, a recent survey found that doctors often view men with chronic pain as “brave” or “stoic” but women with chronic pain as “emotional” or “hysterical”2. There are also unhelpful beliefs that pain is simply a part of a woman’s life that should be accepted and ignored. Worse still, there are unhelpful myths that women feel less pain than men3.
But with 90% of women describing period cramps as moderate to severe – the equivalent of a heart attack – these out-dated attitudes are long overdue an update.
Research, understanding and training
In terms of research, women were not mandated to be included in clinical trials until 1993. This has had long-lasting knock-on effects – for example, 70% of chronic pain patients are women yet 80% of pain studies are conducted on male mice or human men4.
This lack of research bleeds through (pun intended) into medical training, with many medical schools not reflecting sex differences in diagnosis, treatment and prognosis in their curriculum5.
Translation into the clinic
All this means there is great disparity in the experiences of men and women when they present with pain to healthcare providers. For example, in a recent survey over half of women in the UK felt their pain was ignored or dismissed by their healthcare provider6. This dismissal persists throughout their journey to diagnosis, with women experiencing longer diagnosis times than men even when reporting the same level of pain: less than half of women receive a diagnosis within 11 months, whereas two thirds of men receive a diagnosis in that time frame1.
In terms of treatment, women in pain are more likely to be given sedatives rather than painkillers compared to men2 or even medication for anxiety and depression.
Women are also less likely to seek treatment from healthcare providers and instead self-care, with 20% of women saying they do so because they felt ignored on a previous occasion, compared to only 10% of men. This disparity is even more marked in conditions that only affect women, with 59% of endometriosis patients believing they were offered self-care because the healthcare provider didn’t believe the severity of their symptoms4.
IP and the gender pain gap
We think that IP has an important role to play in helping to close the gender pain gap. Patents can protect new targeted products to treat pain, and can be a tool for existing drugs, such as repurposing drugs for new patient subgroups. There are many options for IP in this area, so talk to our Women’s Health team about building out a strong and investable IP position.
Summary
The 2023 Gender Pain Gap Report compiled by Nurofen found that, distressingly, the gender pain gap is widening. The cancellation of a clinical trial investigating sildenafil citrate in relieving menstrual pain due to a lack of funding7 also shows that there is a long way to go until women’s pain is taken seriously.
It therefore remains vital that efforts to raise awareness of the pain gap continue. Reasons to be hopeful include the Nurofen See My Pain programme and their Gender Pain Gap Index Reports. Also, Wellbeing of Women and Reckitt have announced a £300,000 research grant to be awarded to a project focused on period pain in adolescence. Campaigns like Just a Period are working to break down the stigma and bring about the normalisation of period symptoms and gynaecological conditions.
Watch out for our next blog discussing new treatments for women’s pain and please get in touch – we’d love to hear from you!
References
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Gendered pain: a call for recognition and health equity. Lancet (2024), 69:102558
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“Brave Men” and “Emotional Women”: A Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain. Samulowitz et al., Pain Res Manag 2018:6358624
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https://www.ucl.ac.uk/news/2021/apr/analysis-womens-pain-routinely-underestimated-and-gender-stereotypes-are-blame
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https://www.health.harvard.edu/blog/women-and-pain-disparities-in-experience-and-treatment-2017100912562
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https://awis.org/resource/closing-the-gender-health-gap-in-medical-school-education/#:~:text=Only%2010%25%20had%20an%20office,the%20traditional%20obstetrics%2Fgynecology%20rotation.
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The Gender Pain Gap Index Report, Nurofen, 2023 https://www.nurofen.co.uk/static/nurofen-gender-pain-gap-index-report-2024-8eede5529e884b5e496a1c02beea4210.pdf
