8/10/2019 Are Women More Predisposed to Pain Than Men

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ARE WOMEN MORE PREDISPOSED TO PAIN THAN ARE MEN?

Rodolfo Gari MD MBAMedical Director at Texas Pain Relief GroupTop Contributor

 An article in today's Wall Street Journal suggests women are more predisposed to pain than are

men and Testosterone may be the reason. What do you think?

http://online.wsj.com/news/article_email/SB10001424052702304691904579349212319995486-

lMyQjAxMTA0MDAwMTEwNDEyWj 

Comments

William Raffaeli

President ISAL Foundation ONG - Institute for Research on Pain

There is a lot of literature about it and also on the pathogenesis (experimental data on animals ) It

seems very strong the correlation with sexual hormones. At least there is the clinical experience:

everyone know Fibromyalgia- Endometriosis... Are you not agree with it?

Luis Nieves

Interventional Pain Management at Texas Pain Relief Group

Hormone levels definitely have a link with pain. Lower estrogen levels lead to osteoporosis and

predispose to vertebral compression fractures. Low Vitamin D levels also seem to contribute to higher

pain levels. Estrogen receptor blockers used in breast cancer therapy, aromatase inhibitors, cause an

increase in joint pain. That is why a comprehensive pain management evaluation is so important. That

is our goal at Texas Pain Relief Group.

Carol Levy

sole employee at It's A Whimsy (r)

The PA Senate has passed a “women in pain awareness month” resolution for 3 of the past 4 years.*

The gender bias has been manifest for many many years. Women doctors are no more in tune with

women patients then male doctors. Both employ bias since both train in the same places and in the

same way. (Even after the cause for my trigeminal neuralgia was found I had a well-known

neurologist write in the chart "there are days like today when I believe in her pain." Patients, men and

women, should not have to deal with whether a doctor believes them or not. Most people, most

women are not malingerers and hypochondriacs.

Often chronic pain is disabling and debilitating. A woman who comes to the doctor with hair not well

done, clothes not pressed etc often come home with a diagnosis of depression rather than a

prescription/diagnosis for their chronic pain. If they come well-coiffed and dressed then obviously their

pain cannot be that bad or they would appear more dishevelled.

 As for catastrophizing, yes, women are more programmed to catastrophize. As parents, as themajority are, catastrophizing is important in the taking care of children. One must be aware of if I do A,

then these are the potential outcomes, including the worst that could happen.

Carol Jay Levy,

(I include this info below as my bona fides as both a chronically pained person and advocate for

women in pain awareness

Women In Pain Awareness Group, FB. founder, administrator

author A PAINED LIFE, a chronic pain journey,

accredited to the U.N. Convention on the Rights of Persons with Disabilities member U.N. NGO

group, Persons With Disabilities )

Link for Pa resolution:

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http://www.legis.state.pa.us/cfdocs/legis/PN/Public/btCheck.cfm?txtType=HTM&sessYr=2013&sessInd=0&billBody

=S&billTyp=R&billNbr=0174&pn=1292 

Peter Smith

Pain relief specialist at Talking Cures

Dear Carol

Nice post.

It is the stupidity and control of Men and the Medical Profession who have to try to justify how little the

really know by being Gender separatist.

There is no difference between man a women - apart from Women, the stronger race are able to

withstand pain much longer than man and bear the failures to understand pain by men doctors and

sometimes women doctors much longer and without the whimpering complaining.

Best wishes

Peter Smith Talking Cures

Jane L. Brown

Founder and Organizer of Disabled People Want To Meetup Too!, tax lawyer, procurement manager

Many pain studies but little attention is given to pain in medical schools; WHY?!

Peter Smith

Pain relief specialist at Talking Cures

Dear Jane L Brown

The answer to your question is like understanding Pain and Fatigue - extremely easy to say. As is

sickeningly Women are seemingly the very last in the pecking order line.

Throughout the world billions of people are with Pain of some sort or another, a clear and

unambiguous demonstration Scientific Medicine for all of its qualified Scientific Proof is of little value

in the understanding the true cause of pain and then, not having created a Cure delivered it to the

billions of people in Pain.

 As the years pass since the creation of Pain Clinics by - to the best of my knowledge, Anesthetists - a

short term fix, the ability of even poorly managing pain has become evident by the many people losingtheir life to pain.

Tiredness unrelieved by sleep is perhaps the very first biological demonstration, we, as people waiting

to develop pain, make.

When this tiredness - cutely called Chronic Fatigue or ME - is not understood by the very loved ones

who created it “We” automatically as the body is now both Toxic and Caustic - create Pain.

Now for Medical Science to understand this and admit it is all a process of the Mind following

childhood emotional traumas and then to overturn Rene Descartes rule of Dualism would mean they

have to admit they were then and still are, so very wrong regarding the understandings relating to ALL

illness, let alone Pain and Fatigue.

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 And to understand the very fundamental cause of ALL illness would be the end of the requirement for

medical research to find the cause of cutely named (RSD CRPS FM CFS ME, the list is endless)

symptoms of ill health, as they are all derivatives of Tiredness and thus their Noble Prize and financial

profit for constantly finding failures through Charitable Organizations and others funding; WOULD BE

LOST FOREVER.

Hope this answers your question?

Best wishes

Peter Smith Talking Cures

Dr A Breck McKay

Research Director

 As per usual Peter Smith has lots of words, BUT he totally ignores and denigrates the established

scientific facts.

Men and women do experience pain differently. Through their past experience base and also thedifferent opioid receptors associated with the pain process (periphery to cerebral areas) that results in

the brain perceiving a concept called 'pain'.

Peter Smith does not know this, because he is self-blinded to reality by his confirmation bias.

Peter Smith

Pain relief specialist at Talking Cures

Dear Rodolfo

Whenever I respond to a posting, I do it with the utmost integrity and wisdom with information I

believe to be relevant to the original posting, honest and a truthful representation of the information

gleaned from years of experience.

If in my past as a much younger man and not very well “qualified” I was or appeared to be.

Chauvinistic in my attitude towards women, it was because I had not learned the integrity to see there

are many ways of looking at pertinent information and had not yet developed the wisdom to know the

difference.

Today with the benefit of Hindsight, thankfully I not only have learned, but also seen the truth.

With this in mind, I will not practice or tolerate any form of Suppression, Censorship or administrative

review.

 As it is a clear demonstration, of Low Self-Worth and lack of any form of trained for intelligence?

Moreover, Suppression/oppression are not forms of defense they are weapons of mass destruction.

Women are not only the strongest race, without them the Human race and indeed the Animal race

would soon cease to exist. Because we stupid men do not have the necessary body parts to create

the greatest trick in the book; Carry and give birth to a child which survival of the our race depends on

and am mindful of the ability of the so-called weak to create evolutionary change.

Thus, Women may well in the future dispense with man’s part in the creation of life, by self-

impregnating as some species on this planet have evolved to do. Careful what one wishes for, comes

easily to mind?

It is not in my desire or intention to hide my lack of knowledge by making useless contributions to an

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extremely necessary discussion on Women in Pain.

May we remind ourselves Pain is so poorly treated worldwide not only in Women but Men and

Children as well, something has to change with the research provide to our most dedicated front line

Doctors with treatments which work instead of not working, before every one is in Pain or ill?

Moreover, it is a Scientifically Proven Fact! Pain is so poorly treated demonstrating whether Women

and Men feel Pain Different or not pales into insignificance - to be of any real scientific value.

Finely to REDUCE the complexity of Pain down to just “testosterone, primarily a MANS hormone? If I

have my poor biological knowledge correct” may well explain why pain is so poorly treated in

Women.

Rodolfo; Well done for this posting and keep up the good work.

Best wishes

Peter Smith Talking Cures

Jane L. Brown

Founder and Organizer of Disabled People Want To Meetup Too!, tax lawyer, procurement manager

Back to the article ~ what will it take to bring relief to women who are in chronic pain?

 An understanding of the need; the potential size of the market and earnings to be expected, would be

a good start. It should prove to be a very lucrative endeavor!

Sabina Romero F.

Presidenta del Capitulo de Dolor Anestesia Regional y Ultrasonido en Sociedad Venezola deAnestesiologia

The topic of discussion is that women are more prone to suffering pain in our clinic in the Unit of Pain

and Palliative Care, a higher proportion of women in chronic pain. Further studies should be made at

each of our centers where we manage pain, and so we can exchange information.

Dr A Breck McKay

Research Director

Simple...we need a lot more women in the Pain Research field who are interested in the difference of

pain in women.

Jane L. Brown

Founder and Organizer of Disabled People Want To Meetup Too!, tax lawyer, procurement manager

Dr. McKay, that would help, but it means we are discounting the ability/willingness of men to step up

and address a huge field of research that is currently being ignored. I'm not understanding why there

is such wide ranging willingness to ignore this research when it would certainly be lucrative.

Dr A Breck McKay

Research Director

In 1620 Francis Bacon described Confirmation Bias...once a researcher develops an hypothesis and

then constructs research around it...they are very unwilling to change from that path, despite how

much evidence is produced to demonstrate the error.

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In all the pain medicine research I have seen, there are many major errors of common sense,

anatomical, physiological, biomechanical error etc and when you raise such errors in public fora, you

are ignored, told you do not know etc, so it is not just getting researchers to consider the difference of

pain in men and women; it is also difficult to get some people to even accept that there is a

difference!

Such are the problem of researchers being bogged down in their preferred (but not always accurate)

research, so found get wasted rather than used more effectively.

 A classic example is the funny belief that there is a simple maximum for opioid does that applies to

everyone and that is not to be exceeded. Research by Dr Marie Smith (Uni of Queensland Australia)

clearly demonstrates that the adsorption rates and metabolism rates for opioids are very different in

people (esp between men and women) and there is a genetic link behind them all.

We first have to break the Confirmation Bias of researchers (who get top funding) to free up good

research into the men/women Pain issues.

Luis Nieves

Interventional Pain Management at Texas Pain Relief Group

For too long, pain management as a specialty has been behind in performing good, quality research

that evidenced-based medicine has required. That is why our specialty has been criticized and has

been subject to cuts by insurers. Pain syndromes and their treatment in women has certainly been

under studied.

Jean-François MARC

Rheumatologist, Sport Medicine

 AN EXAMPLE OF PAIN IN RHEUMATOLOGY: THE FIBROMYALGIA SYNDROME (FMS). WHY

WOMEN ARE MORE AFFECTED?Marc J.F. MD,

 ABSTRACT

Fibromyalgia is a model of chronic pain in rheumatology with its nociceptive, neuropathic, and

psychological mechanisms. Female to male ratio is approximately 8:1. Why? In algology, according

to the theory of pain pathway disturbance, some sexual differences are admitted…but sex hormone

influences also play a role. According to the neuroendocrine theory, female foetus would be more

sensitive to stress. Those Fibromyalgia baby girls, weakened by a stress which disturbs their adrenal

and cortisone axis, will have vulnerability to stress in their post-natal life with an emergence of

fibromyalgia in adulthood, often being in conditions of chronic burn out (EVSS).

For the opponents of the organic origin of fibromyalgia syndrome, this entity would follow the decline

of spasmophilia as a psychosocial pathology. Considering this type of pain, our society might feel

concerned about women’s conditions of life in our occidental societies. For psychiatrists, depressive

state is often associated and frequently found in family history. This enables us to clarify the particular

psychological profile of those patients. Muscle, autoimmune or genetic explanations are worth

considering. Sexual differences can also be seen from the perspective of a lower efficacy of

analgesics. Those various arguments can explain a large part of the sex ratio, but don’t we have

to add the difference coming from the opinion of male doctors on this female pathology?

The author suggests that we eliminate our prejudices and take into consideration those sexual

differences in the development of our therapeutic strategies in order to prevent Fibromyalgia from

being an underestimated pathology.

Congress MWIA , Medical women international association, Paris , 2012 

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