Yes Virginia—Men and Women Are Different
When I saw the recent New York Times headline—In Rating Pain, Women Are The More Sensitive Sex—I was stunned. Not that men and women feel pain differently but that this well researched fact should be considered a news-breaking headline.
For many decades, research studies focused on men until researchers finally realized that the treatments they’d tested as successful in men weren’t working so well in women. This really opened the medical community’s eyes that men and women are more different that just hairstyles, figures, and shoe selections.
In the pain world, a ton of research has been done looking at how men and women differ when it comes to pain. While the author of the NY Times article questions whether these difference might be biological or women just learning to complain more, studies in animals clearly show the same thing—women are more sensitive to pain. This is not a research question anymore but a fact. Perhaps equally important, men and women respond to pain medications differently.
Read the excerpt below from The Woman’s Migraine Toolkit to learn more.
If Hormones Control Sexual Development, What Do They Have to Do with Pain?
Although we call estrogen, progesterone, and androgens sex hormones, they do more than just affect reproductive development. Sex hormones have strong influences on the brain and nervous system, and they have important roles in brain development and function. For example, estrogen affects both the anatomy and physiology of the part of the brain called the hippocampus. The hippocampus—from the Greek word for seahorse because of its shape—plays an important role in long-term memory, orientation, and navigation. This may explain why women are better at remembering anniversaries and have different ways of giving directions than men do.
You can think of the brain as though it’s a giant communication network. Nerve cells in our brain and nervous system talk to each other by sending chemical messages from one nerve to the next. The places where communication between nerves occurs are called synapses, and these synapses sit on structures on the nerves called dendritic spines. The dendritic spines are like cell-phone holders of the nerves, with the synapses being the cell-phones ready to send and receive messages. Estrogen affects nerves by actually increasing the numbers of dendritic spines and synapses, making communication between neighboring nerves easier. (Didn’t you already know women are great communicators?) This enhanced communication network is thought to also make sending pain messages easier, which may explain why women are more sensitive to pain than men.
Sex hormones also influence the brain by affecting the levels of several important signaling chemicals, called neurotransmitters. The chemical messages they transmit amplify, relay, and change information across synapses from nerve to nerve. Estrogen, for example, directly affects the level and activity of both headache-producing (e.g., dopamine and norepinephrine) and headache-protecting (e.g., serotonin, gamma amino-butyric acid [GABA], and endorphins) neurotransmitters. In general, elevated estrogen increases headache protectors, reducing headache risk. Conversely, decreases in estrogen levels increase dopamine and norepinephrine, which in turn increase the chance of a headache occurring.
Are There Other Important Differences in Pain Between Men and Women?
Men and women feel pain differently. Research studies consistently show that women are more sensitive to pain than men. They show that women feel pain at a lower stimulus than men, and pain becomes intolerable to women sooner than men.
- Women can first detect pain with a stimulus that’s nearly 20 percent less than the stimulus needed for men to feel pain.
- Pain becomes intolerable with a stimulus that’s 15 percent lower in women than men.
Similarly, studies also show that women find needle sticks and intravenous catheter placement to be more painful than men do.
References: Parker-Pope, Tara (2011). In Rating Pain, Women Are the More Sensitive Sex. NY Times: http://well.blogs.nytimes.com/2012/01/23/in-rating-pain-women-are-the-more-sensitive-sex/-