Is There Gender Bias in Pain Management?

According to research, there are differences between men and women when it comes to chronic pain. Women experience pain more intensely and more often than men. Females also respond to pain management differently, and their pain is not only often under-treated, it is treated less aggressively than their male counterparts. In a recent study it was revealed that doctors were 22 times more likely to recommend knee surgery for men than they were for women, even though the surgery is considered a definitive way to treat arthritis when other therapies have failed.

• One study indicated that women are more likely to be given sedatives for their pain, while men are more likely to be given pain medication
• Another study shows that women are less likely than men to be referred to a specialty pain clinic, at least upon initial encounters with their physicians
• A study reviewing cancer care at seven outpatient clinics in California found that female cancer patients were prescribed half the pain medication as male patients with the same pain intensity score
• According to an analysis of recent pain research, women are more likely than men to seek treatment for their pain and are less likely to receive it. Physicians may treat women less for pain based on the presumption women can handle more pain or, conversely, that women are in fact imagining pain where none exists.
• An FDA study of 185 drugs approved between 1995 and 1999 found that (despite the fact that 37 of those drugs have known gender-specific differences in interactions) there were no dosage differences based on sex.

Why does this bias occur?

• Our culture often encourages women to express pain, and men to hide it. But this does not mean that friends, relatives — and doctors — react sympathetically to women’s expression of pain.
• Men often communicate their pain in ways that doctors understand. (Perhaps this is because there are more male pain physicians than female pain physicians). Physicians may view women’s statements as emotional, rather than objective.
• Women are more likely to have chronic pain conditions that are more difficult to diagnose and treat. (TMJ Disorder, fibromyalgia), and in many cases these are treated as mental or hormonal rather than as a disease or disorder.
• Physicians are often quick to assume either that women can handle more pain or that they are exaggerating the level of pain they experience

•  Talk to your physician about your pain management. Be assertive, you do not have to accept under-treated pain.
• Maintain a pain record. Note location, time of day, severity, what you were doing at the time and what relieved the pain.
• Make sure that before you leave the doctors office that you understand the medication prescribed. If you have any questions, consult with the pharmacist when filling the prescription.
• Find a new doctor if at any time you feel that your pain is not be treated adequately or you are uncomfortable in your patient-doctor relationship.