A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
That men and women are different has been discussed since Adam and Eve. That they experience and cope with pain differently has been consistently described in research studies.
It is concerning, however, to learn that women may experience more pain than men, but receive less treatment for it.
In a study of 1,000 emergency room patients, it was found that women were up to 25 percent less likely to receive opioid pain medications to treat their pain despite reporting the same pain scores as men. In addition, they were made to wait more than 15 minutes longer compared to men to receive their medications.
In patients with cancer, another study found that women were more likely to be undertreated for their pain.
An online survey of more than 2,400 women with chronic pain conducted by the National Pain Report, a chronic pain awareness organization, found more than 90 percent of those who responded felt the health care system discriminates against female patients. In addition, 49 percent felt doctors were less inclined to prescribe an opioid pain medication to them because they are female.
Why are women treated differently?
Women are more likely to be treated “less aggressively” for their pain symptoms, and have them characterized as emotional or psychological in nature.
Indeed, an inherent bias appears to exist in the medical treatment of women who experience pain where they are considered to be more emotional, than actually suffering from pain. For example, in one study that examined patients after surgery, women complaining of pain were more likely than men to be given sedatives rather than painkillers.
Unfortunately, women tend to wait longer to seek help for their pain and many prefer to suffer in silence. However, the power of self-help cannot be understated. Women should feel empowered to speak out and seek the help and treatment they need for their pain.
Self-advocacy in health care entails learning to obtain pertinent information and to self-assess your health-related strengths, weaknesses and the goals you wish to achieve. It requires you to communicate these effectively and to negotiate and assert your needs.
Key barriers to self-advocacy in health care have been previously described. One such barrier is a perceived power differential where patients naturally relinquish control to “trained” medical experts. Fearing negative outcomes, patients fail to assert their needs.
Understanding that you do not need to live in pain and researching the many options in pain management that may be open to you are key. Seeking help early from specialists in pain medicine can be instrumental.
Gender bias in pain treatment is becoming recognized and has led to a mandate by the National Institutes of Health (NIH) that all human clinical trials supported with NIH funds include a representative sample of females.
Following an extensive review of the latest literature, the American Society of Anesthesiologists has released its 2015 Women’s Pain Update, which underscores the wide variety of pain afflicting women as well as the many options available for controlling it. For instance, some of the findings reveal how women’s foot pain may be linked to depression, while knee pain may be linked to an increased risk of death, due to women being less active as a result of their pain. A number of encouraging findings were also reported this year, including that exercise can ease pain associated with pregnancy or arthritis.
Advances in pain medicine
Many painful conditions are especially unique to women such as back pain after childbirth or chronic pain after breast surgery. There is no need to suffer in silence as advances in pain medicine ensure you have many options to treat these conditions. From newer medications to injections and advanced pain therapies, most women can manage their pain and return to their normal active lives.
Speaking to a pain medicine specialist can help women be better informed of their treatment options. While research directed specifically at women’s pain is growing, there are many options available today to treat their pain.
Padma Gulur is an anethesthesiologist.
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