Women and pain: why they get more pain conditions than men

23rd December, 2022 • 12 min read

One survey found that 1 in 6 women say they experience severe pain every day – from back pain and arthritis to endometriosis, fibromyalgia and vulval pain. And more than half of these women feel that they've had their pain ignored or dismissed. So what’s going on? And how can you get your pain taken care of when you need help? Here’s what you need to know.

The gender pain gap is real (but things are starting to change)

When it comes to pain, women have traditionally been labeled the ‘weaker’ sex. But this is laughable when you consider our near-superhuman ability to deal with labor pains and the monthly cramps and backaches that come with our

periods
. Not to mention the fact that there are several painful conditions that affect women more than men.

“Women do seem to get more pain conditions than men,” says Dr Ann Nainan, family doctor and Healthily expert. “And there’s evidence that their pain is perceived differently and sometimes taken less seriously, in society and by the medical profession.”

Women’s pain not taken as seriously

There are several theories around why women’s pain is sometimes underestimated and undertreated, including:

  • “it’s all in their heads” – a recent study found that when men and women expressed the same amount of pain, observers saw it differently. They viewed female pain as less intense than male pain, and more likely to benefit from psychotherapy rather than medicine
  • “they don’t really need pain relief” – another study found women were between 13% and 25% less likely to be given opioid painkillers (such as tramadol) if they went to hospital with sharp pains in their stomach. What’s more, certain medical procedures – such as having a
    pap test (cervical screening)
    , or having an
    IUD
    inserted – are more painful for some women than others, but they’re often done without pain relief being offered
  • “they need to calm down” – other researchers have reported that women’s pain is likely to be taken less seriously as men’s pain in the ER department, and that women are more likely than men to be given sedatives rather than painkillers for pain
  • “they like to complain” – the vaginal mesh scandal – where thousands of women reported pain after being treated with vaginal mesh devices for bladder problems – illustrates how hard it can sometimes be for women to get their voices heard about their pain

Thankfully, with more research studies now including women, and investigations into the effects of sex hormones, pain perception and how women are treated for pain, the outlook is changing.

But in the meantime, here’s the key information you need to fight your corner with confidence, and get the help you need.

Pain conditions that are more common in women than men

There’s a long list of chronic pain conditions that seem to affect more women than men. “It’s a complex issue,” says Dr Ann. “We don’t yet know whether the difference is biological – because women have a different pain tolerance than men – or just that it’s more socially acceptable for women to talk about their pain.”

But whatever the reason, studies and research do show that women more often have symptoms of or are diagnosed with chronic pain conditions, including the following.

Migraines and tension headaches

  • tension headaches – women are about 6 times more likely to get this common type of headache than men. Symptoms include pain on both sides of your head, plus feeling like something is pressing on your head or being tightened from behind. Find out how to treat tension headaches
  • migraines – women are 2 to 3 times more likely to get migraines than men. These are usually more intense headaches. Common symptoms include throbbing pain, usually on one side of the head, and sometimes nausea and sensitivity to light and noise. Read about how to treat migraines

Irritable bowel syndrome (IBS)

In the US, about twice as many women as men get

irritable bowel syndrome (IBS)
. This causes symptoms such as gut pain and
bloating
, diarrhea and
constipation
.

Read about how to get the right IBS treatment and relief.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune condition that’s 2 to 3 times more common in women than men. It causes painful, swollen joints and can lead to joint damage.

Find out how to treat rheumatoid arthritis and how to manage it with self-care tips.

Fibromyalgia

Fibromyalgia, or ‘fibro’, is a chronic pain condition that’s estimated to affect up to 9 times more women than men.

Back pain

Back pain is very common, with research suggesting lower back pain affects between 60% and 80% of us at some point.

But it’s more common in women. For example, a German survey of 5,000 people found it had affected 40% of women in the previous 7 days, compared with 32% of men.

Female pain conditions are under-researched

There are also several ‘female-specific’ pain conditions (which only women get, because they’re related to their sex organs) where the cause is still unclear and under-researched, meaning treatment options can be limited.

Women can face long delays in getting a diagnosis for these conditions – such as endometriosis, where the wait is about 4 years in the US and 9 years in Europe.

Some of these female pain conditions become ‘normalized’ – meaning women get so used to putting up with them and/or their doctors see the problem so often that they’re thought of as ‘normal’.

Here’s what you need to know about them, so you can get help if you need it.

Period pain

  • period pain is very common, and most women get it at some point
  • between 5 and 10 in 100 women get period pain so severe it disrupts their daily lives
  • if this happens to you, it isn’t ‘normal’. It may mean you have an underlying medical condition, such as
    fibroids
    or endometriosis, so you should see your doctor

Read about

how to manage period pain
, including self-care and how your doctor can help.

Endometriosis

  • endometriosis is a gynecological condition that affects about 1 in 10 women
  • common symptoms include painful or heavy periods, and pain in you tummy, pelvis, lower back or legs
  • although it can take years to get a diagnosis, there are signs that things are improving thanks to greater awareness of the condition

Read about when to see a doctor and

how endometriosis is treated
.

Breast pain

Pain in your breasts related to your

menstrual cycle
can range from a dull ache to stabbing pain. Read more about
breast pain
, including the symptoms and how to treat it.

Painful bladder conditions

Read more

treatments for interstitial cystitis
and
chronic UTI treatment
.

Painful sex

Check out our

vaginal health guide
for more information about pain and other conditions.

Clitorial pain

Recent research found that there are 10,000 nerve fibers in the clitoris – 2,000 more than was reported in 1976 – which may help with understanding conditions such as clitoral pain.

A study of more than 1,000 pictures of women’s vulvas found that 1 in 5 had clitoris adhesions – which can cause discomfort, hypersensitivity and pain.

The authors said that such problems are often overlooked and underdiagnosed, as the clitoris isn’t routinely examined by gynecologists, and they recommend that examination be taught in medical school.

Pelvic pain

One study found that about 15% of women of childbearing age in the US have

pelvic pain
that lasts 6 months or more. Read more about pelvic pain.

What’s the cause of pain differences between men and women?

There are a few ideas about what causes the gender pain gap.

Who feels more pain – males or females?

Studies have shown that women exposed to the same pain as men report greater levels of pain. For example, in 1 study of people with knee joint pain and stiffness (

osteoarthritis
), women reported more pain – and more widespread pain – than men.

Scientists say there are several possible explanations, including:

  • women may be better at sensing pain, or be more sensitive to it
  • men and women may have different ways of processing pain through their nervous systems and brains
  • women may have more experience of dealing with pain (due to monthly periods and childbirth), so they’re more used to talking about it – and men are less likely to do so

Female hormones and pain

When scientists look for answers about whether women have a higher pain tolerance than men, or men have a higher tolerance than women, hormones have to come into the picture.

Some scientists suggest women may be more sensitive to pain because of the monthly ups and downs of the female sex hormones estrogen and progesterone. And that men may be protected by their higher levels of testosterone.

Different social pressures for men and women

Ideas about how ‘feminine’ and ‘masculine’ it is to feel comfortable talking about pain or admit to feeling pain could also play a part.

The women and men in 1 study all said men are less likely to admit to being in pain. But this can vary from culture to culture – with 1 study showing men and women in Israel were less likely to admit to pain, compared with women and men in the US.

How to get your pain taken – and treated – seriously

“It’s really important to talk about your pain and be aware of when it just isn’t at a ‘normal’ level, meaning you need help and effective treatments,” says Dr Ann. “And if you haven’t been diagnosed, it’s important to find out what could be causing it, as this will help your doctor work out the best treatments for you.”

For example:

  • period pain or heavy menstrual bleeding – having cramps that ruin your life every month isn’t normal, so you should see your doctor
  • headaches – it’s normal to get the occasional headache. But having migraines that last a few days a month isn’t normal, and you may need preventative treatments
  • joint pain – if this is stopping enjoying your normal social, work, family or love life, you need help to find the right treatment

Learn how to describe and rate your pain

A good discussion with your pharmacist or doctor is key to getting the right pain relief. This information also helps your doctor build up a picture of the impact your pain is having on your life, so they can understand how serious it is for you.

“You can help your doctor by describing how your pain feels,” says Dr Ann. For example:

  • is it a throbbing, shooting or aching pain?
  • does it stop you concentrating at work?
  • is it constant, or does it come and go?
  • does it stay in 1 place or move to other areas?
  • do you have any other symptoms, such as nausea or vomiting?
  • how much pain are you in on a scale of 1 to 10?

Keep a symptom diary

“Keeping a symptom diary can help track your symptoms, so your doctor can see if they’re getting better or worse, or you have a ‘flare up’ pattern,” says Dr Ann.

It’s useful to keep a daily diary, both before you start treatment and afterwards. Note down:

When it happens:

  • how it feels
  • the pain score out of 10
  • whether you’ve taken your pain medicines
  • whether you’ve done any pain management self-care

What triggers it or makes it worse:

  • if it’s worse when you do certain things – such as have sex, eat, bend over, walk or sit down
  • if it comes on after you do things – such as drinking alcohol, staying up late or exercising
  • if it’s worse at certain times – such as when you get up in the morning or at night

Use the Healthily Smart Symptom Checker

The

Healthily Smart Symptom Checker
is a registered medical device that can help you work out your best next steps, and whether you should see a doctor.

Get the pain relief you need

“If you’ve been prescribed painkillers and they aren’t working for you, tell your doctor,” says Dr Ann. “Men and women can break down (metabolize) and absorb medication in different ways, and you may need a different dose or a different type of drug.

“For example, estrogen can affect pain ‘pathways’, and how you respond to certain types of medicine, such as opioids. Because women have higher levels of estrogen than men, they can have greater sensitivity to opioids – meaning they work better – but they’re also more likely to get side effects such as drowsiness and slower breathing (a risk factor for overdose), so they may need lower doses than men.

“And if you’ve previously found a procedure such as a pap smear or IUD insertion painful, ask your doctor about pain relief – how painful these procedures are does seem to vary between individual women.

“Finally, for chronic conditions such as fibromyalgia, if treatments and lifestyle changes aren’t helping with your pain, ask if you can be referred for a pain management course.”

You can also check out our

self-help tips to treat pain without medication
.

Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.