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Psychologist Discusses Gender Differences in Pain

Women experience chronic pain longer, more intensely and more often than men, according to a psychologist who works with both men and women dealing with diseases and conditions that leave them suffering.

“Chronic pain affects a higher proportion of women than men around the world,” said Jennifer Kelly, PhD, of the Atlanta Center for Behavioral Medicine. “We need to encourage women to take a more active role in their treatment and reduce the stigma and embarrassment of this problem.”

Speaking at the annual convention of the American Psychological Association, Kelly said the latest research offers interesting insights into how physicians and mental health providers can better treat women with chronic pain.

Pain is considered chronic when it lasts six months or longer and most medical treatment options have been exhausted. Chronic pain conditions that are more prevalent in women than in men include fibromyalgia, irritable bowel syndrome, rheumatoid arthritis, and migraines, said Kelly.

Women are also more likely than men to experience multiple painful conditions simultaneously, which can lead to greater psychological distress and greater likelihood of disability, according to the report.

Hormones may be to blame for these differences, said Kelly, who added that estrogen clearly plays a role in conditions such as migraines. Rates of other painful conditions increase for girls as they pass through puberty whereas rates for adolescent boys are stable or rise less steeply. “Pain perception does vary according to the menstrual cycle phases in women with chronic pain,” said Kelly. “For example, temporomandibular [jaw] pain, or TMJ, is highest in the pre-menstrual period and during menses.”

As for treating pain, studies have shown men and women experience different side effects of analgesic medications. There have also been studies into whether men respond better to opioid medications, but the findings are ambiguous at best, she said. However, research has shown that there are numerous factors involved in response to pain medications. “Genetic and hormonal differences may be the main reason for any differences, but it’s becoming increasingly clear that social and psychological factors are also important,” said Kelly.

Kelly offered the following tips for better treatment of patients with chronic pain, especially women:

• encourage patients to take an active role in their treatment and in caring for themselves, such as eating well and getting exercise;

• provide psychological support;

• explore cognitive coping strategies; and

• offer relaxation and biofeedback training.

— Source: American Psychological Association