Saturday, August 14, 2010

Women Suffer Chronic Pain More Than Men

Conference NotesAccording to a recent conference presentation, women experience chronic pain longer, more intensely, and more often than men. Attending to both the physical and mental suffering of women with chronic pain may be critical for successful treatment outcomes.

Speaking on August 13, 2010 at the 118th Annual Convention of the American Psychological Association in San Diego, CA, Jennifer Kelly, PhD, from the Atlanta Center for Behavioral Medicine, said, “Chronic pain affects a higher proportion of women than men around the world [and] we need to encourage women to take a more active role in their treatment and reduce the stigma and embarrassment of this problem.” Fibromyalgia, irritable bowel syndrome, rheumatoid arthritis, and migraines are more prevalent in women than in men, and women also are more likely to have multiple, concurrent painful conditions leading to greater psychological distress and disability.

Kelly noted that hormones may account for some of the differences; for example, estrogen clearly may play a role in conditions such as migraines. “Pain perception does vary according to the menstrual cycle phases in women with chronic pain," said Kelly. "For example, temporomandibular joint pain is highest in the pre-menstrual period and during menses." There also may be differences in how women respond to pain relieving medications, and Kelly observed that studies have shown men and women may respond differently to strong analgesics and experience dissimilar side effects.

“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," she said. For one thing, "women tend to focus on the emotional aspects of pain, [whereas] men tend to focus on the physical sensations they experience. Women who concentrate on the emotional aspects of their pain may actually experience more pain as a result, possibly because the emotions associated with pain are negative.’

Kelly offered some tips for healthcare providers treating women with chronic pain: (1) encourage patients to take an active role in their treatment and in caring for themselves, such as eating well and getting exercise, (2) provide psychological support, (3) explore cognitive coping strategies, and (4) offer relaxation and biofeedback training. Depressed patients may benefit from psychotropic medications, she said, but antidepressants should not serve as a replacement for psychological intervention; rather, she prefers cognitive coping strategies that work on changing the thoughts associated with the pain. "If women can see the pain as something that can be managed and something that they can work with, then they can make more positive modifications in their life and become more functional," she concluded.

NOTE: We just recently reported [here] on research demonstrating that women generally receive inadequate pain assessment and treatment in primary care settings, and that they often have less effective skills for coping with their pain, as compared with men. Also of some importance, prior research [which we noted here] found that emotional issues and psychological distress may motivate greater substance abuse in women than men, and women who misuse pain medications often have a history of mental health problems. These concerns highlight the need for attending to the psychological factors affecting women with chronic pain, as stressed by Jennifer Kelly in her presentation, along with counseling regarding the dangers of relying solely on medications to reduce stress.

> Kelly JF. Translating Research on Chronic Pain in Women to Practice. American Psychological Association Annual Meeting, San Diego, CA, Aug. 12-15, 2010. Author may be contacted at:
> Also reported via EurekaAlert! All pain is not the same: Psychologist discusses gender differences in chronic pain. 2010(Aug 12) [
available here].