It’s not all in your head – women really are more likely to feel pain

Women report feeling more pain than men – and with good reason,writes Anna Bartter.

There are few things more painful in life than blearily stepping on a stray piece of Lego first thing in the morning. As a mum of three, I’m used to it, but recently everything seems to be hurting more than it used to. Chatting with friends, I realise I’m not the only one who feels as though they’re becoming more sensitive to pain. Instinctively, we tend to blame hormones or the ageing process, but research shows that women and men do feel pain differently, both in terms of how often they feel pain and how acutely.

What’s going on here, then? We asked the experts to shed some light. 

Do women really feel more pain than men?

“Generally, women report more pain across their lifespan and have a greater sensitivity to pain when compared to men,” says Ed Keough, professor of psychology at the University of Bath and deputy director of The Bath Centre for Pain Research.

“Women are also more likely to use over-the-counter and prescription pain medications and more likely to be referred to pain clinics. Men also have pain, of course, but it seems that women have more of it.”

OK, so we do feel more pain than men – but why? These are just some of the reasons researchers suggest.

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Women are more likely to develop painful diseases

Not only are women more likely to report feeling pain, but studies show that women are more susceptible to developing pain-related issues such as migraine, stomach pain and arthritis. 

Plastic surgeon Dr Paul Banwell tells Stylist how prevalent this is: “In the UK alone, approximately 7.8 million people live with chronic pain, and women suffer with almost all chronic pain conditions to a greater extent than men. Fibromyalgia, a condition characterised by chronic, widespread pain, is significantly more prevalent in women, with 80-90% of diagnosed cases in women.” 

Do women experience pain differently to men?

Women feel pain more acutely than men 

According to research by the American Society of Plastic Surgeons, women have more pain receptors than men, with 35 nerve fibres per centimetre of skin, while men average 17. This means that women are more likely to feel acute pain, which may account for a biologically lower pain threshold.

Banwell explains also that “women have greater nerve density than men, which may cause them to feel pain more, while some studies have shown that women have a more intense response to painful stimuli”.

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What causes this gender difference in pain?

According to Keough, to understand the gender difference in pain perception, it’s important to consider what we mean by pain. “We need to step back and think about what pain is,” he says. “There are a whole range of possible reasons why women are affected more, and we’re still trying to work out what they are, and which are the most important.”

In simple terms, research shows that there are biological, psychological, social and physiological factors at play here, so let’s break it down.

Basic biology 

“Biology is clearly important here,” says Keough. “The differences in pain seem to emerge around puberty, with fewer differences found in children, suggesting sex hormones might have a role here.”

Hormonal shifts 

Dr Banwell agrees, stating that “the fluctuating nature of female hormones can increase the body’s perception of pain. When oestrogen levels are low – during the menstrual cycle or post-menopause – pain receptor activity is increased.”

So that’s why a bikini wax hurts so much more at certain times of the month. 

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Psychological factors 

“Stress and tiredness both have an impact on how the body experiences pain,” says Banwell. “Aches and pains can result from increased levels of stress, and some research has shown that chronic pain can be associated with higher levels of stress and an increased level of cortisol.”

Interestingly, Keough also reveals that mood and expectation around pain has an impact, as he explains that “how we feel we ‘should’ respond to pain plays a role. As well as the sensory perception of pain, how we perceive pain is affected by thoughts, feelings and context, for example, expectations and placebo effects.”

A good example of this expectation is the child in a playground who falls over and is totally fine until she sees her mum, and only then does she react to the pain. 

Social factors

“Social and cultural factors can impact how we think about pain, how we experience it, and how we express it,” says Keough. “This can be due to our upbringing and how we are taught to express ourselves, with gender-based beliefs and biases affecting how we express pain and also when and how we seek help.”

Banwell agrees: “Stereotypically, in childhood, little girls will be comforted when they’re in pain, whereas boys might be told to get on with it. This can lead to men not admitting when they feel pain as quickly as women.”

And research does back this up, with women being more likely to say they are feeling pain than men. “This is taken to suggest that women have a lower pain threshold than men,” says Keough. “But this depends on self-reporting, and men may be less willing to report pain, so we have to consider that.”

Added to this, it’s accepted that pain in women can be normalised, as Keough explains that “women with persistent pain often report not being believed, which contributes to lots of pain being under-treated, and this may be more pronounced for women.”

More research is needed

It’s clear that this is a complicated subject, but it is important to understand the factors at play in order to be able to manage both long- and short-term pain across genders. Banwell stresses: “It is important to remember that pain experiences vary considerably within genders as well, as everyone’s individual pain threshold is different.”

Put simply, if you need a sit down after stubbing your toe, you go ahead. 

Images: Getty

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