The Gender Pain Gap

Izzy Humphreys for Distilled Post

Everyone knows about the gender pay gap, but a lesser-known phenomenon steeped in similar gender stereotypes has emerged in the medical field over the last twenty years: the gender pain gap. The coining of the term has opened up conversation on how women’s physical pain is experienced and treated in comparison to that of men. Research studies, statistics, and the experiences of women have brought this concept to the fore, and the revelations are astonishing and bleak. Women are told to listen to their bodies, but 1 in 4 do not feel heard at their gynaecology appointment. So what is the gender pain gap, and how is it affecting women suffering from reproductive disorders?

What is the gender pain gap?

The official term “gender pain gap” originated from a breakthrough study carried out by Professor Diane Hoffman at the University of Maryland in 2001. A study that finally gave credibility to the notion that women’s pain is not taken as seriously as men’s, thus going misdiagnosed and mistreated with sometimes fatal outcomes. It also encompassed the way women experience pain – more frequently and often more intensely.

A variety of studies have since been carried out in relation to this phenomenon. One 2008 study reports that women are 13% to 25% less likely to be prescribed opioid analgesia (pain relievers) when dealing with acute abdominal pain in emergency departments. They reportedly also waited longer to receive them on average.

Debatably the most significant finding has been, however, that women are more likely to experience chronic pain, being more susceptible to conditions such as fibromyalgia, migraines, and reproductive disorders like endometriosis, fibroids, and polycystic ovary syndrome (PCOS). This is where the gender pain gap really emphasises the misunderstandings and ‘wilful ignorance’ surrounding women’s health, particularly women’s reproductive health.

How and why is pelvic pain ignored?

For women and people with female reproductive organs, pelvic pain is often one of the most glaring symptoms of reproductive disorders. But there have been many examples of women’s pain, particularly pelvic pain, being ignored by medical professionals. Often women are told it is stress or anxiety-related, or the pain is dismissed as being related to their menstrual cycle. That it sometimes is, but that doesn’t mean it’s normal.

There also appears to be a research trend that suggests women are generally perceived to overestimate or ‘catastrophise’ their pain. Whilst there are studies that show women feel pain more intensely, this does not mean they are exaggerating their level of pain, though this appears to be the prevailing thought. Yentl Syndrome epitomises this notion as the phenomenon whereby women are misdiagnosed and poorly treated unless their symptoms or diseases conform to that of men.

The bias towards the underestimation of women’s pain may have roots in historical gender stereotypes. The results of a 2021 study showed that women’s pain was perceived to benefit more from psychotherapy than painkillers when compared to the pain of men. This harks back to the historical misdiagnosis of many women with “hysteria”, which often landed women in insane asylums or undergoing surgical hysterectomies. Female hysteria encompassed a host of symptoms often linked to the menstrual cycle and female reproductive system – things that only came to be understood in their own right during the 20th Century.


Diagnosis of reproductive disorders

Despite medicine having come leaps and bounds from the antiquated hysteria diagnoses, it is alarming how symptoms related to menstruation and women’s reproductive system continue to be misunderstood and overlooked. Endometriosis is a prime example of this, with women suffering from this condition having to wait an average of 7.5 years in the UK for a diagnosis, even with estimations suggesting around 1 in 10 women are affected by it globally. Despite the alarming increase in rates of endometriosis leading some researchers to describe it as a ‘modern pandemic’, the condition remains largely ignored in government policy and research funding globally. This has led to continued gaps in professionals’ understanding of the disease, and many women dealing with debilitating symptoms for years without receiving treatment.

Due to the predominant symptom of conditions like endometriosis, fibroids, and PCOS often being intense pelvic pain, many women have spoken out about how often this is dismissed as a normal part of the menstrual cycle. Women have been told their pain is all in their heads and “just part of being a woman”, whilst some won’t even bother going to their GP due to the internalised notion that it’s nothing out of the ordinary.

It does not all boil down to sexism, however, and whilst studies and women’s lived experiences paint a stark picture of the gender gap in healthcare, there are other difficulties in diagnosing reproductive disorders. Many of the conditions share similar symptoms, making them difficult to differentiate between, and a diagnosis for these conditions will also likely involve an uncomfortable and invasive procedure; something that medical professionals may not want to put someone through unnecessarily.

Regardless of these facts, however, gender stereotypes are still hindering the diagnosis and treatment of women with reproductive disorders, and it is clear that more funding and research is needed, as well as a reframe of women’s experience of pain, to keep more women from falling through the gender pain gap.