Women
and Pain
by Barbara D. Allan
Author of Conquering Arthritis
Women really do feel pain differently than men. Dr.
Jeffrey Mobil's lab at McGill University has shown just
that through a study of genes and pain signaling pathways.
His research team discovered that males have only one
pain pathway. Block this pathway and males feel no pain.
Females, however, have two pain pathways. If you block
the pathway that females share in common with males,
they will still feel pain. This is because their second
pain sensing pathway is still functional.
This explains why many women are more sensitive than
men to pain and typically do not get the same relief
from pain relievers. Despite what many women have been
told, it is not just 'all in our heads,' and it isn't
'our fault' that analgesic drugs don't work as well
for us. Our heightened and more robust sensitivity to
pain is simply hardwired into us.
Redheads
In an odd twist, there is a human female 'mutant form'
of the female specific pain pathway. These 'mutants'
are commonly referred to as red heads. They are actually
more responsive to a certain form of analgesia (pain
killer) than women of other genotypes (i.e. other hair
colors) and all men.
Testing Both Males and Females
According to Dr. Mobil, the discovery of a female specific
pathway was made entirely by chance. It only occurred
because his lab routinely tests male and female mice
in all experiments. Many pain researchers test only
males. Dr. Mobil believes many pain researchers are
loathe to include female subjects in their experiments
because of a belief that females display more variability
in their responses than males. This problem isn't just
in the field of pain research. Historically, most medical
and drug testing has been done only on males. Standards
of treatment were then established based on what worked
best for these men.
Dr. Mobil and others have conducted experiments that
specifically disprove the assumption of higher variability
in females. (In fact, variability depends on what is
being studied--sometimes women have greater variability,
sometimes men do.) Furthermore, the fact that women
and men often respond quite differently to various drugs
has made it quite clear that not testing females (in
both animal and human studies) is unethical.
Since a congressional mandate in 1993, NIH clinical
research, at least, has been required to include women
as subjects.
Hope for the Future
We can only hope that as more women are included in
medical studies that standards of care will be optimized
for our unique needs as women. Sex based differences
need to be studied and understood so that all of us,
men and women, can have access to the treatments that
will work best for us.
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