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  What Doctors Don't Tell You
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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.

Photo by Bob Jagendorf


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.

 →Are you arthritis pain medications helping or hurting your arthritis?

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