Are you taking a pill for migraines or painful periods, but only getting minimal relief? You're not alone. New research shows that women and men not only experience pain differently, but they also react differently to common medications. Hormonal differences, slower metabolisms, and years of neglect of women in clinical trials mean that medications like ibuprofen, aspirin, and even morphine aren't always as effective for women as they are for men.
Difference in pain perception
As recently as 1993, women were not required to be included in clinical trials. Many drugs were tested exclusively on men , and their effects and dosages were automatically considered universally valid for both sexes. Only more recent research has confirmed that the female body reacts differently in many ways - for example, to pain itself, but also to methods of treatment.
Although pain perception is a highly individual matter, many studies suggest that biological sex characteristics also play a role. The commonly held belief that women have a higher pain threshold because they can handle childbirth is not entirely true. In fact, men have a higher pain threshold, mainly due to hormonal differences:
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Hormonal influences : Sex hormones, particularly testosterone and estrogen, affect pain sensitivity. Testosterone, which men naturally produce in higher amounts, reduces pain intensity . For example, one study found that boys with higher levels of testosterone reported lower perceived pain. In another study, when both men and women were exposed to the same painful stimulus, such as cold, heat, or pressure, women tended to report higher levels of pain. ( 1 )
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Endorphins : When a woman is in pain, her brain produces fewer endorphins, the so-called natural opiates that help reduce pain and improve mood. This can lead to a more intense experience of pain.
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Endogenous opioid system : This system, which is involved in regulating pain and stress, works differently in both sexes. This also affects the effectiveness of some painkillers. For example, women need, on average, up to 30% higher doses of morphine to achieve the same relief as men. ( 2 )
Does this mean that women have a harder time coping with pain or that their experiences are not real? Absolutely not. The female body simply reacts differently. Moreover, statistics confirm that women suffer more often from chronic and intense pain:
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Lower effectiveness of medications
Not only do women experience pain more intensely, but they also often respond less well to common painkillers such as ibuprofen, opioids, or steroids. Why is this?
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Estrogen affects drug metabolism – It slows gastric emptying, increases body fat, and reduces the amount of specific proteins that bind active ingredients. All of these change the speed and efficiency of drug absorption and breakdown in the body.
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Stronger immune response – Women have a more active immune response, which can lead to a stronger inflammatory response and therefore more intense pain. As a result, they often need higher doses of medication or longer use to achieve the same effect as men.
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Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin tend to be less effective in women than in men. Similarly, glucocorticoids , which are often used to reduce inflammation, tend to be less effective in women. ( 7 )
In other words, the drug may take longer to work in a woman, be less effective, or may require a higher dose to provide the same relief as in a man.
Side effects and risks
Due to differences in metabolism, some drugs are not absorbed by the female body. are broken down more slowly , leading to higher concentrations of the active substance in the blood. This may increase the risk of side effects such as nausea, headaches, hallucinations , or seizures . Women are more likely to reduce their dosage or discontinue treatment altogether because of these problems. ( 8 ) Some drugs have even been withdrawn from the US market in the past due to the high health risks for women.
Another factor is that women tend to have a lower body weight and different metabolisms, which affect their tolerance to certain medications, such as opioids. This puts women at significantly higher risk of overdose or addiction at lower doses. ( 9 )
Hope for change for the better
The fact that women experience pain differently is not a "hypersensitivity" but a biological fact. Hormones, specific drug metabolism, and the historical neglect of women's health in research contribute to the fact that many women do not get the relief they need. Whether it is menstrual pain, migraines, endometriosis, or other chronic conditions.
It is essential that healthcare is tailored to the specifics of the female body. But this requires further research that takes female biology seriously and finally brings effective and equitable treatment to women.
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What else can you read on the Femspace blog?
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Endometriosis: A New Perspective on Pain, Diagnosis, and a Holistic Approach to Care
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The discomfort that companies overlook: Why it's time to address menstrual pain in the workplace
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Sources used
BALCH, Bridget. Do women and men feel pain differently? AAMCNews [online]. Available from: https://www.aamc.org/news/do-women-and-men-feel-pain-differently
CAMERO, Katie. Painkillers don't work as well for women. Here's why. National Geographic [online]. Available from: https://www.nationalgeographic.com/science/article/women-pain-medications
EVANS, Susan. Genders experience pain differently and women have it more. International Association for the Study of Pain [online]. Available from: https://www.iasp-pain.org/publications/relief-news/article/genders-experience-pain-differently/
