“Women’s pain is underreported and under-treated.” The complaint of the CFU

Less known than the gap in terms of income and economic conditions (gender pay gap), the Gender Pain Gap is the phenomenon whereby pain, when reported and perceived by women, is underestimated and undertreated.

“As fibromyalgia patients, we know this phenomenon and experience it firsthand,” she says Barbara Suzzi, President of CFU Italy “We know that chronic pain also causes social exclusion and insufficient treatment exposes us to the risk of chronicity, depression, insomnia, asthenia, with impairment of personal functioning and repercussions on work.

Pain has women as a privileged target: these not only accuse more serious and frequent pain syndromes: the difference is above all attributable to biological, hormonal and neurosensory differences. Abundant epidemiological data show that chronic pain is more prevalent in women than in men (Fillingim et al., 2009). Women are twice as likely to have multiple sclerosis, 2 to 3 times more likely to develop rheumatoid arthritis and 4 times more likely to have chronic fatigue syndrome than men. In the case of fibromyalgia, around 90% of women are a real ‘gender’ disease.

“The difference with which women’s pain is systematically underestimated, not considered and not treated is a cultural problem” continues President Suzzi “and is attributable to the dominance of masculine power where men and women are viewed as inherently different and masculine values ​​are viewed as more positive than feminine. This culture is not only a form of gender-related discrimination and bias, but it is reflected in health carewith medically unjustified differences in the treatment of men and women.

Although women experience more conditions that have chronic pain as a leitmotif than men (including endometriosis, dysmenorrhea, dyspareunia, vulvodynia, migraine and of course fibromyalgia), their pain is treated less seriously. Some research has revealed that women who report pain they are more likely to see each other prescribe an anti-anxiety medication, compared to men who are prescribed painkillers.

That gender gap also extends to the emergency room, where men wait an average of 49 minutes before receiving painkillers for acute abdominal pain while women wait an average of 65 minutes in the same situation. Women are also half as likely as men to receive pain relievers after coronary bypass surgery. Education conducted in the UK reveal that interpreting pain as anxiety contributes to 50% more misdiagnoses after a heart attack. A 2020 survey of people with endometriosis, which takes an average of seven to nine years to be diagnosed, found that women Gynecologic pain associations contributed to delayed and missed diagnoses in 50 percent of cases (1).

In the landmark 2001 paper, “The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain,” Diane Hoffman and Anita Tarzian found that “women report more severe levels ofmore frequent incidences of pain and pain of longer duration than men, but are still treated for pain in a milder, less aggressive way“.

“Women are not taken seriously, or it is believed that having to give birth they are more accustomed and “destined” to bear it. A sort of contradiction: because women are simultaneously considered weak and unable to tolerate pain or overestimate its levels ” continues Barbara Suzzi “When women’s physical pain is dismissed as exaggerated and imagined, or misdiagnosed as psychological, women’s health is affected.”

(1) Diagnosis (Berl)2020 May 26;7(2):97-106. doi: 10.1515/dx-2019-0020. Patient perceptions of misdiagnosis of endometriosis: results from an online national survey