Pain / Migraines Fundamentals

Women consistently report more chronic and severe sensory pain, as well as emotional discomfort in more body parts, than their male counterparts. We also experience more pain following injuries. Even those health conditions considered not to be gender specific, such as irritable bowel syndrome, headaches, TMJ pain, urinary tract infections, arthritis, and fibromyalgia, tend to hit us harder, more often, and are less easily relieved than in men.

Chronic pain, which partially or totally disables 50 million Americans, is a major public health problem in the United States, with 45% of all Americans seeking care for persistent pain at some point in their lives. Of the 36 million Americans missing work each year due to pain, women are 50% more likely to take a sick day than their male co–workers.

Researchers are starting to conclude that our genetics underpin at least some of the difference, and that females really do feel pain more than males. It is currently hypothesized that men𔃅s and women’s brains process pain using different circuits. Some pain scientists feel it is only a matter of time before painkillers are formulated differently for men and women in order to compensate for this difference.

While pain has long been considered a bothersome female complaint, our discomfort has sometimes been trivialized by healthcare providers, rather than being treated as a legitimate symptom of something being physically wrong. Since more studies are now being done on female subjects, it appears science is realizing that our pain is not in our heads, but rather in our wiring.

When studies are conducted where women and men are subjected to the same irritant, women usually give it a higher pain rating. Why is chronic pain more common in women? In many instances, such as with autoimmune disorders, pain affects women more drastically because they often are dealing with the insomnia, fatigue, loss of appetite, muscle atrophy, and depression that goes along with these types of disorders.

Women are also more sensitive to the same sensations and less tolerant than males due in part to their brain chemistry which ebbs and flows during the menstrual cycle. Hormones have also been linked to many of the painful disorders we mentioned earlier like rheumatoid arthritis, irritable bowel syndrome, fibromyalgia, migraines and TMJ – and it appears that the problem does not dissipate with age. A recent study suggests that hormone replacement therapy may actually aggravate TMJ even in healthy menopausal women, with the women on HRT reporting more pain–sensitivity than those who were not.

From arthritis to migraines, scientists are also finding differences in how men and women respond to the pain of common diseases and disorders:

• Women suffering from arthritis report significantly more severe pain
• Pre–menopausal women dealing with cardiac problems have higher rates of false–positive chest pain syndromes, while post–menopausal women have relatively high rates of asymptomatic or silent heart disease.
• Women are more likely to have high blood pressure and diabetes as complicating medical problems which can change the way they experience pain

Further evidence also suggests men and women respond differently to certain types of drugs which include analgesics used to treat pain. Development of new pain medications and old pain medications in new combinations may allow women to benefit from more effective pain relief in the future.

Women are three times more likely to experience migraines than men, beginning at puberty when hormone fluctuations kick in. They seem to strike whenever estrogen, the neurotransmitter serotonin, and beta endorphins are low.

A migraine usually is a throbbing headache that occurs on one or both sides of the head. The headache typically is accompanied by nausea, vomiting or loss of appetite. Activity, bright light or loud noises can make the headache worse, so someone experiencing a migraine often seeks out a cool, dark, quiet place. Most migraines last from four to 12 hours, although they can be shorter or sometimes much longer in duration.

Many migraine sufferers report unique sensations that occur before the headache strikes. This is known as a prodrome, and the symptoms may include fatigue, hunger, and nervousness. Once a severe migraine headache has ended, many patients report feelings of exhaustion that last a day or two.

Women dealing with migraines often report visual changes that include a sort of aura. In a typical aura, a person suddenly develops blurry or distorted vision, or begins seeing pulsating lights. These changes in vision can last up to 30 minutes, sending a sort of alert that a headache is about to begin. Sometimes, an aura can also affect the sense of hearing, smell or taste. You should know that everyone who gets migraines does not experience these auras.

Migraines can be triggered by certain activities, foods, smells or emotions. Some people are more likely to experience migraines when they are under stress, while others develop migraines when stress is relieved (for example, the day after exams or an important meeting). Migraines also tend to run in families.

In the United States, migraine prevalence is highest among Caucasians, followed by African–Americans and Asian–Americans. While differences in socio–economic status, diet, and symptoms may contribute to a variation of migraine’s prevalence, it is believed that race–related differences in genetic vulnerability to migraine are more likely the reason for this disparity.

Although millions suffer from migraines, scientists are still trying to understand exactly why they occur. It is believed that the pain of migraines results from swelling in blood vessels and nerves surrounding the brain. This swelling may be triggered by changes in chemicals and electrical activity in a primitive part of the brain known as the brain stem. The brain chemical serotonin appears to play an important role in this process as it does in other conditions, including depression and eating disorders. However to–date, the causes of changes in brain stem activity and serotonin levels are still not well understood.