The Discrimination in Your Doctor's Office

Women ache more often than men, but guys get better pain relief from doctors. What’s going on? And what can you do about it?

By Alice Lesch Kelly
dr doctor pain discrimination hand prescription Rx
Photograph: Oleg Prikhodko

For four years, Candy Pitcher experienced agonizing back pain from a spinal fracture she suffered while cutting down a tree. And for four years, a series of doctors, including neurosurgeons and orthopedic surgeons, failed to relieve her misery. “They didn’t take me seriously,” complains Pitcher, who lives in Cary, North Carolina. “One doctor entered the exam room and said, ‘There’s nothing I can do for you. Lots of people suffer from back pain—you just need to learn to live with it.’ And that was before he had even examined me!” she says.

While Pitcher ultimately found a compassionate physician who has ameliorated her discomfort, plenty of other women can recount stories about doctors who brushed off their pain. Cynthia Toussaint of Los Angeles spent 13 years hearing from MDs that she was imagining her pain, which began in her right leg after a ballet injury, then spread throughout her body. “One doctor patted me on the head and said, ‘Darling, you’re making a mountain out of a molehill.’ Then he sent me to a psychiatrist,” says Toussaint, who was eventually told she had a condition known as complex regional pain syndrome. Toussaint was so outraged by that doctor’s cavalier attitude that in 2002 she founded For Grace, a nonprofit organization dedicated to addressing gender disparity in pain treatment.

Research corroborates the experiences of these women. For instance, in a study reported last year in the Journal of Pain, University of Michigan Health System researchers found that doctors at a specialty pain center prescribed strong opioid painkillers to 33 percent of male patients with chronic pain but only to 21 percent of female patients in the same situation. Similarly, a 2008 analysis of an urban hospital emergency room’s experiences concluded that women with abdominal pain were 7 percent less likely than comparable men to receive pain relievers—even though the two sexes had almost the same pain scores. It also took women longer to receive pain medication: 65 minutes versus 49 minutes. “Women are treated less often for pain than men,” concludes Scott M. Fishman, MD, chief of the division of pain medicine and a professor of anesthesiology at the University of California, Davis.

The irony is that on a daily basis, women tend to experience more discomfort than men, notes Roger Fillingim, PhD, a University of Florida, Gainesville, psychologist and pain researcher who was the lead author in a 2009 review of studies on sex, pain and gender in the Journal of Pain. Women are much more likely to suffer from long-lasting conditions that can cause pain, such as fibromyalgia (tenderness in joints, muscles, tendons and other soft tissues), osteoarthritis in the hands and knees, irritable bowel syndrome and migraine headaches. Plus, the odds are higher that a woman, not a man, will have more than one painful condition at a time.

So why are women in pain being brushed off? And what can you do if you’re the one suffering?

Women Seen as Tougher
One explanation for the brush-off: “Many doctors believe that women can handle more pain than men,” says Fishman. This is presumably based on women’s ability to get through childbirth. However, “it’s abundantly clear that women tolerate pain less well than men do,” says Fillingim. In his studies, volunteers are subjected to a painful stimulus—for example, placing their hands in a bucket of ice-cold water—and are asked to endure it until it becomes intolerable. Women nearly always give up sooner, an outcome consistent with findings by other pain researchers. Fillingim has also shown that women have a lower pain threshold, the point at which a stimulus starts to hurt.

First Published March 21, 2011

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