Gender and Pain Research

By Christine Cupaiuolo — December 28, 2006

Back in September I mentioned “The Painful Truth,” a University of Maryland conference on gender and pain research. I haven’t read much about it since, but the Washington Post recently ran an interesting piece about how women and men respond to and treat pain that picked up on some of the research presented at the conference. Francesca Lunzer Kritz writes:

[The] goal at the University of Maryland meeting was not just to update research. The idea was also to devise guidelines to help standardize future research, says Joel Greenspan, a professor in the department of biomedical sciences at the dental school and a chairman of the pain conference. Without this, Greenspan says, it will be harder to compare findings or apply them in clinical practice.

For example, since studies show that men’s tendency to delay pain treatment increases their risk during a heart attack, should pain scales be sex-specific to ensure more-prompt care? Or should women in a clinical trial of pain medication all start painkillers on the same day of their menstrual cycle so that researchers can factor in how estrogen might relieve or exacerbate pain — and whether women need different doses of pain relievers than men?

Answers to these and other questions are expected to be published in a pain journal next year. For now, says Lee Ann Rhodes, an internal medicine specialist and head of the pain center at the Washington Hospital Center, there is not enough evidence to steer patients toward different pain relief options at the start of treatment on the basis of sex alone.

Kritz begins the article with a personal story detailing the speed with which she’ll down three 200-milligram ibuprofen tablets to quiet a headache so she can move on with life, as compared to her husband, who typically delays any form of treatment until the pain is unbearable. All of which reminded me of an excellent book, “All in My Head,” by Paula Kamen, billed as “a black comedy, a candid memoir and an informed journalistic report.” Here’s more from the book description:

It’s about my often absurd struggles to try to cure (but ultimately manage) one long 15-year migraine (now diagnosed as “chronic daily headache”), through odysseys through the extremes of both Western and alternative medicine.

Meanwhile, the book stops to address different “big picture” issues involved, such as framing chronic pain as a “women’s issue.” This book is the first one written on “chronic daily headache,” a constant or near-constant headache, that affects about 4-5 percent of the population (and about 10 percent of women of childbearing age).

Check it out. Paula also maintains a good list of websites, articles and academic resources on women and pain.

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