Wimps And Whiners: Do Men, Or Women, Tolerate Pain Better?

Women, popular belief has it, tend to tolerate pain better than men. If you're a mother who has ever experienced unmedicated labor, you might find it especially funny to check out some of the videos around the web in which men try labor simulators during which a pain that mimics that of contractions is delivered to guys' abdomens, backs, and thighs. They are, of course, writhing in pain after mere minutes, declaring a new-found appreciation for their mothers.

Are women naturally "better" at pain because they're biologically designed for childbirth? Are they just, as some people say, more stoic about pain because doctors tend to take women less seriously when they are in pain so they have learned to simply suck it up? Or is, perhaps, the idea that women handle pain more easily than men actually false? Let's take a look at what science has to say about that. 

How Does Pain Actually Work?

When our body meets a pain stimulus, that's immediately picked up by nociceptors. Nociceptors are a kind of nerve ending that's found all over the body. They detect all kinds of other stimuli besides pain as well, including temperature and pressure, but don't get activated as easily as some other receptors. Because nociceptors have a higher activation threshold, they essentially let you know that something big, to which you should pay attention, is happening.

Research as far back as the 1960s discovered that the brain can and does modulate and alter the nervous system in response to pain, meaning that the brain plays a much more flexible role in pain perception that was previously believed. This is where things get really interesting: it could be that women and men have Differing pain modulation systems, and that the hormone estrogen plays a significant role in how women react to pain.

What Do Patient Reports Say?

Pain is a subjective experience, and therefore rather hard to measure. So how can it be done? One underused but readily available resources is a sea of electronic medical records. One research team from Stanford University decided to make used of these EMTs by looking at pain levels self-reported by 11,000 patients. The patients' pain levels were recorded, but the diagnoses made didn't specifically seek to diagnose pain. You know how doctors often ask you to rate your pain levels on a scale from one to 10? Well, the researchers found that women had higher average pain ratings than men did, especially in cases of acute inflammation. The report actually concluded that "pain in women is underdiagnosed and undertreated". 

Does that mean that women are actually less tolerant to pain than women, then? Interestingly, not necessarily. This is where hormones come in. The study found, for instance, that migraine prevalence is roughly equal among boys and girls pre-puberty, while adult women get migraines much more frequently than adult men. Those women who used hormone replacement therapy after the menopause, and those women who used hormonal contraceptives, were also shown to be at a higher risk of experiencing several types of pain. It may not be that women react differently to the same pain stimuli, but that they are more likely to experience certain kinds of pain.

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On the other hand, men are notorious for crumbling completely when they get the flu. Denigratingly dubbed the "man flu", this phenomenon was recently proven to be a science fact — because men's immune systems don't have the benefit of added estrogen, men get worse cases of the flu!

Pain: What About Socialization, Then?

Despite the seemingly rather prevalent belief that women handle pain better than men, historically, men were expected to be tough and strong, while women were expected to be more vocal about any pain they were experiencing. Such attitudes actually still exist today. The Gender Role Expectations of Pain (GREP) study found that both men and women expect women to be more sensitive to pain, more likely to report it, and less able to cope with it. Yet another study revealed that women believed talking about their pain openly to be more acceptable than men — revealing that men don't necessarily experience less pain, they're just less likely to admit it.

It is, therefore, rather hard to find out whether one sex is actually more tolerant of pain than another — no matter where in the world we find ourselves, we live in a society where men and women aren't socialized in the same way, and the same holds true for every society that came before ours.

Is Women's Pain Taken Less Seriously?

"Women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively", one paper noted. It's true — while men visiting an Emergency Room in the US wait an average of 49 minutes before being given painkillers for acute abdominal pain, their female counterparts have to wait, on average, 65 minutes. They're also given opioid pain relief up to 25 percent less often, and another study shows that female cancer patients were much less likely to receive adequate care for their pain.

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Perhaps even more shockingly, a 2001 study showed that women who looked more physically attractive had a significantly lower chance of being taken seriously when they reported they were in pain. 

What Now?

The bottom line, then, is that pain research is still an emerging field. Interesting discoveries are being made all the time, discoveries such as, for instance, the finding that kappa-opioid medications work better for women than they do for men. As research continues, pain relief may be tailored to a person's sex and pain will be treated more effectively. However, it is all of us, as a society, who have to tackle discriminatory and outdated notions — whether they are that men are wimps, or that women are whiners.