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Is Pain a Gender Issue?

Posted on February 8th, 2016 by in Chemistry

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How sensitive are you to pain? Many women feel that men are more sensitive to pain (or at least make more fuss about it). They often cite childbirth as one of the many reasons females are so much tougher than males.

According to the authors of a review in Bioinorganic and Medicinal Chemistry Letters on ‘New Approaches to Treating Pain’, “how patients perceive and react to pain is influenced by social, cultural and psychological factors”. Perhaps, in some countries at least, it is socially acceptable for men to be more vociferous when in pain? Likewise, I think most of us realized early on that a doctor or dentist telling you “this won’t hurt” usually meant that it would. Depending on character, you quickly learnt to harden yourself against the inevitable or start screaming and crying.

Reading the article you realize that pain is a fascinating subject (unless you are suffering from it). Short-lived (or acute) pain is often uncomfortable but has the advantage, as its name suggests, of being of relatively short duration. Chronic pain is defined as lasting longer than 3 months. It is then strange to learn that more drugs are available to treat acute pain than chronic pain.

In the USA the financial loss of productivity due to chronic pain is said to be around USD 600 billion a year. Worldwide there are more than 1.5 billion chronic pain sufferers, so there would seem to be a ready market for new drugs. Perhaps the reason why more medication is available for acute pain is because most pain killers work by telling the brain that there is no pain. It is easier to sustain this illusion for a short period of time than for many years.

Pain can take many forms and while sometimes the source of it is obvious (such as a cut finger or a dentist’s drill) at other times it can be difficult to locate and treat. Lower back pain, for example, is notoriously difficult to treat. According to the American Pain Foundation only one in four patients receives effective treatment for pain. One area now receiving a lot of attention is the pain caused by cancer treatment.

How do you measure pain when the effect on every individual is different? Just brushing against the skin is painful for some individuals: in contrast, there are examples of people desensitizing themselves to pain so that they can walk across fire or stick needles into themselves. I know a lot of people are very insensitive to others’ pain (it’s easy when it does not hurt you) and it is sometimes be very difficult to find a doctor who will take your pain symptoms seriously.

It is strange to think that some of the most common painkillers, such as aspirin and opiate derivatives, were known to our Neolithic ancestors (but not in handy blister packs). Developments in the past 50 years have concentrated on modifying the signals received by the brain to improve the effectiveness of drugs. Another method is to alter the signaling paths so that fewer signals are received in the brain. Drugs developed for other uses such as antidepressants or anticonvulsants are also proving to be effective for some types of pain. Research has improved our understanding of the various ways that pain is signaled which, in turn, makes it easier to find the correct medication to relieve a particular type of pain.

Despite the major advances in medication it seems that there is still a long way to go in the development of effective, long term pain relievers.

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