The pain of childbirth – experienced by women throughout the world every day – is considered to be one of the worst pains humans can bear. But women don’t have to give birth to know more pain than men.
研究表明，女性比男性更容易出现疼痛的肌肉骨骼问题和自身免疫疾病。例如，纤维肌痛的发病率是男性的七倍，而类风湿性关节炎的发病率是女性的两到三倍。狼疮是一种影响关节、皮肤和内部器官的疼痛性疾病，女性患狼疮的几率是男性的九倍。此外，患有紧张性头痛、肠易激综合征和骨质疏松性骨折等一系列疼痛问题的女性人数也超过了男性。
Differences in Pain Perception
就像女性比男性更容易出现许多疼痛症状一样，研究表明，女性对疼痛的感受往往也更强烈。加州斯坦福大学医学院的疼痛心理学家Beth Darnall博士说:“女性更频繁地报告疼痛，对疼痛刺激的耐受性较低。”
In other words, even when men and women have problems that appear the same, women tend to feel and express more pain as a result.
Two recent studies of men and women with knee osteoarthritis – a condition that affects the sexes relatively equally – bear this out. In the first, published in 2014 inOsteoarthritis and Cartilage, researchers assessed pain in 2,712 men and women with knee OA. The researchers found that women generally reported greater knee pain than men even when the severity of OA as shown in x-rays was equal. The difference was greatest in women with widespread pain, suggesting that central sensitization – a condition in which the nervous system becomes highly activated – may be an important contributor to pain in this group.
In the second study, published in 2016 inArthritis Care & Research, 288 men and women with knee OA completed a battery of pain assessments measuring their responses to cold, heat, mechanical pressure and pin-pricks applied to specific points on the skin. When compared to men, women exhibited greater sensitivity to pain stimuli, as well more widespread pain. These results suggest that enhanced central sensitivity may be an important contributor to pain in the women.
Why Women?
达尔说，对于为什么女性会经历更痛苦的问题或更严重的疼痛，没有一个单一的答案。可能的因素包括男女之间的激素和神经系统差异。
She explains that women’s hormones are different from men’s, and “that is tied into the experience of pain.”
Studies on laboratory animals suggest the male hormone testosterone may provide a protective effect against pain. Researchers at Washington State University found that depriving male baby rats of testosterone made them more sensitive to pain, while giving testosterone to baby female rats made them less sensitive. When the male rats reached adulthood, giving them testosterone reversed their pain sensitivity.
“Women are also more prone to anxiety and depression, and these psychological factors and central nervous system functioning can put women at risk for greater pain,” says Darnall.
Rethinking Treatment
If pain is different in men and women, experts suggest that treatment should be too.
Many currently used pain treatments were developed when clinical trials largely excluded women. The effectiveness of some pain relievers may not have been adequately studied in women, and some have now been shown to be less effective in women. For example, in a 2003 study published inAnesthesia and Analgesia,researchers found that women required 30% more morphine than men to control their pain following a surgical procedure.
Furthermore, narcotic pain relievers can have harmful side effects in women, including risks to their babies if the drugs are taken during pregnancy or while breastfeeding, says Darnall.
To successfully treat pain, women may need to focus treatment on psychotherapy and other mind-body treatments for pain, anxiety and depression. Women may also need different drugs or different doses of drugs than are used in men.
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Mary Anne Dunkin for the Arthritis Foundation