Jan. 23, 2012 -- The question has been around as long as “he said/she said” has been a phrase: Basically, who is more capable of handling pain?

Though not likely to be the final word, new research shows that women may feel pain more intensely than men do, especially for specific types of pain.

Researchers mined electronic medical records from more than 11,000 men and women. They showed that across 47 diseases and painful conditions considered in the study, women said they felt significantly more pain than men in 14 of them.

As part of the studies, all participants rated their pain on zero-to-10 scales, where zero stands for “no pain” and 10 means the “worst imaginable” pain.

The difference in pain for women was most pronounced for musculoskeletal pain, such as low back pain and/or osteoarthritis. Researchers also identified gender differences in certain painful conditions for the first time, including acute sinusitis and neck pain.

In some cases, women rated their pain a full point higher than men did. Researchers were unaware of whether study participants were taking any medication prior to rating their pain.

The findings appear in the Journal of Pain.

Exactly why women feel more pain than men is not known, says researcher Atul Butte, MD, PhD. He is an associate professor of medicine and pediatrics at Stanford University School of Medicine in Stanford, Calif.  “We don’t know why. But it’s not just a few diseases here and there; it’s a bunch of them.”

Roger Fillingim, PhD, says the jury is in when it comes to differences in how the sexes feel and rate their pain. He is a professor in the College of Dentistry at the University of Florida in Gainesville. “The new study does give credence to the idea that men and women may have different pain experiences, and we need to understand that better so that we can treat pain more effectively in both men and women,” he says.
Treat the Person, Not the Gender

But blanket statements about treating pain don’t apply. “The new findings do not suggest that all women feel more pain than all men and need to be treated more aggressively," Fillingim tells WebMD. “Each person should be treated based on their symptoms, not their gender. We still need to individualize treatments for pain.”

Michael D. Lockshin, MD, reviewed the findings for WebMD. He is a professor of medicine and obstetrics-gynecology at Weill-Cornell Medical Center and the director of the Barbara Volcker Center at the Hospital for Special Surgery, both in New York City.

Differences between men and women may be the result of cultural, hormonal, and/or anatomical issues, he says. At the end of the day, it is not the “why” that matters: “A person’s pain report is not something physicians should be making judgments about. We need to accept the idea that what patients are reporting is real and respond accordingly. Pain is an invisible and subjective symptom,” he says.