Kate Collins of Kentucky fought for 10 years, beginning at age 18, to have a hysterectomy to stop “extreme pain and extreme bleeding” that caused vomiting and depression. Her periods could last as long as nine months, with abdominal bloating so hard and painful that she was unable to stand. Over the next decade, Collins recounted by email, doctors frequently told her such things as “some women just have bad periods” and “there’s nothing more we can do for you.” Many refused to give her a hysterectomy due to her young age: “One doctor told me when I was 19 to have a baby that I didn’t want and couldn’t afford,” says Collins. Another asked, “Aren’t you worried about what your future husband might want?”
Since tests did not reveal any abnormalities, doctors continued to throw up their hands or put her on birth control pills. “As long as the tests came back normal, people didn’t believe me.” A decade later, Collins finally found a doctor who offered her a hysterectomy. “I feel wonderful. I got my life back,” she says.
Many women have their pain dismissed as hormonal — which can be code for “emotional” or “not real.” However, a growing body of research acknowledges that hormones may play a very real part in pain sensitivity. While research into the mechanisms of pain is subject to variability as women’s hormones fluctuate across the menstrual cycle or during hormone treatments, women’s sensitivity to pain may be heightened by gonadal steroid hormones, which are produced by sex organs. A 2010 study in the journal Metabolism notes that boys and girls, who have the same approximate chance of migraines prior to puberty, see a dramatic change after puberty: The risk of migraines is three times higher in women than in men. Even more telling, according to the same study, transgender women undergoing hormone treatment with the female sex hormones estradiol and antiandrogens experienced more frequent incidences of chronic pain than transgender men treated with testosterone.
Furthermore, women’s inflammatory processes are more active than men’s, which is linked to greater incidences of inflammatory autoimmune diseases known to cause chronic pain, such as rheumatoid arthritis, lupus, and collagen vascular disorders, as well as an overall increased pain sensitivity.
While there is plenty of piecemeal evidence of variance in pain sensitivity between the sexes, there is still a great deal of research to be done and psychosocial factors to be taken into consideration. If nothing else, women’s testimonies about their pain and its treatment suggests a need for better training among medical professionals.