Doctors told to heed painful truth on different ways the sexes suffer

Published on Monday 18 August 2008 19:56

WOMEN are being left in pain because doctors do not listen to them and they are forgotten in clinical research, a conference heard yesterday.

The World Congress on Pain in Glasgow heard women were three times more likely than men to suffer headaches and four times more likely to have irritable bowel syndrome. They also took more painkillers.

Experts said there were gaps in the care women received, leading to delays in diagnosis of the causes of their pain.

The conference also heard calls for more guidance and research focusing on the different ways men and women responded to treatment.

It comes after the NHS was criticised over its management of chronic pain, with one expert telling The Scotsman patients were being "fobbed off" with higher doses of painkillers rather that getting other kinds of care.

Yesterday author Hilary Mantel warned women were being ignored when they went to their doctor complaining of pain. Ms Mantel has suffered the painful condition endometriosis since she was a teenager, but went undiagnosed until she was 27, when she needed radical surgery which left her unable to have children.

Ms Mantel said the condition, in which cells like those found in the womb lining grew on organs outside the womb, causing pain and bleeding, had a "devastating influence" on her life.

"For years I was told I was imagining the pain," she said.

Ms Mantel said she knew from her role as patron of charity the Endometriosis SHE Trust that this was still happening.

"When someone says to a doctor they are in pain, whether that is a woman or a child, you should start from the position of believing them and listening to them," she said. "That may sound blindingly obvious but in my experience that is not always the case."

Professor Maria Giamberardino, from the University of Chieti in Italy, told the conference – attended by almost 6,000 delegates from around the world – research showed women were more likely than men to suffer several painful conditions.

She said women suffered headache three times more often than men, four times as much irritable bowel syndrome and seven times as much fibromyalgia.

Prof Giamberardino said women could suffer several conditions together, making pain even worse, but effective treatment of one condition could reduce the effects of another.

Another expert called for more research and guidance on treating pain in women. Anita Holdcroft, emeritus professor of anaesthesia at Imperial College London, said men and women reacted differently to drugs such as morphine. At the moment, she said, there was no official guidance on pain management that was gender-based.

"And yet there is more and more evidence coming out about this," she added.

The researcher said international research showed differences between men and women after surgery, with women more likely to suffer adverse effects.

"But it may be that drugs work differently in men and women," Prof Holdcroft added.

"We need to recognise if a woman isn't responding that she might need something else or a different type of drug and not just say 'she's a woman' and leave her in pain."

Dr Michael Serpell, a consultant anaesthetist in Glasgow who helped organise the conference, said much pain research was under way in Scotland.