Pain physicians often see more women than men in practice. Some pain-related diseases have a definitively higher frequency of occurrence in women compared to men. Fibromyalgia, for instance, is at least three times more common in women. Many rheumatologic conditions and headache problems are also more common in women. As science has become more sophisticated, we are beginning to obtain some of the reasons that pain is more frequent in women.
Estrogen and Testosterone
At this time, one of the leading hypotheses is that estrogen in women and testosterone in men impact nerve sensitivity. Research is indicating that estrogen increases the sensitivity of nerves. Women have more estrogen and thus are more sensitive to painful conditions. The connection is especially evident in fibromyalgia, where there appears to be a global increase in pain sensitivity throughout the body.
Testosterone is the opposite of estrogen, and men have much higher levels of it than women. Testosterone appears to be protective and decreases overall pain sensitivity. Young men often appear to endure more severe painful activities. It is common to watch men power through injuries during athletic competition as testosterone attempts to lessen the pain.
As men and women age, estrogen levels and testosterone levels begin to drop, and the difference in levels is less pronounced. As a specialist, I see a more even distribution between men and women with pain as patient age increases.
The answer of hormone replacement for men or supplements in women is much more complex. As we are studying hormone replacement in both women and men, it appears the side effects and dangers of supplements may be significantly more dangerous. Rates of cancer and other complications tend to increase with hormone adjustments. At this time, it is probably not a great idea to treat most pain with hormone adjustments.
Science is giving us some unique insights into pain. Unfortunately, it is often just making our understanding of pain more complex. In the future, it may lead to better pain treatments, however now we just know that hormones do influence our pain perceptions in some manner.