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9 min read
Sarah Sinclair
The vast majority of patients experiencing chronic pain are women, yet one in two say they have had their pain “ignored” or “dismissed”. We take a close look at the gender pain gap.
The gender pain gap is not a recent phenomenon. Historically, there have been huge disparities in how women, and those who identify as female, have been treated in fields of science and medicine.
Yet only recently has this been brought into the public discourse, with reports highlighting the experiences of countless women who feel they have been dismissed by healthcare professionals as a result of their gender.
We examine why this has led to many seeking alternative therapies outside of conventional medicine, including medical cannabis treatment.
Despite 70% of chronic pain patients identifying as women, many feel their symptoms are not taken seriously by medical professionals.
A 2022 study examining gender inequalities in pain across 19 European countries found that “significant gender pain inequalities exist across Europe” with the authors going as far as to describe it as a “public health concern”.
Published the same year, the first Nurofen Gender Pain Gap Index Report, revealed that many women felt their pain was “disproportionately ignored or dismissed” compared with men.
While awareness of disparities in healthcare has been growing, Nurofen’s latest Gender Pain Gap Index Report, which surveyed over 5,000 UK adults, found it had actually widened from 7% in 2022 to 11% in 2023.
Women are in pain more often and more severely than men, with one in six women experiencing pain everyday. In a 2017 survey by the UK government, women reported a higher prevalence of chronic pain than men. More women than men are likely to experience pains such as headaches (13% difference), stomach pains (9% difference) and migraines (6% difference), due to oestrogen in the menstrual cycle. But less than half (47%) of women surveyed received a diagnosis for their pain within 11 months, compared with two-thirds (66%) of men.
Yet one in two women surveyed said they have had their pain ignored or dismissed. And, nearly three-quarters felt gender discrimination was the reason a man's pain is taken more seriously by healthcare professionals.
There are many contributing factors which have led to such substantial differences in how women’s pain is treated, many of which are rooted in how they are viewed more widely in society.
The Nurofen Pain Index asked survey participants what they thought were the key contributing factors to the Gender Pain Gap. These included: women being expected to naturally suffer pain due to childbirth and menstruation; women not always being taken seriously because they are viewed as ‘emotional’; women’s pain being seen as ‘psychological’; and women being more likely to exaggerate their pain to get attention.
There are also biological differences in how women and men experience pain, but clinical trials have traditionally excluded women, with 80% of research being conducted on males.
Although we know that biology can play a major role in how diseases present, as well as the effectiveness of pharmaceuticals and medical devices, before 1993 women were rarely included in clinical trials.
Throughout history, women’s bodies have been considered ‘atypical’, with many researchers even avoiding conducting studies on female mice due to the additional costs and concerns that the fluctuating hormones and reproductive systems of females might impact the study results.
This was compounded following the thalidomide scandal in the 1970s, when the US Food and Drug Administration (FDA) introduced the National Institutes of Health (NIH) Office of Research on Women’s Health, largely excluding women of reproductive age from Phase 1 and 2 clinical trials.
It was only in 1993 that the US passed a law requiring the inclusion of women in clinical research.
As a result, the current model of medicine often fails to take into account the complexity of the female body and many women are still unaware of what can be debilitating health conditions such as pelvic inflammatory syndrome (PIS) or vulvodynia, which often go undiagnosed and untreated for years. Meanwhile, we still don’t know how well many drugs and medical devices actually work for women.
Today in medical schools male biology is often still considered the default and many doctors don’t receive specific training on the differences of female biology unless they choose a relevant specialism. In 2021, it was revealed that almost half (41%) of UK university medical schools do not have mandatory menopause education on the curriculum.
In 2020, a UK Government inquiry found that serious medical conditions were commonly dismissed as “women’s problems”, contributing to a string of healthcare scandals over several decades.
As these findings have come to light, recent efforts have been made to address the gender pain gap through further research and initiatives.
In the UK, the findings of the Government inquiry led to the launch of the Women’s Health Strategy for England, which aims to improve the health and wellbeing of women and girls over the next decade.
Elsewhere, the National Institutes of Health (NIH) in the US is funding studies specifically aimed at understanding sex differences in pain, while many universities and teaching hospitals are conducting their own research into the gender pain gap, including institutions like Harvard, Stanford, and the Mayo Clinic.
As part of the Gender Pain Gap Index Report, Nurofen has made a number of commitments to close the gap, including investing in women’s health research, working alongside organisations such as Wellbeing of Women, and offering free training for healthcare professionals.
Feeling let down by conventional medicine has resulted in many women looking for alternative options, from yoga and acupuncture to medical cannabis.
Since medical cannabis was legalised in the UK in November 2018, chronic pain has become the most common indication for which it is prescribed. This includes related conditions such as fibromyalgia, neuropathic pain, migraine and many more.
While research evaluating its safety and effectiveness remains in the initial stages, there is a wealth of real-world evidence that suggests medical cannabis can reduce pain and improve patients’ overall quality of life.
Women are reporting that they find prescribed cannabis medicines helpful in managing their health condition.The rebalancing of their endocannabinoid system may be particularly effective in the management of gender-specific conditions such as endometriosis, bladder and nerve pain, gynaecological pain and PMS.
Some women have also spoken about how it helps them manage some of the common symptoms of menopause, which can include poor sleep and anxiety.
Despite women thought to make up the majority of CBD consumers, research from the UK indicates that more men are currently accessing medical cannabis on prescription. As of June 2024 data from the Drug Science patient register T21 shows that 64% of medical cannabis patients identify as male, compared to 34% of women.
This could be due to a number of factors, including stigma. Women are often the primary caregivers for children or young people, and are more likely to hold jobs in health, social care and education.
It could also be that after years of being misdiagnosed and generally feeling unsupported by the medical system, women are less likely to seek out other healthcare professionals and may even experience trauma in medical settings. One US study from 2021 found that men report higher levels of support for medical cannabis from both specialist and primary care physicians.
There is still a lot we don’t know about how medical cannabis affects men and women differently, and researchers have called for more studies looking specifically at the effects in women and gender-specific health conditions.
But new research is on the horizon. A number of early studies have explored the experiences of women using medical cannabis for gynaecological conditions, with promising results in terms of both symptom management and quality of life.
Meanwhile in the UK, NHS Scotland recently granted funding for the first randomised control trial investigating the efficacy of a high-CBD medical cannabis product in the treatment of endometriosis.
While there is no quick fix when it comes to tackling inequalities in healthcare, there may be some reasons to be optimistic. With growing awareness, comes increased action.
Modern day clinical trials should be more inclusive and representative of all demographics, meanwhile, there are now dedicated research centres focusing solely on women’s health and pain management. Ever-advancing technology could also be harnessed to help better understand pain patterns and develop more effective treatments.
In the meantime, medical cannabis may offer a promising solution for those who have not had their needs met by more conventional treatments. Some patients report being able to function better day-to-day and return to work, which can, of course, boost their overall wellbeing and quality of life.
If you’re interested in trying treatment with medical cannabis, Releaf has a free eligibility checker and you can find out more about cannabis treatments for chronic pain.
It is important to seek medical advice before starting any new treatments. The patient advisors at Releaf are available to provide expert advice and support. Alternatively, click here to book a consultation with one of our specialist doctors.
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Check your eligibilitySarah, a distinguished journalist with over a decade in publishing and communications, now excels in cannabis health and policy journalism in the UK, advocating for informed health decisions through her award-winning work.
Our articles are written by experts and reviewed by medical professionals or compliance specialists. Adhering to stringent sourcing guidelines, we reference peer-reviewed studies and scholarly research. View our editorial policy.
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