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The Naked Truth About Women and Pain: Finding the Right Treatment

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Women, Hormones, and Pain

Experts aren't sure why women experience more chronic pain than men, but they suspect we may be built to feel it more acutely. "Women report more episodes of severe pain, as well as pain in more parts of the body, than men do," says Fillingim.

The physiology of chronic pain is a mystery. Normally, when the body is injured, the nervous system sends pain signals to the brain until the ailment heals. But with chronic pain, the process malfunctions, and the signals -- and the hurt -- continue.

For women, the likely culprits are female hormones like estrogen and progesterone, which regulate everything from sex drive to periods to pregnancy. Studies suggest that when estrogen levels are high -- typically right after a woman has her period or during pregnancy -- the brain releases natural painkillers, such as endorphins, that provide relief. When estrogen levels fall, the soothing effect disappears. "Women with a chronic condition, such as migraines, almost always report that pain gets worse premenstrually or during a period," says Allen Lebovits, PhD, an associate professor of anesthesiology and psychiatry at New York University Medical Center.

Hormones are just part of the picture, however. Intriguing new research showing that men and women respond differently to pain medication suggests that women's brains may be wired to process agony in a unique way. "The systems that transmit and control discomfort may be fundamentally different," says Fillingim. Scientists believe there may be an evolutionary reason for this: In prehistoric times, men couldn't afford to be sidetracked by pain because they had to hunt and kill their family's dinner. Women, on the other hand, had to be highly receptive to others' distress -- a baby crying, for example -- in order to ensure the survival of the species. Over time, the theory goes, this trait may have evolved into a sensitivity to pain.

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