What I Learned from Pain Research
As a massage therapist who specializes in pain relief, I try to keep up on the most recent pain studies for my own knowledge. However, my joy at discovering a surprising fact is not always shared. People tend to get strangely angry with me about this one.
Men have a higher pain threshold and tolerance than women.
First let’s define some terms. “Threshold" is when someone begins to identify a feeling as painful. Their “tolerance” is when they can absolutely no longer stand the pain. In this case, I am talking about experimentally induced pain. Most studies use electricity or cold to create this effect. When I say “women/men”, I do not just mean people assigned female/male at birth, but also those who have chemically transitioned. (More on this later).
The information itself is almost as fascinating as the overwhelming “nuh uh!” reaction to it. I am a woman, and I was surprised to read this information, but by no means offended or defensive. Instead, I wondered why I have believed this. Have I been sexist all this time? I really did think that women had a higher tolerance and threshold than men! I wonder if this is because I subconsciously view women as weaker, and so I am impressed when they are not sensitive? Maybe it is because of exactly what everyone says when I tell them about this research. Women birth children, and have since the beginning of time. Having done that myself, I can definitely tell you the process is painful. But does enduring more pain and physical trauma something that makes one more tolerant to it… or less? While increasing exercise can raise someone’s pain threshold there is not much to suggest that repeatedly exposing yourself to pain is going to do any good (unless you are killing your nerve endings entirely).
My next question is “why”? Some scientists think that hormones might have something to do with it. I was delighted to see that studies have already been done on cisgender versus transgender patients using hormone replacement therapies. While there are not many of these studies, they do show that higher testosterone levels correlate with higher pain tolerances, while estrogen has the opposite effect. If regulating hormones can help manage pain, especially in chronic pain sufferers, this could be life-saving information. While I doubt a little testosterone would have the same effect as, perhaps, an opioid painkiller, the effect over time might cause someone to avoid taking an addictive drug instead.
Another answer to the “why” has not been studied in depth just yet, but seems obvious to me. Gender-roles and expectations of pain tolerance are a factor in our pain thresholds. Women are allowed to acknowledge pain from a young age, whereas men are supposed to be stoic. This internalization of gender-roles might not be at the forefront of our minds, but our bodies are only following our instructions. If we teach our nervous system it is not allowed to react for long enough, maybe it really will dampen our sensations. In the end, we are social creatures, and it is imperative to our survival that we do what is expected of us within society.
So… why are people so defensive when they learn this?
If I tell my students that the majority of people with osteoarthritis are over 75 years of age, they nod and accept this fact. Some raise their eyebrows and say, “Wow, I didn’t know that!” We then move on to talk about the types of arthritis more common in younger people. Surprising facts are not usually upsetting, certainly not to the point of attempting to deny the validity of the many, many studies that supply solid supporting evidence. Usually, someone in my class googles the issue angrily for a little bit, and at best comes up with a study saying men and women are equal in tolerance if you account for gender roles (like the study I linked earlier). There aren’t any studies that I have seen which conclude that women have a higher threshold/tolerance for pain than men.
In my experience, people only feel the need to be defensive when they are threatened.
I have not done or found any studies on this question, but I will throw out a few hypothesis of my own. I wonder if we humans think that feeling pain is a weakness. As a society, we are told this is true. People with chronic pain have to take days off, and in our capitalistic society, they are considered “weak” and “less” somehow because of those days spent unable to contribute in a way we can equate easily in the form of a dollar sign. A man who gets stabbed and says nothing at all about it is “stronger” than a man who gets stabbed and screams. Isn’t this a bit archaic? Is strength and fortitude really so simple? I assure you, pain is a biological function, just like hunger, thirst, and the need to pee. I am often dehydrated and have to constantly drink water and electrolytes, but no one thinks I am weak because I listen to my body’s needs. Why is it different when I say “ouch” after a bee stings me?
I don’t know if that hypothesis is right, but either way, I hope any women who read this know that if your pain tolerance does happen to be lower than a man’s, this says nothing of your strength or the things you have endured. In fact, maybe you are just a little more attuned to your own body and its silent language.
