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Feature Article

Managing women with persistent pain

Meredith Craigie

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Abstract

Women frequently present to GPs with persistent, often multiple complaints of pain. Consultations can be challenging, so recognising the many facets of the pain problem and formulating a comprehensive approach to assessment and management may ease the pain for all affected women.

Key Points

  • Women report a higher incidence of pain conditions, multiple pain sites and pain-related disability than men.
  • A higher incidence of anxiety and depression is observed in women and this exacerbates persistent pain conditions.
  • Sex and gender differences have been demonstrated in nociceptive pathways, endogenous opioid systems, cognitive appraisal of pain and social acceptability of pain complaints.
  • Visceral pain syndromes are common but are often hidden causes of persistent pain in women.
  • A biopsychosocial approach to pain management leads to better outcomes.
  • Oestrogen and progesterone play important roles in pain modulation and can be manipulated as part of the pain management strategy.

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