Feature Article

Managing women with persistent pain

Meredith Craigie



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.