For centuries, women’s pain has been misunderstood, minimised, or labelled as “emotional”. The historical roots of this bias run deep, dating back to Hippocrates, who described “hysteria” as a condition caused by a wandering uterus. Although modern science has progressed, echoes of this outdated thinking persist. Research continues to show that women’s pain is often dismissed or treated less urgently than men’s- a reminder of how gender, emotion, and psychology intertwine in the experience of pain.
Pain is not purely physical- it is deeply influenced by emotion. Studies reveal that emotions with negative valence and low arousal, like anxiety, can amplify pain, while high-arousal emotions such as fear may temporarily dull it. On the other hand, positive emotions, even mild ones, consistently reduce pain perception. For instance, when faced with threat-related situations, women tend to experience stronger emotional reactions, making them more sensitive to pain. Men, conversely, may experience more pain relief from positive stimuli such as pleasure or reward. This emotional modulation suggests that the mind plays as much of a role as the body in how pain is processed.
Biology also contributes to the parity. Research shows that testosterone may reduce pain intensity, while estrogen’s fluctuating levels can heighten pain sensitivity-particularly during menstrual phases. For example, women with conditions like fibromyalgia, endometriosis, or migraines often report heightened pain linked to hormonal changes. Moreover, women generally require high doses of opioid medication to achieve similar pain relief as men, possibly due to differences in how their opioid receptors and hormones interact.
Recent animal studies even suggest that the immune system and certain brain cells, like microglia, may regulate pain differently across sexes, hinting that the roots of these differences extend down to the cellular level.
Beyond biology, social expectations shape how pain is expressed and treated. Women often adopt emotionally focused coping styles, talking about their pain and seeking social support. Men, meanwhile, may use distraction or avoidance, sometimes masking their distress.
This difference has real-world consequences: while women report chronic pain more often, men are overrepresented in “deaths of despair”, such as suicide and substance misuse. Social conditioning affects not only how pain is expressed but also how it’s perceived by the sufferer and by healthcare professionals,
From longer emergency wait times to misdiagnoses of conditions like endometriosis, women’s pain continues to be underestimated. A shift toward a biopsychosocial model, one that integrates body, mind, and environment, is crucial. Clinicians can help by validating women’s experiences, using multidisciplinary approaches (including therapy, physical rehabilitation, and mindfulness), and advocating for more inclusive research.
Pain is not “all in your head” but your mind can help heal it. Whether you are coping with chronic illness, trauma, or persistent discomfort, therapy can be a safe space to explore the emotional dimensions of your pain and regain control over your life. What if the key to understanding pain lies not in fighting it, but in listening to what it’s trying to tell us- about our emotions, our bodies, and our unmet needs?
At Imperfect Psychotherapy, we view pain through a biopsychosocial lens. By addressing both emotional and physical experiences, therapy helps individuals feel heard, validated, and empowered to heal beyond symptoms, reconnecting with their bodies and inner resilience.
