Being in pain is an incredibly lonely place, no matter who you are. But not everyone’s pain is treated equally. The UK government’s Women’s Health Strategy for England points out that healthcare still makes men the default in research and clinical trials. This means that women’s pain is consistently under-researched, under-treated, and less well understood.
Nurofen’s Gender Pain Gap Index Report1 revealed that one in six women experience severe pain every day, and more than half of women feel their pain is ignored or dismissed; for those who felt that way, one in four women said no one took their pain seriously. But what can we do about it?
My life with chronic pain began in 2015, when a series of viruses and an unfortunate whiplash injury triggered bizarre symptoms that I still live with today. Over the past few years, I’ve received a number of diagnoses to explain my pain, but my earliest interactions with doctors were marked by disbelief and dismissal – even when I became housebound.
Put simply, I’m no stranger to the real-world effects of the gender pain gap. And while individual actions can’t fix systemic bias, there are a few techniques I’ve developed to better advocate for myself as a patient.
Recently, I spoke to Dr Hannah Barham-Brown, a GP and disability rights campaigner, who has experienced the issue from both sides of the doctor’s desk. Between us, we discussed my tips for self-advocacy, and the reasons why they might be effective.
1 Keep a pain diary
“Pain diaries can be so useful to us as medics,” Barham-Brown told me. “But be prepared for us to need time to look at them. We might not be able to do it properly the moment you hand it over.”
When you live with pain every day, it can be difficult to notice how it changes over time. But by setting out a clear diary on paper, you may notice specific triggers or times of day when your symptoms flare. Even if you don’t notice anything obvious, it might be that your doctor will.
“When we’re experiencing pain, it can be really hard to consider it objectively,” Barham-Brown says. “Having a professional look at a pain diary with fresh eyes may highlight particular triggers for flares, give an idea of timings, and help us to construct not only a management plan, but methods to reduce it.
“Often, we can’t remove all of the pain, but we can work to make it manageable, and this is a key step.”
2 Explain your pain in recognisable terms
Unfortunately, language can be a barrier to accessing care. “Pain” is a vague term, encompassing both the subtle sting of a papercut and the agony of a broken bone. By developing specific words to describe not just the intensity, but the quality of the pain, you can help a doctor move closer to diagnosis.
“I often ask people to describe the ‘character’ of their pain,” says Barham-Brown. “Stabbing pain may well have different causes to aching pain, for example. I’ve developed a whole range of descriptors for my own pain, from ‘a toothache, but in the joints’, to ‘like someone has a screwdriver in my hip socket and is wrenching the bones apart’.”
Describing the ways in which pain has changed your day-to-day life can also be useful in helping a doctor to understand.
“This works well, particularly in the context of explaining what your ‘normal’ is,” Barham-Brown told me. “For instance, saying: ‘Normally I can do 10 minutes on the exercise bike without much discomfort, but today I can’t even climb on it,’ gives us context.
“Pain is so individual, and people’s coping mechanisms vary hugely. It’s the changes to your normal that help us.”
3 Bring an advocate with you
I find it endlessly frustrating that the moment I started to bring my male partner with me to medical appointments, I also started getting taken more seriously. Particularly if he then discussed how my pain affected him.
Barham-Brown tells me that while it can be helpful to have someone accompany you, this advice comes with a caveat.
“If it helps you feel heard, or you struggle to explain what’s going on, this can be really useful,” she says. “But do think about who you’re bringing and what you’re comfortable with them hearing.
“Firstly, there’s little more disruptive to an appointment than your well-meaning but very enthusiastic Auntie Flo taking it over, and not allowing you to be heard. Secondly, you may not be able to anticipate everything we’ll ask.
“You might not feel comfortable chatting about your sexual history in front of chatty Flo, for example. But having two minds present is often helpful, as a good advocate can help ensure that everything is covered appropriately.”
4 Confirm next steps
Medical appointments are overwhelming at the best of times. But if you’re in pain, and frightened, and aren’t feeling as though you’ve been heard, asking a doctor to summarise your discussion at the end can be helpful. This summary can help make sure that you both understand what’s been discussed, and makes it clear whether or not your doctor has a follow-up strategy in mind.
“Do feel free to take in and make notes to clarify things,” Barham-Brown advises. “If it’s a specialist, check they’ll be copying you into any letters they send to other health professionals, as these are often really comprehensive.
“I tend to ask: ‘Is there anything you need me to be doing whilst you do X or Y?’, or: ‘To ensure my understanding, the next steps are X, Y, Z?’ As a patient, this helps me make sure that I have the information I need, without feeling like I’m being combative.”
Ultimately, disparities in healthcare can’t be overcome by individuals alone, which is why research such as Nurofen’s Gender Pain Gap Index Report is so important. But no matter who you are, your pain deserves to be taken seriously. Learning how to advocate successfully may help you to access the treatment you need.
If you want to learn more about the Gender Pain Gap and read the full Gender Pain Gap Index Report commissioned by Nurofen visit nurofen.co.uk/see-my-pain
1 GPG Index Survey References Document (26.08.2022 16.00GMT)
Nurofen 200mg Tablet for short-term, mild to moderate pain. Contains Ibuprofen. Always read the label. RKT-M-18834
