A new government inquiry will examine women’s pain and treatment. How and why is it different?
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The Victorian government has announced an inquiry into women’s pain. Given women are disproportionately affected by pain, such a thorough investigation is long overdue.
The inquiry, the first of its kind in Australia and the first we’re aware of internationally, is expected to take a year. It aims to improve care and services for Victorian girls and women experiencing pain in the future.
The gender pain gap
Globally, more women report chronic pain than men do. A survey of over 1,750 Victorian women found 40% are living with chronic pain.
Approximately half of chronic pain conditions have a higher prevalence in women compared to men, including low back pain and osteoarthritis. And female-specific pain conditions, such as endometriosis, are much more common than male-specific pain conditions such as chronic prostatitis/chronic pelvic pain syndrome.
These statistics are seen across the lifespan, with higher rates of chronic pain being reported in females as young as two years old. This discrepancy increases with age, with 28% of Australian women aged over 85 experiencing chronic pain compared to 18% of men.
It feels worse
Women also experience pain differently to men. There is some evidence to suggest that when diagnosed with the same condition, women are more likely to report higher pain scores than men.
Similarly, there is some evidence to suggest women are also more likely to report higher pain scores during experimental trials where the same painful pressure stimulus is applied to both women and men.
Pain is also more burdensome for women. Depression is twice as prevalent in women with chronic pain than men with chronic pain. Women are also more likely to report more health care use and be hospitalised due to their pain than men.
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Medical misogyny
Women in pain are viewed and treated differently to men. Women are more likely to be told their pain is psychological and dismissed as not being real or “all in their head”.
Hollywood actor Selma Blair recently shared her experience of having her symptoms repeatedly dismissed by doctors and put down to “menstrual issues”, before being diagnosed with multiple sclerosis in 2018.
It’s an experience familiar to many women in Australia, where medical misogyny still runs deep. Our research has repeatedly shown Australian women with pelvic pain are similarly dismissed, leading to lengthy diagnostic delays and serious impacts on their quality of life.
Misogyny exists in research too
Historically, misogyny has also run deep in medical research, including pain research. Women have been viewed as smaller bodied men with different reproductive functions. As a result, most pre-clinical pain research has used male rodents as the default research subject. Some researchers say the menstrual cycle in female rodents adds additional variability and therefore uncertainty to experiments. And while variability due to the menstrual cycle may be true, it may be no greater than male-specific sources of variability (such as within-cage aggression and dominance) that can also influence research findings.
The exclusion of female subjects in pre-clinical studies has hindered our understanding of sex differences in pain and of response to treatment. Only recently have we begun to understand various genetic, neurochemical, and neuroimmune factors contribute to sex differences in pain prevalence and sensitivity. And sex differences exist in pain processing itself. For instance, in the spinal cord, male and female rodents process potentially painful stimuli through entirely different immune cells.
These differences have relevance for how pain should be treated in women, yet many of the existing pharmacological treatments for pain, including opioids, are largely or solely based upon research completed on male rodents.
When women seek care, their pain is also treated differently. Studies show women receive less pain medication after surgery compared to men. In fact, one study found while men were prescribed opioids after joint surgery, women were more likely to be prescribed antidepressants. In another study, women were more likely to receive sedatives for pain relief following surgery, while men were more likely to receive pain medication.
So, women are disproportionately affected by pain in terms of how common it is and sensitivity, but also in how their pain is viewed, treated, and even researched. Women continue to be excluded, dismissed, and receive sub-optimal care, and the recently announced inquiry aims to improve this.
What will the inquiry involve?
Consumers, health-care professionals and health-care organisations will be invited to share their experiences of treatment services for women’s pain in Victoria as part of the year-long inquiry. These experiences will be used to describe the current service delivery system available to Victorian women with pain, and to plan more appropriate services to be delivered in the future.
Inquiry submissions are now open until March 12 2024. If you are a Victorian woman living with pain, or provide care to Victorian women with pain, we encourage you to submit.
The state has an excellent track record of improving women’s health in many areas, including heart, sexual, and reproductive health, but clearly, we have a way to go with women’s pain. We wait with bated breath to see the results of this much-needed investigation, and encourage other states and territories to take note of the findings.
Jane Chalmers, Senior Lecturer in Pain Sciences, University of South Australia and Amelia Mardon, PhD Candidate, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Plant-Based Alternatives for Meat Recipes
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝How about providing a plant-based alternative when you post meat-based recipes? I appreciate how much you advocate for veggie diets and think offering an alternative with your recipes would support that❞
Glad you’re enjoying! And yes, we do usually do that. But: pardon, we missed one (the Tuna Steak with Protein Salad) because it’d be more than a simple this-for-that substitution, we didn’t already have an alternative recipe up (as with the salmon recipes such as the Chili Hot-Bedded Salmon and Thai Green Curry Salmon Burgers).
Our recipes, by the way, will tend towards being vegan, vegetarian, or at least pescatarian. This is for several reasons:
- Good science suggests the best diet for general purpose good health is one that is mostly plants, with optional moderate amounts of fermented dairy products, fish, and/or eggs.
- Your writer here (it’s me, hi) has been vegan for many years, transitioning to such via pescatarianism and ovo-lacto vegetarianism, and so the skill of cooking meat is least fresh in my memory, meaning I’d not be confident writing about that, especially as cooking meat has the gravest health consequences for messing it up.
Note on biases: notwithstanding this writer being vegan, we at 10almonds are committed to reporting the science as it stands with no agenda besides good health. Hence, there will continue to be unbiased information about animal products’ health considerations, positive as well as negative.
See also: Do We Need Animal Products To Be Healthy?
…as well as, of course, some animal-based classics from our archives including:
We Are Such Stuff As Fish Are Made Of & Eggs: All Things In Moderation?
Finishing with one for the vegans though, you might enjoy:
Which Plant Milk? We Compare 6 Of The Most Popular
Some previous articles you might enjoy meanwhile:
- Pinpointing The Usefulness Of Acupuncture
- Science-Based Alternative Pain Relief
- Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
- What Does Lion’s Mane Actually Do, Anyway?
Take care!
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What Your Eyes Say About Your Health (If You Have A Mirror, You Can Do This Now!)
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In an age when doctors are increasingly pressed to get you out of their office quickly and not take the time to do thorough tests, having a good basic knowledge of signs and symptoms of disease has become more important than ever for all of us:
The eyes have it:
Dr. Siobhan Deshauer is back, this time working with Dr. Maria Howard, a Canadian optometrist, who advised behind-the-scenes to ensure the best information about these signs and symptoms and what they tell us:
- Color blindness test: Ishihara color test identifies color blindness; in the version in the video, seeing “74” is normal, “12” indicates red-green color blindness, and no numbers suggest complete color blindness due to genetics or retinal/optic nerve issues.
- Yellow sclera (scleral icterus): yellow sclera indicates high bilirubin from excessive red blood cell breakdown, liver damage, bile duct blockage, or Gilbert syndrome.
- Blue sclera: indicates thin collagen in the sclera, which can be linked to osteogenesis imperfecta, Ehlers-Danlos syndrome, and Marfan syndrome.
- Pink eye: caused by infections, autoimmune diseases, or trauma; persistent symptoms or associated pain/vision changes need medical evaluation.
- Physiologic diplopia (double vision): normal test where fingers appear doubled when focusing on different planes; absence may indicate amblyopia.
- Pinhole test (visual acuity): looking through a small pinhole can determine if glasses are needed for clearer vision.
- Nearsighted vs farsighted: nearsightedness risks retinal tears and night vision issues, while farsightedness increases the risk of glaucoma.
- Eye color and health: brown eyes lower cancer risk but higher cataract risk; light eyes higher cancer risk but lower cataract risk; sudden changes may indicate a condition.
- Kayser-Fleischer rings: golden-brown rings around the iris suggest copper buildup from Wilson disease, treatable with chelation therapy.
- Corneal arcus: gray/white ring around the iris indicates cholesterol buildup, normal with aging but concerning in younger individuals, signaling hypercholesterolemia or artery narrowing.
- Limbal rings: dark rings around the iris are generally aesthetic and not health-related.
- Red desaturation test: a difference in red color perception between eyes may indicate optic nerve or retinal issues.
- Eye twitching: often linked to stress, sleep deprivation, or caffeine; persistent twitching or muscle involvement requires medical attention.
- Pupillary reflex: pupil constriction in light; abnormal responses suggest trauma, overdose, or poisoning.
- Cataracts: lens cloudiness due to age, UV exposure, smoking, diabetes, or prednisone; also occurs sometimes in youth due to conditions like diabetes.
- Yellow spots (pinguecula and pterygium): sun damage, wind, and dust exposure cause yellow spots; protect with sunglasses to prevent progression impacting vision.
- Dark spots in the eye: includes freckles, moles (nevi), and melanoma; changes require medical evaluation.
- Hypnotic induction profile: eye roll test assesses susceptibility to hypnosis.
- Floaters: normal clumps in the eye; sudden increases, flashes, or curtain-like effects may signal retinal detachment.
- Retinal detachment: caused by aging-related vitreous shrinkage; treated with lasers, gas bubbles, or retinal buckles.
- Macular degeneration (Amsler grid test): wavy, fuzzy lines or missing vision spots may indicate this condition.
- Giant cell arteritis: no, that’s not a typo: rather it is about blood vessel inflammation that can cause blindness; treated with prednisone, symptoms include headaches and vision changes.
- Near point of convergence: focus test to detect convergence issues common with excessive screen time.
- Blepharitis: eyelid inflammation causing itchiness, burning, or flaky skin; treated with hygiene, antibiotics, or tea tree oil.
- Proptosis (Graves’ disease): bulging eyes due to hyperthyroidism; treatable with medications, radiation, or surgery.
- Ptosis (droopy eyelids): indicates myasthenia gravis, temporarily improved with the ice pack test.
- Night vision issues: caused by retinal problems or high myopia, not typically vitamin A deficiency in developed countries.
- Dry eyes: caused by screen time, smoking, medications, or autoimmune diseases; managed with lubricating drops, reduced screen time, and adjustments.
- Watery eyes: caused by irritation or blocked tear ducts; treated with lubricating drops or surgery.
- Retinoblastoma: rare childhood cancer detectable through flash photography showing one white pupil; early detection enables treatment.
For more on all of these plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
What Your Hands Can Tell You About Your Health
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Escape Self-Sabotage
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Stop Making The Same Mistakes
It’s easy to think that a self-destructive cycle is easy to avoid if you have no special will to self-destruction. However, the cycle is sneaky.
It’s sneaky because it can be passive, and/or omissions rather than actions, procrastinations rather than obvious acts of impulse, and so forth.
So, they’re often things that specifically aren’t there to see.
How to catch them
How often do you think “I wish I had [done xyz]” or “I wish I had [done yxz] sooner”?
Now, how often have you thought that about the same thing more than once? For example, “I should have kept up my exercise”.
For things like this, habit-trackers are a great way to, well, keep track of habits. If for example you planned to do a 10-minute exercise session daily but you’ve been postponing it since you got distracted on January the 2nd, then it’ll highlight that. See also:
How To Really Pick Up (And Keep!) Those Habits
Speaking of habits, this goes for other forms of procrastination, too. For example, if you are always slow to get medical check-ups, or renew your prescriptions, or get ready for some regularly-occurring thing in your schedule, then set a reminder in your preferred way (phone app, calendar on the wall, whatever) and when the appointed time arrives (to book the check-up, renew the prescription, do your taxes, whatever), do it on the day you set your reminder for, as a personal rule for you that you keep to, barring extreme calamity.
By “extreme calamity” we mean less “running late today” and more “house burned down”.
Digital traps
Bad habits can be insidious in other ways too, like getting sucked into social media scrolling (it is literally designed to do that to you; you are not immune modern programming hijacking evolutionary dopamine responses).
Setting a screentime limit (you can specify “just these apps” if you like) will help with this. On most devices, this feature includes a sticky notification in the notification bar, that’ll remind you “27 out of 30 minutes remaining” or whatever you set it for. That’ll remind you to do what you went there to do, instead of getting caught in the endless scroll (and if you went there to just browse, to do so briefly).
Here’s how to set that:
Instructions for iOS devices | Instructions for Android devices
Oh, and on the topic of social media? If you find yourself getting caught up in unproductive arguments on the Internet, try the three-response rule:
- You reply; they reply (no progress made)
- You reply; they reply (still no progress made)
- You reply; they reply (still yet no progress made)
You reply just one more time: “I have a personal rule that if I’m arguing on the Internet and no progress has been made after three replies, I don’t reply further—I find this is helpful to avoid a lot of time lost to pointless arguing that isn’t going anywhere. Best wishes.”
(and then stick to it, no matter how they try to provoke you; best is to just not look until at least the next day)
When “swept up in love” gets to one of those little whirlpools…
The same works in personal relationships, by the way. If for example you are arguing with a loved one and not making progress, it can be good if you both have a pre-arranged agreement that either of you can, up to once on any given day, invoke a “time-out” (e.g. 30 minutes, but you agree the time between you when you first make this standing policy) during which you will both keep out of the other’s way, and come back with a more productive head on (remembering that things go best when it’s you both vs the problem, rather than vs each other).
See also:
Seriously Useful Communication Skills: Conflict Resolution
What if the self-sabotaging cycle is active and apparent?
Well, that is less sneaky, but certainly no less serious, and sometimes moreso. An obvious example is drinking too much; this is often cyclical in nature. We wrote about this one previously:
That article’s alcohol-specific, but the same advices go for other harmful activities, including other substance abuse (which in turn includes binge-eating), as well psychological addictions (such as gambling, for example).
Finally…
If your destructive cycle is more of a rut you’ve got stuck in, a common advice is to change something, anything, to get out of the rut.
That can be very bad advice! Because sometimes the change you go for is absolutely not the change that was needed, and is rather just cracking under pressure and doing something impulsive.
Here’s one way to actively get out of a slump:
Behavioral Activation Against Depression & Anxiety
Note: you do not have to be depressed or anxious to do this. But the point is, it’s a tool you can use even if you are depressed and/or anxious, so it’s a good thing to try for getting out of most kinds of slumps.
And really finally, here’s a resource for, well, the title speaks for itself:
When You Know What You “Should” Do (But Knowing Isn’t The Problem)
Take care!
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Longevity for the Lazy – by Dr. Richard Malish
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There are some people who devote all their resources to longevity, which can become a full-time occupation, not to mention a very expensive endeavor. This book’s for those who want to get the best possible “bang for buck” by doing the things that have the most favorable cost:worth ratio.
Dr. Malish covers what can be done easily for personal longevity, as well as what technological advances can be enjoyed that those before us didn’t have as options. He also discusses the diseases that are most likely to kill us, and how to avoid those.
He preaches a proactive approach, but one that is simple and consistent and based in good science, and good statistics. Indeed, while he’s served 20 years as an army doctor and a cardiologist, he now works as a healthcare policy consultant, so he is well-placed to advise.
The style of the book is halfway between regular pop-science and a textbook; you can either read it cover-to-cover, or skim first though the key points, highlight boxes, summaries, and the like. He also provides a time-phased task list, for those who like things to be laid out like that.
Bottom line: this is a very good, methodical guide to living longer without making it a full-time occupation.
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Best Workouts for Women Over 40 To Give Your Metabolism A Makeover
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After 40, the usual course of events goes: your lean muscle mass decreases, which slows your metabolism and makes it easier to gain fat. At the same time, bone density decreases, increasing the risk of osteoporosis and frailty. This leads to lower mobility, flexibility, and overall frustration.
But it doesn’t have to be that way! Fitness coach Jessica Cooke explains how:
It all depends on this
Strength training helps counteract these effects by increasing lean muscle mass, which boosts metabolism and fat burning. It also improves bone density, reducing the risk of osteoporosis. Plus, it builds strength, fitness, and a toned physique.
The best part? It doesn’t require long workouts—short, effective sessions work best.
While walking is very beneficial for general health, it doesn’t provide the resistance needed to build muscle. Without resistance, your body composition won’t change, and so your metabolism will remain the same. Strength training is essential for burning fat at rest and improving overall fitness.
You don’t have to do high-impact exercises or jumping to see results. Low-impact strength training is effective and gentle on the joints. Lifting weights or using your body weight in a controlled manner will help build muscle and improve strength.
Many women only do cardio and neglect strength training, leading to minimal progress. Another common mistake is overcomplicating workouts—simple, consistent strength training is all you need.
Aim to strength train three times per week for 20 minutes. Focus on compound movements that work multiple muscle groups, such as:
- squats
- lunges
- deadlifts
- press-ups
- shoulder presses
- upright rows
- planks
- glute bridges
- sit-ups
- Russian twists
Start with light (e.g. 2-3 kg) weights and maintain proper form.
For more on all of this, enjoy:
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Want to learn more?
You might also like:
Don’t Let Menopause Run You Down: 4 Critical Things Female Runners Should Know
Take care!
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New study suggests weight loss drugs like Ozempic could help with knee pain. Here’s why there may be a link
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The drug semaglutide, commonly known by the brand names Ozempic or Wegovy, was originally developed to help people with type 2 diabetes manage their blood sugar levels.
However, researchers have discovered it may help with other health issues, too. Clinical trials show semaglutide can be effective for weight loss, and hundreds of thousands of people around the world are using it for this purpose.
Evidence has also shown the drug can help manage heart failure and chronic kidney disease in people with obesity and type 2 diabetes.
Now, a study published in the New England Journal of Medicine has suggested semaglutide can improve knee pain in people with obesity and osteoarthritis. So what did this study find, and how could semaglutide and osteoarthritis pain be linked?
Pormezz/Shutterstock Osteoarthritis and obesity
Osteoarthritis is a common joint disease, affecting 2.1 million Australians. Most people with osteoarthritis have pain and find it difficult to perform common daily activities such as walking. The knee is the joint most commonly affected by osteoarthritis.
Being overweight or obese is a major risk factor for osteoarthritis in the knee. The link between the two conditions is complex. It involves a combination of increased load on the knee, metabolic factors such as high cholesterol and high blood sugar, and inflammation.
For example, elevated blood sugar levels increase the production of inflammatory molecules in the body, which can damage the cartilage in the knee, and lead to the development of osteoarthritis.
Weight loss is strongly recommended to reduce the pain of knee osteoarthritis in people who are overweight or obese. International and Australian guidelines suggest losing as little as 5% of body weight can help.
But losing weight with just diet and exercise can be difficult for many people. One study from the United Kingdom found the annual probability of people with obesity losing 5% or more of their body weight was less than one in ten.
Semaglutide has recently entered the market as a potential alternative route to weight loss. It comes from a class of drugs known as GLP-1 receptor agonists and works by increasing a person’s sense of fullness.
Semaglutide for osteoarthritis?
The rationale for the recent study was that while we know weight loss alleviates symptoms of knee osteoarthritis, the effect of GLP-1 receptor agonists was yet to be explored. So the researchers set out to understand what effect semaglutide might have on knee osteoarthritis pain, alongside body weight.
They randomly allocated 407 people with obesity and moderate osteoarthritis into one of two groups. One group received semaglutide once a week, while the other group received a placebo. Both groups were treated for 68 weeks and received counselling on diet and physical activity. At the end of the treatment phase, researchers measured changes in knee pain, function, and body weight.
As expected, those taking semaglutide lost more weight than those in the placebo group. People on semaglutide lost around 13% of their body weight on average, while those taking the placebo lost around 3% on average. More than 70% of people in the semaglutide group lost at least 10% of their body weight compared to just over 9% of people in the placebo group.
Osteoarthritis of the knee is the most common type of osteoarthritis. SKT Studio/Shutterstock The study found semaglutide reduced knee pain significantly more than the placebo. Participants who took semaglutide reported an additional 14-point reduction in pain on a 0–100 scale compared to the placebo group.
This is much greater than the pain reduction in another recent study among people with obesity and knee osteoarthritis. This study investigated the effects of a diet and exercise program compared to an attention control (where participants are provided with information about nutrition and physical activity). The results here saw only a 3-point difference between the intervention group and the control group on the same scale.
The amount of pain relief reported in the semaglutide trial is also larger than that reported with commonly used pain medicines such as anti-inflammatories, opioids and antidepressants.
Semaglutide also improved knee function compared to the placebo. For example, people who took semaglutide could walk about 42 meters further than those on the placebo in a six-minute walking test.
How could semaglutide reduce knee pain?
It’s not fully clear how semaglutide helps with knee pain from osteoarthritis. One explanation may be that when a person loses weight, there’s less stress on the joints, which reduces pain.
But recent studies have also suggested semaglutide and other GLP-1 receptor agonists might have anti-inflammatory properties, and could even protect against cartilage wear and tear.
While the results of this new study are promising, it’s too soon to regard semaglutide as a “miracle drug” for knee osteoarthritis. And as this study was funded by the drug company that makes semaglutide, it will be important to have independent studies in the future, to confirm the findings, or not.
The study also had strict criteria, excluding some groups, such as those taking opioids for knee pain. One in seven Australians seeing a GP for their knee osteoarthritis are prescribed opioids. Most participants in the trial were white (61%) and women (82%). This means the study may not fully represent the average person with knee osteoarthritis and obesity.
It’s also important to consider semaglutide can have a range of side effects, including gastrointestinal symptoms and fatigue.
There are some concerns that semaglutide could reduce muscle mass and bone density, though we’re still learning more about this.
Further, it can be difficult to access.
I have knee osteoarthritis, what should I do?
Osteoarthritis is a disease caused by multiple factors, and it’s important to take a multifaceted approach to managing it. Weight loss is an important component for those who are overweight or obese, but so are other aspects of self-management. This might include physical activity, pacing strategies, and other positive lifestyle changes such as improving sleep, healthy eating, and so on.
Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney and Christina Abdel Shaheed, Associate Professor, School of Public Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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