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.

woman lies in bed in pain
Women seem to feel pain more acutely and often feel ignored by doctors.
Shutterstock

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.The Conversation

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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  • Spiced Fruit & Nut Chutney

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    ‘Tis the season to make the chutney that will then be aged chutney when you want it later! And unlike supermarket varieties with their ingredients list that goes “Sugar, spirit vinegar, inverted glucose-fructose syrup,” this one has an array of health-giving fruits and nuts (just omit the nuts if you or someone you may want to give this to has an allergy), and really nothing bad in here at all. And of course, tasty healthful spices!

    You will need

    • 2 red onions, chopped
    • 1½ cups dried apricots, chopped
    • 1½ cups dried figs, chopped
    • 1 cup raisins
    • ½ cup apple cider vinegar
    • ½ cup slivered almonds
    • ½ lime, chopped and deseeded
    • ¼ bulb garlic, chopped
    • 1 hot pepper, chopped (your choice what kind; omit if you don’t like heat at all; multiply if you want more heat)
    • 2 tablespoons honey or maple syrup (omit for a less sweet chutney; there is sweetness in the dried fruits already, after all)
    • 1 tbsp freshly grated ginger
    • 2 tsp sweet cinnamon
    • 1 tsp nutmeg
    • 1 tsp black pepper
    • ½ teaspoon allspice
    • ½ MSG or 1 tsp low-sodium salt
    • Extra virgin olive oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Heat some oil in a heavy-based pan that will be large enough for all ingredients to go into eventually. Fry the onions on a gentle heat for around 15 minutes. We don’t need to caramelize them yet (this will happen with time), but we do want them soft and sweet already.

    2) Add the ginger, garlic, and chili, and stir in well.

    3) When the onions start to brown, add the fruit and stir well to mix thoroughly.

    4) Add the honey or maple syrup (if using), and the vinegar; add the remaining spices/seasonings, so everything is in there now except the almonds.

    5) Cook gently for another 30 minutes while stirring. At some point it’ll become thick and sticky; add a little water as necessary. You don’t want to drown it, but you do want it to stay moist. It’ll probably take only a few tablespoons of added water in total, but add them one at a time and stir in before judging whether more is needed. By the end of the 30 minutes, it should be more solid, to the point it can stand up by itself.

    6) Add the almonds, stir to combine, and leave to cool. Put it in jars until you need it (or perhaps give it as gifts).

    Alternative method: if you don’t want to be standing at a stove stirring for about an hour in total, you can use a slow cooker / crock pot instead. Put the same ingredients in the same order, but don’t stir them, just leave them in layers (this is because of the pattern of heat distribution; it’ll be hotter at the bottom, so the things that need to be more cooked should be there, and the design means they won’t burn) for about two hours, then stir well to mix thoroughly, and leave it for another hour or two, before turning it off to let it cool. Put it in jars until you need it (or perhaps give it as gifts).

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Goat Milk Greek Yogurt vs Almond Milk Greek Yogurt – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing goat milk yogurt to almond milk yogurt, we picked the almond milk yogurt.

    Why?

    Surprised? Honestly, we were too!

    Much as we love almonds, we were fully expecting to write about how they’re very close in nutritional value, but the dairy yogurt has more probiotics, but no, as it turns out when we looked into them, they’re quite comparable in that regard.

    It’s easy to assume “goat milk yogurt is more natural and therefore healthier”, but in both cases, it was a case of taking a fermentable milk, and fermenting it (an ancient process). “But almond milk is a newfangled thing”, well, new-ish…

    So what was the deciding factor?

    In this case, the almond milk yogurt has about twice the protein per (same size) serving, compared to the goat milk; all the other macros are about the same, and the micronutrients are similar. Like many plant-based milks and yogurts, this one is fortified with calcium and vitamin D, so that wasn’t an issue either.

    In short: the only meaningful difference was the protein, and the almond came out on top.

    However!

    The almond came out on top only because it is strained; this can be done (or not) with any kind of yogurt, be it from an animal or a plant. 

    In other words: if it had been different brands, the goat milk yogurt could have come out on top!

    The take-away idea here is: always read labels, because as you’ve just seen, even we can get surprised sometimes!

    seriously if you only remember one thing from this today, make it the above

    Other thing worth mentioning: yogurts, and dairy products in general, are often made with common allergens (e.g. dairy, nuts, soy, etc). So if you are allergic or intolerant, obviously don’t choose the one to which you are allergic or intolerant.

    That said… If you are lactose-intolerant, but not allergic, goat’s milk does have less lactose than cow’s milk. But of course, you know your limits better than we can in this regard.

    Want to try some?

    Amazon is not coming up with the goods for this one (or anything even similar, at time of writing), so we recommend trying your local supermarket (and reading labels, because products vary widely!)

    What you’re looking for (be it animal- or plant-based):

    • Live culture probiotic bacteria
    • No added sugar
    • Minimal additives in general
    • Lastly, check out the amounts for protein, calcium, vitamin D, etc.

    Enjoy!

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  • Chetna’s Healthy Indian – by Chetna Makan

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    Indian food is wonderful—a subjective opinion perhaps, but a popular view, and one this reviewer certainly shares. And of course, cooking with plenty of vegetables and spices is a great way to get a lot of health benefits.

    There are usually downsides though, such as that in a lot of Indian cookbooks, every second thing is deep-fried, and what’s not deep-fried contains an entire day or more’s saturated fat content in ghee, and a lot of sides have more than their fair share of sugar.

    This book fixes all that, by offering 80 recipes that prioritize health without sacrificing flavor.

    The recipes are, as the title suggests, vegetarian, though many are not vegan (yogurt and cheese featuring in many recipes). That said, even if you are vegan, it’s pretty easy to veganize those with the obvious plant-based substitutions. If you have soy yogurt and can whip up vegan paneer yourself (here’s our own recipe for that), you’re pretty much sorted.

    The cookbook strikes a good balance of being neither complicated nor “did we really need a recipe for this?” basic, and delivers value in all of its recipes. The ingredients, often a worry for many Westerners, should be easily found if you have a well-stocked supermarket near you; there’s nothing obscure here.

    Bottom line: if you’d like to cook more Indian food and want your food to be exciting without also making your blood pressure exciting, then this is an excellent book for keeping you well-nourished, body and soul.

    Click here to check out Chetna’s Healthy Indian, and spice up your culinary repertoire!

    Share This Post

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  • 7 Kinds Of Rest When Sleep Is Not Enough

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Taking Rest Seriously (More Than Just Sleep)

    This is Dr. Matthew Edlund. He has 44 years experience as a psychiatrist, and is also a sleep specialist. He has a holistic view of health, which is reflected in his practice; he advocates for “a more complete health: physical, mental, social, and spiritual well-being”.

    What does he want us to know?

    Sleep, yes

    Sleep cannot do all things for us in terms of rest, but it can do a lot, and it is critical. It is, in short, a necessary-but-not-sufficient condition for being well-rested.

    See also: Why You Probably Need More Sleep

    Rest actively

    Rest is generally thought of as a passive activity, if you’ll pardon the oxymoron. Popular thinking is that it’s not something defined by what we do, so much what we stop doing.

    In contrast, Dr. Edlund argues that to take rest seriously, we need do restful things.

    Rest is as important as eating, and we wouldn’t want for that to “just happen”, would we?

    Dr. Edlund advocates for restful activities such as going to the garden (or a nearby park) to relax. He also suggests we not underestimate the power of sex as an actively restful activity—this one is generally safer in the privacy of one’s home, though!

    Rest physically

    This is about actively relaxing our body—yoga is a great option here, practised in a way that is not physically taxing, but is physically rejuvenating; gentle stretches are key. Without such things, our body will keep tension, and that is not restful.

    For the absolute most restful yogic practice? Check out:

    Non-Sleep Deep Rest: A Neurobiologist’s Take

    this is about yoga nidra!

    Rest mentally

    The flipside of the above is that we do need to rest our mind also. When we try to rest from a mental activity by taking on a different mental activity that uses the same faculties of the brain, it is not restful.

    Writer’s example: as a writer, I could not rest from my writing by writing recreationally, or even by reading. An accountant, however, could absolutely rest from accounting by picking up a good book, should they feel so inclined.

    Rest socially

    While we all have our preferences when it comes to how much or how little social interaction we like in our lives, humans are fundamentally social creatures, and it is hardwired into us by evolution to function at our best in a community.

    This doesn’t mean you have to go out partying every night, but it does mean you should take care to spend at least a little time with friends, even if just once or twice per week, and yes, even if it’s just a videocall (in person is best, but not everyone lives close by!)

    If your social life is feeling a little thin on the ground these days, that’s a very common thing—not only as we get older, but also as many social institutions took a dive in functionality on account of the pandemic, and many are still floundering. Nevertheless, there are more options than you probably realize; yes, even for the naturally reclusive:

    How To Beat Loneliness & Isolation

    Rest spiritually

    Be we religious or not, there are scientifically well-evidenced benefits to religious practices—some are because of the social aspect, and follow on from what we talked about just above. Other benefits come from activities such as prayer or meditation (which means that having some kind of faith, while beneficial, is not actually a requirement for spiritual rest—comparable practices without faith are fine too).

    We discussed the overlapping practices of prayer and meditation, here:

    The Science Of Mantra Meditation

    Rest at home

    Obviously, most people sleep at home. But…

    Busy family homes can sometimes need a bit of conscious effort to create a restful environment, even if just for a while. A family dinner together is one great way to achieve this, and also ties in with the social element we mentioned before!

    A different challenge faced by a lot of older people without live-in families, on the other hand, is the feeling of too much opportunity for rest—and then a feeling of shame for taking it. The view is commonly held that, for example, taking an afternoon nap is a sign of weakness.

    On the contrary: taking an afternoon nap can be a good source of strength! Check out:

    How To Nap Like A Pro (No More “Sleep Hangovers”!)

    Rest at work

    Our readership has a lot of retirees, but we know that’s not the case for everyone. How then, to rest while at work? Ideally we have breaks, of course, but most workplaces do not exactly have an amusement arcade in the break room. Nevertheless, there are some quick resets that can be done easily, anywhere, and (almost) any time:

    Meditation Games: Meditation That You’ll Actually Enjoy

    Want to know more?

    You might also like:

    How To Rest More Efficiently (Yes, Really)

    Take care!

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    Learn to Age Gracefully

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  • Is Unnoticed Environmental Mold Harming Your Health?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Environmental mold can be a lot more than just the famously toxic black mold that sometimes makes the headlines, and many kinds you might not notice, but it can colonizes your sinuses and gut just the same:

    Breaking the mold

    Around 25% of homes in North America are estimated to have mold, though the actual number is likely to be higher, affecting both older and new homes. For that matter, mold can grow in unexpected areas, like inside air conditioning units, even in dry regions.

    If mold just sat where it is minding its own business, it might not be so bad, but instead they release their spores, which are de facto airborne mycotoxins, which can colonize places like the sinuses or gut, causing significant health issues.

    Not everyone in the same household is affected the same way by mold due to genetic differences and varying pre-existing health conditions. But as a general rule of thumb, mold inflames the brain, nerves, gut, and skin, and can negatively impact the vagal nerve, which is linked to the gut-brain connection. Mycotoxins also damage mitochondria, leading to symptoms like fatigue, brain fog, and cognitive issues. To complicate matters further, mold illness can mimic other conditions like anxiety, chronic fatigue, fibromyalgia, IBS, and more, making it difficult to diagnose.

    Testing is possible, though they all have limitations, e.g:

    • Home testing: testing the home for mold spores and mycotoxins is crucial for effective treatment; professional mold remediation companies are a good idea (to do a thorough job of cleaning, without also breathing in half the mold while cleaning it).
    • Mold allergy testing: mold allergy testing (IgE testing or skin tests) is often used, but it doesn’t diagnose mold-related illnesses linked to severe symptoms like fatigue or neurodegeneration.
    • Serum antibody testing: tests for immune reactions (IgG) to mycotoxins may not always show positive results if the immune system is weakened by long-term exposure.
    • Urine mycotoxin testing: urine tests can detect mycotoxins in the body, though are likely to be more expensive, being probably not covered by public health in Canada or insurance in the US.
    • Organic acid testing: this urine test can indicate mold colonization in areas like the sinuses or gut. Again, cost/availability may vary, though.

    For more information on all of this, enjoy:

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    Want to learn more?

    You might also like to read:

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    Take care!

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  • Healing Spices – by Dr. Bharat Aggarwal & Debora Yost

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    This is exactly what the subtitle promises it to be, and more. It’s actually herbs and spices, but definitely mostly spices, and includes the kinds found in even the smallest supermarket, to some you might not have heard of, and might need to order online.

    We are treated to an explanation of the health-giving properties of each (and any potential contraindications), as well as the culinary properties, many tables of what goes with what and how and why, and even recipes to use them in. For the more adventurous, there’s even advice on how to grow, prepare, and store each of them.

    An extra benefit is that everything is cross-linked such that you can look things up by spice or by health condition or by flavor profile, and find what you need and what’ll go with it.

    The style is simple and informational, clearly laid-out in encyclopedic form.

    Bottom line: this book should be in your kitchen (or related nearby kitchen-book-place).

    Click here to check out Healing Spices, and advance your culinary repertoire!

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