Why Women Report (And Endure) More Pain—And How to Treat It Right?

Across conditions and across the lifespan, women and girls report more frequent and intense pain than men. Large electronic-medical-record analyses and decades of lab and clinical studies find higher pain reports among women for many diseases and experimental pain tasks. Mechanisms are biopsychosocial: hormones and immune pathways, sex-specific neurobiology, higher prevalence of pain conditions like dysmenorrhea and migraine, and social factors including trauma exposure and gender bias in care.

Physician-author Gabor Maté has popularized the idea that chronic stress and developmental trauma can dysregulate mind–body systems and amplify pain—a view echoed by empirical research linking adverse childhood experiences (ACEs) to adult chronic pain.

• How biased research and “it’s psychosomatic” thinking harmed women’s pain care?
• What is the best way to treat pain in women and teenage girls?
• What are the mental health approaches for pain management?
• How do psychotherapists help with women’s pain?
• Can art therapy help chronic pain?

1. How biased research and “it’s psychosomatic” thinking harmed women’s pain care?

For decades, women were underrepresented in research; only in 2016 did the NIH require “sex as a biological variable” in funded studies. When sex isn’t analyzed, treatments may underperform or cause harm for women.

In the clinic, classic and contemporary studies show gender bias in pain assessment and treatment. Women’s pain is more likely to be minimized, psychologized, or treated with sedatives rather than analgesics; in emergency departments women receive opioids less often and wait longer for relief than men. Qualitative and education studies show women are more often judged as “emotional,” reinforcing psychogenic attributions. Outcomes: delayed diagnoses, inadequate analgesia, and prolonged, ineffective care.

2. What is the best way to treat pain in women and teenage girls?

• Start with a supportive, patient-centred primary care clinician. Team-based, trauma-informed, patient-centred care is the direction of national strategies (e.g., Canadian Pain Task Force). A strong therapeutic alliance—clear goals, collaboration, empathy—is linked to better pain outcomes and satisfaction.
  
• Self-advocacy (bringing a symptom diary, asking for options/risks/benefits, requesting sex-specific evidence) helps counter dismissal.
  
• Physical activity (move what you can, regularly): Exercise is one of the most evidence-supported treatments for chronic pain (e.g., low back pain). Follow WHO/Canadian 24-hour movement guidance and tailor type/intensity to condition and flare cycles.
  
• Nutrition (think whole-food, anti-inflammatory patterns): Systematic reviews suggest whole-food dietary patterns can modestly reduce pain and improve function in chronic pain, though no single “best” diet consistently outperforms others. Aim for quality, nutrient density, and weight stability where relevant.

• Mental health care matters: Depression, anxiety, catastrophizing, and trauma histories can increase pain intensity and interference—treating them improves outcomes. (This does **not** mean the pain is “all in your head”; it means brain–body systems are intertwined.)

• Special note for teens: Dysmenorrhea is extremely common and undertreated; persistent pelvic pain warrants evaluation for endometriosis. Chronic pain affects \~1 in 5 adolescents, with higher prevalence in girls—so early, validating care is crucial.

3. What are the mental health approaches for pain management?

• CBT for Chronic Pain (CBT-CP): studies show small-to-moderate improvements in pain, distress, and disability when delivered by trained clinicians.
  
• Mindfulness-Based Stress Reduction (MBSR): Studies found that MBSR improved pain and function among individuals with chronic back pain.
  
• Expressive therapies (e.g., art therapy): Evidence is emerging and studies found active visual art therapy improved some outcomes among individuals with chronic pain.

4. How do psychotherapists help with women’s pain?

Trained psychotherapists in Toronto can:

• Provide psychoeducation about pain neurobiology (central sensitization, pacing, flare planning).
  
• Deliver CBT-CP or mindfulness-based approaches to reduce fear-avoidance, catastrophizing, and disability.
  
• Offer trauma-informed care, integrating ACEs history when relevant, and collaborate with medical teams.
  
• Support self-advocacy and shared decision-making with primary care and specialists.

5. Can art therapy help chronic pain?

Yes—as an adjunct. Art therapy can be a valuable tool for managing chronic pain, working alongside medical care to improve quality of life. Creating art engages the brain in ways that distract from pain signals, offering temporary relief. It also provides a safe, non-verbal outlet for emotions like frustration, anxiety, or grief that often accompany long-term pain.

Through guided exercises, clients can externalize their pain—turning it into an image or symbol—which helps reframe their relationship with it. Mindful art practices, such as slow drawing or clay sculpting, encourage relaxation and body awareness, reducing tension that can worsen pain.

In group settings art therapy sessions in Toronto, art therapists foster connection and support, reducing the isolation many people with chronic pain feel. While it’s not a stand-alone cure, research shows art therapy can meaningfully enhance coping skills and improve daily functioning.