Women's Pain FAQs

Women's pain syndromes are complicated and probably involve multiple factors, both genetic and environmental, but several aspects are critical to the development and treatment of female pain syndromes.

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What are the triggers of female pain disorders?

Much anecdotal evidence suggests that pain disorders are often preceded by specific events or conditions. For example, fibromyalgia is sometimes preceded by a viral infection and precipitated and exacerbated by fatigue, lack of sleep and possibly nutritional factors. Similarly, migraines are often associated with hormonal changes occurring at the onset of puberty and during the normal reproductive cycle. Pelvic pain has also been tied to use of birth control at an early age and to menopause. With a better understanding of what triggers pain syndromes, we will be armed to develop strategies to prevent and treat these disorders.

• IND: Women's Pain Division (WPD) researchers are already looking at the role of improved sleeping habits on progression of fibromyalgia.

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Why do some pain disorders occur so frequently in women?

Why some pain disorders occur predominantly in women is unclear. However, a role of female reproductive hormones has been long suspected.

• IND: Research by WPD investigators has shown that estrogen and related hormones do alter sensory responses to uncomfortable stimuli in animal models. Ongoing studies are aimed at determining the extent to which hormones may play a role in female pain disorders.

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What is the biological basis of female pain disorders?

There is mounting evidence that these pain syndromes are rooted deeply in the biology of the nervous system. Some types of pain are associated with increased amounts of certain proteins that can affect the excitability of pain-sensing pathways. Estrogen can affect the proteins that alter nervous system properties and can affect sensitivity of the nerves themselves. Some tissues that are affected in female pain syndromes have been shown to have greater than normal numbers of nerves.

• IND: WPD researchers have been aggressively investigating physical and chemical changes in the nervous system (neuroplasticity) associated with acute and chronic pain, and with changes in hormone status.

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How can we better diagnose female pain disorders?

Because there may be no overtly obvious damage or deformity, female pain disorders are typically very difficult to diagnose. Indeed, this may contribute to the under-diagnosing of these very common pain syndromes. A major part of the problem is a lack of good markers for pain disorders.

• IND: By better understanding the nature of female pain conditions, investigators at the WPD will be better positioned to identify markers of certain disease states, such as elevation of certain blood proteins, genetic modifications, and brain imaging patterns. ‘Biomarker' identification will not only facilitate diagnosis but may predict which therapeutic approaches are best suited to a particular pain syndrome.

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Can we develop therapeutic approaches that not only treat the symptoms but also the causes of female pain disorders?

Our ability to address some symptoms associated with female pain syndromes has advanced rapidly in recent years. In addition to behavioral management techniques that improve quality of life, this includes development and marketing of new drugs such as triptans for migraines and anti-seizure medications for pelvic pain and fibromyalgia. However, treatments to date are essentially all aimed at the symptoms rather than the causes.

• IND: Researchers and physicians of the WPD take a multidisciplinary approach by applying information they obtain from investigating the mechanisms of women's pain towards cure. These approaches include developing new strategies toward preventing triggers from initiating chronic pain, to the quest for identifying new drugs and behavioral interventions that can treat pain disorders by addressing the basic biological mechanisms.