FEMALE PAIN IS OFTEN DISMISSED

VARIATIONS in the way men and women are treated can be found in almost all areas of medicine, suggesting that there are more complex social factors at play than mere differences in physiology. For example, women’s pain is less likely to be taken seriously than men’s, and women are more likely to receive sedatives rather than effective pain medication. Chronic, debilitating conditions such as endometriosis are frequently dismissed as ‘period problems’ — leading the health watchdog NICE to issue guidelines telling GPs to listen a lot more carefully to their female patients. The symptoms of aggressive ovarian cancer are also often put down to ‘bloating’. And psychiatrists have only recently begun to acknowledge that autism may be far more widespread in girls and women than previously believed, because the condition can present differently between the sexes. Dementia is another area where women are being sidelined. Women have a higher risk of developing dementia during their lifetime than men, and around two-thirds of the people living with dementia in the UK are female. But while some of this difference is due to the fact that women tend to live longer than men, there’s still a lot we don’t know about how sex affects dementia risk, according to Professor Tara Spires-Jones, an expert in Alzheimer’s disease at the University of Edinburgh. ‘Male and female brains are different, though that’s not to say one is better or worse,’ she says. ‘Both have around 100 billion nerve cells wired up with more than 100 trillion connections. These are particularly impacted by hormones such as oestrogen, which changes during the menstrual cycle and in the menopause. ‘There’s so much we don’t know — the brain is incredibly complicated and complex, so when you add in hormones and sex differences, it becomes even more difficult.’ Given that Alzheimer’s disease is more common in women than men, it seems likely that there are fundamental biological differences at play. This suggests that sex-specific tests or treatments might be beneficial. But, as Professor Spires-Jones points out, ‘we simply don’t know, because there is a lack of research in this area’.