Estrogen imbues women with the ability to conceive and foster the spark of life, and the capacity to withstand the pain of childbirth. Does the pain protection offered by estrogen give all women a higher general threshold of pain?
Pain and estrogen
There is a scientific concensus that women perceive pain differently than men. This difference is due in part to the activity of 3 hormones that we collectively call ‘estrogen’: estradiol, estriol, and estrone.
Estrogen likely contributes to an increased pain threshold in women- it increases opioid and endorphin production, and elevates the concentration of neurotransmitters like serotonin and dopamine at the point of nerve synapse. Estrogen also increases the number of neurotransmitter receptors, which allows more of these pain-killing molecules to bind and activate. Women can chemically cope with pain in a way that men cannot.
Estradiol levels skyrocket to over a thousand times their normal during birth. This increase stimulates a massive chemical harmony of opioid and endorphin activity, allowing mothers to better withstand labour and birth pain.
Seems simple, right? Estrogen is a wonder-drug and women are badasses because they have 5x more of it coursing through their veins than men.
Why we can’t say ‘women definitely have a higher pain threshold than men’:
Like everything #science, this is not black and white.
Not all studies have found that women can withstand more pain when their estrogen levels are high, as we might expect. Although there is evidence that women experience temporomandibular (jaw/neck) and migraine pain more frequently and more intensely during times of low estrogen, some studies have found that women are more sensitive to other kinds of pain even at times of high estrogen.
There have also been scant few studies comparing general pain tolerance between men and women, and each is plagued with science-y problems like small sample sizes or lack of reproducibility. Some don’t include one gender, and instead use a standardized pain scale.
Some studies have even found that men have a higher tolerance to pain. One study concluded that men had a higher pain threshold because they were able to leave their hands in ice-water for a longer period of time than women.. with a cash incentive for holding your hand under longer and in a room full of other dudes.
Many men have insecurity issues rivaling the White House, and asking them to compare pain thresholds with other men is tantamount to asking them to compare penises. There a lot of social and cultural factors that contribute to pain thresholds, and we simply haven’t done the right studies yet.
The implications of pain and estrogen go beyond the battle of the sexes.
Consider: a woman goes to the doctor because she crashed while drunk-mountain biking home from her buddy’s birthday kegger and tore all the cartilage that attaches her collarbone to her shoulder, as has been known to happen to people. If she has her accident in the third week of the reproductive rhythm, when her estrogen is high, she might report a different level of pain than in the first week, when her estrogen is low.
If she is prescribed a certain dosage of painkiller while she has high estrogen, the prescription may not be enough to protect her during times of low estrogen. So, while most doctors strive to treat men and women equally, they could be denying women the specificity they require to fully address their pain management.
Guys are dolls
In comparison to women, men are completely static, the hormonal equivalent of mannequins. Testosterone does fluctuate in males because of stress, exercise, etc.. but by no more than ~10%. The cycling of estrogen in the female body involves a complicated rhythm where estrogen levels soar to as much as 400% of their basal levels and then tumble to back to baseline, all in as little as a few days.
Next time you see a woman walking with a cast or squinting through the pain of a migraine, have a little sympathy- she likely has a higher pain threshold than her male counterpart, but it doesn’t make her life any easier.