Estrogen Likely Gives Women A Higher Pain Tolerance Than Men

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?

Estrogen is a actually a trio of hormones: estradiol, estriol, and estrone. They perform a variety of important functions for folks of all sexes and genders, and not just as sex hormones: estrogen(s) help to modulate the secretion of hormones from the pituitary gland, assist in immune response via the thymus, and even work to protect parts of the cardiovascular system.

Importantly, these three also contribute to increased pain tolerance in women: they increase opioid and endorphin production, and elevate the concentration of neurotransmitters like serotonin and dopamine at the point of nerve synapse. Estrogens also increase the number of neurotransmitter receptors, which allows more of these pain-killing molecules to bind and activate.

Collectively, estrogens are capable of stimulating a massive chemical harmony of opioid and endorphin activity, which provide women with a unique capacity to tolerate 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.

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.

What’s more, 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. 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.

And while it’s true that levels of at least one estrogenic hormone, estradiol, do skyrocket to over a thousand times their normal during birth, which indubitably provides a natural anaesthetic and pain-protective effect, this doesn’t offset the tremendous burden of pain and toil that accompany not only childbirth but the entire hormonal journey that all women face.

Guys are dolls

The cycling of estrogen in the female body involves a complicated rhythm wherein estrogen levels soar to as much as 400% of their basal levels before tumbling back to baseline, all in as little as a few days.

Compared 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 about 10%. Men are ill-equipped to understand how pain inflicts on women, and how women deal with it.

Instead of focusing on who can better withstand pain, I propose that we instead focus on extending women the additional empathy they are due, in part because they experience additional pain that men do not. Next time you see a woman walking with a cast or squinting through a torturous migraine, be kind – she may have a higher pain threshold than her male counterpart, but it doesn’t mean her life is any easier.