July 25, 2024National Pain Week is Australia’s annual awareness event for chronic pain, which focuses national attention on the experiences of those living with chronic pain, and helps to reduce barriers related to their pain.
We spoke to Dr Josephine Vivian-Taylor, Head of Gynaecology at Northern Health, about the impact of women’s pain, and how we can help to manage this pain more effectively.
How prevalent is chronic pain among women compared to men?
Women experience chronic pain at higher rates than men across a lifetime. In part, this is because women experience persistent pelvic pain, period pain, bladder and bowel pain, particularly at the time in their lives that they are having periods and ovulating.
Why do gynaecological pain conditions often go undiagnosed or misdiagnosed?
Evidence into women’s experiences of the healthcare system when they present with gynaecological pain has shown that they are more likely to have their pain disregarded. This may lead to delayed referral, diagnosis and treatment, all of which have the potential to contribute to the pain becoming more chronic in nature, and more difficult to treat.
Pervasive ideas such as, ‘it is normal for sex to be painful,’ and, ‘period pain is normal,’ mean that, for girls and women who experience pain, particularly when it is excessive and negatively impacting their lives, are less likely to seek help in the first place. Many of our patients have internalised these messages to the point where they now feel that it is ‘normal’ to be bedridden for two days a month during their periods. When we are able to tell them that their experience is not ‘normal,’ and that we have ways to help, they express relief that they are not ‘going crazy’ as they had been feeling, up to this point, that their pain had been ignored.
How does chronic pain impact a woman’s quality of life and mental health?
Chronic pain can have an enormous impact on women’s quality of life and mental health. Women with persistent pelvic pain are often young, and not being able to participate in life like their peers, care for children or fulfil their career potential can have devastating effects. I am in awe of these women’s strength to push through and fight in the face of such pain. But why should they have to? Women are tough, but if we could help them manage their pain better, they could put this amazing resilience and energy into other aspects of their lives.
How can we help women manage chronic pain more effectively?
We know that chronic pain is most effectively treated in a multidisciplinary team that includes GPs, pain specialists, physiotherapists, pain psychologists, nurses, dieticians, and in my speciality, gynaecologists. The evidence for this multidisciplinary approach is well established, but the delivery of this model of care in our healthcare system is still being developed.
The women’s health clinics that are being rolled out by the Victoria government across the state over the next four years, along with endometriosis clinics in general practice and health care plans for pelvic health physiotherapy and psychology, aim to improve access to this type of care in Victoria. There is no one solution to treat persistent pelvic pain, so shared decision making, with women at the centre of the care we deliver, is an essential aspect of this care also.
What message would you like to convey to women suffering from chronic pain?
I would like to say ‘we see you and we believe you’. For those who have been put off accessing care due to poor experience or fear of not being believed, I encourage you to advocate for treatment again. I would also encourage women to explore all aspects of the multidisciplinary treatment available for chronic pain so they can find the combination that works best for them.
Dr Vivian-Taylor was this week featured in the Star Weekly newspaper, sharing her thoughts on this important subject. You can read this article here.
