Why Women’s Pain Is Different Than Men’s And Should Be Treated Differently In PT

Pain is a common reason why people visit a physical therapist in Austin, Texas. But did you know that women often experience pain differently than men? Many women live with chronic pain for years without clear answers. Sometimes their pain is misunderstood or dismissed. This happens too often in healthcare.

Physical therapists can play a big role in changing that. One important way is by using sex-specific assessment tools. These are tools and tests designed to understand how pain shows up in women’s bodies.

Why Is Women’s Pain Different?

Many things shape how women feel pain. Some of these include:

• Hormones: Estrogen and progesterone can change how sensitive we are to pain. Pain may get worse during certain times in a woman’s cycle, like before a period or during menopause.
• Immune system: Women are more likely to have autoimmune conditions, like rheumatoid arthritis or lupus, which cause pain and inflammation.
• Nervous system: Women tend to have more nerve endings in some parts of the body and may respond more strongly to touch or pressure.
• Mental and emotional health: Stress, anxiety, and trauma can also affect pain. Women are more likely to report these experiences, which can make pain feel worse or harder to manage.
• Social and cultural factors: Sometimes women are told their pain is “normal” or “all in their head.” This can delay care and make the pain feel even more overwhelming.

These factors show that pain in women is complex. It’s not just about muscles or joints. It involves the whole person: body, brain, and emotions. That’s why we need better ways to assess it. Because so much of this is interconnected for women, it can be easy to dismiss for some professionals because it is not easy to diagnose. However, this system needs to change. 

Thankfully, the system is improving. As a recent review discusses, evidence shows there is a difference between the way the two sexes experience pain due to a variety of factors including genetics, gender roles, and of course hormones. This is a step in the right direction to at least acknowledging there is a difference. Now, it is time to put that difference into action and start tailoring treatments based on sex.

What Are Sex-Specific Assessment Tools?

Sex-specific assessment tools are ways to measure pain, strength, movement, and other functions with women’s unique needs in mind. Their basis is simple and is the same in a way for both genders. However, for women these tools help physical therapists:

• Understand where and how pain is happening
• Learn how hormones or stress may affect symptoms
• Tailor treatment plans that work for each woman’s body and life

This sounds pretty broad, so let’s dive into some more specific examples of what this looks like:

1. Pelvic Floor Assessment

The pelvic floor muscles are often overlooked in traditional exams. But they play a big role in pain, posture, and movement, especially in women. Many women have tight or weak pelvic floor muscles that contribute to back pain, hip pain, or pelvic discomfort. In fact, most women do not even realize that the pain they are experiencing is from their pelvic floor muscles. For example, if your back hurts, you might just think that something is wrong with your back. However, the whole body is connected, and pain can be transferred to another, connected part of the body such as in this example.

Physical therapists trained in pelvic health can assess these muscles through gentle internal or external exams. They check for tightness, weakness, and coordination issues.

2. Hormone-Aware Pain Tracking

Some therapists use pain diaries that include hormone cycle tracking. This helps women see patterns; for example, pain flares before their period or during perimenopause. Knowing this can guide treatment and lifestyle changes. This is actually a good trick for anyone who is experiencing pain that seems random. Track your daily habits and your pain experiences to establish patterns.

3. Central Sensitization Inventories

Women are more likely to have central sensitization. This means the nervous system becomes very sensitive and overreacts to pain. Tools like the Central Sensitization Inventory (CSI) help measure this. If a woman scores high, it may mean she needs a gentler, more gradual approach to movement and therapy. This can be due to a variety of factors, but differences in hormone levels is a big contributor here.

4. Pressure Pain Threshold Testing

Some clinics use tools that gently apply pressure to muscles or joints to determine the threshold of pain. Women often have lower pressure thresholds than men. This doesn’t mean they’re weak, it means their nervous system is more alert. Knowing this helps PTs avoid overloading sensitive tissues. This might sound scary, but all it involves is a light touch or tool with some slight pressure to determine how sensitive you might be.

5. Functional Movement Screens for Women

Movement tests that involve bending, squatting, lifting, or walking can be tailored to a woman’s needs. For example, a new mom may be tested on how she lifts her baby because she may be holding her arms at a strange angle, putting stress on her back. Someone going through menopause might be assessed for bone safety and balance. These screens help PTs understand real-life challenges.