Tales from our Women's Health Hub
“Women are born with pain built in. It’s our physical destiny,” says Kristin Scott Thomas’ character in Fleabag.
Women are inherently connected to pain; it is part of our natural journey in life. Data tells us that women are 10% more likely to report experiencing chronic pain, with half of all chronic pain conditions being more common in women than in men.
Women report that healthcare providers are dismissive when they report pain, and we know that the statistics support the fact that women wait longer in emergency settings for pain relief than men do.*
Case Study
Joyce* came in to see me for a health check at The McIndoe Centre. She told me that she was fed up with going backwards and forwards to the GP complaining of pain in her knees. Every time she went, she was told it was wear and tear and to try strengthening exercises and pain relief. Joyce had a bathroom cabinet full of different pills and potions given to her, but was too afraid to say to her GP “no more prescriptions, I need help!”
*Patient name changed for confidentiality purposes.
Joint pain in older women
Joint pain in older women is extremely common. There are a variety of factors that can lead to painful, inflamed joints.
Wear and tear is a phrase you might hear us healthcare professionals use. Over the course of a lifetime a significant amount of continuous pressure is put onto the joints. Typically, the weight bearing joints of the body are the first to be affected: the knees, followed by your hips. Cartilage between bones that serves to cushion the joints can become eroded and this can result in extreme cases of bone rubbing on bone. This can present with stiffness, pain and inflammation.
With our patient Joyce, I examined her knee. Her left knee was stiff, mildly swollen, and she had signs of osteoarthritis. Joyce told me how sad she felt that it was no longer safe for her to care for her granddaughter, who was just starting to run. Joyce felt she couldn’t keep up with her and it just wasn’t safe.
We were able to perform an X-ray on her knee and confirm the diagnosis and she was referred to an orthopaedic surgeon who has decided to start with joint injections. We also referred her to a physiotherapist who helped her manage her pain with massage and created an exercise plan with her, including advice about using a knee support during certain activities.
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Navigating Pain Through the Years
I thought that it was interesting to look at pain in women along their life course. Hormonal changes and physical demands can lead to varying types of pain, from menstrual cramps in youth to joint pain in menopause. Managing these aches requires adapting pain relief strategies as the body evolves through each life stage.
Puberty
This is a time for many girls when they first experience episodes of pain. Some girls can experience pain and bleeding so extremely that they can faint. It's hard on teenage girls, feeling a bit like aliens in their own bodies, and being told “it’s normal and to keep calm and carry on!”
Helping girls manage period pain is really important and painful periods should not be overlooked. Sometimes painful periods can be associated with underlying conditions such as endometriosis.
Treatment for period pain can involve a combination of lifestyle changes, home remedies, and medical treatments.
Pregnancy
Back pain, neck pain, pelvic pain, abdominal discomfort, gastritis pain, and constipation pain. It all happens in this stage of life. This can be really tricky as many pain killers are off licence in pregnancy and women typically suffer as a result of not being able to take the quantities of pain relief that they need. Staying active is really important. doing gentle exercises such as swimming can help improve circulation and pain. Heat packs and hot water bottles, as well as ice packs can also help. Maintaining good posture is also a good way to reduce the experience of pain, so speak to your occupational health team at work to assess your work station. Avoid lifting heavy objects and invest in pregnancy massages, as they are a great way to relax and help ease stiff muscles. Remember to stay hydrated and eat well. Mindfulness and relaxation techniques can also help. Speak to your midwife or your GP if your pain doesn’t go away or gets worse, as you may need a review and perhaps they will advise you on the safest painkillers to use.
Labour pain
Labour pain is something many of us relate to. Luckily for most, this pain eases quite quickly after delivery. During labour doctors and midwives are very good at helping women manage pain and as they are being continually monitored, more specialist methods of pain relief are used e.g epidurals, spinal blocks and local anaesthetic.
Mid-life pain
Aches and pains are very common at this stage of life, when women experience perimenopause and menopause. Frozen shoulder, tennis elbow, and swollen fingers and joints are frequently reported. Joint pain is one of the hallmarks of menopause, and lots of women tell me that they feel like they are thrown into their elderly years – finding it difficult to get out of bed, or that they feel so stiff, as if they are a “tin man!”
Oestrogen is a natural anti-inflammatory and when our levels start to decline, we can find these conditions appear. Testosterone is thought to play a role in muscle mass and we are starting to see levels of this decline in our mid life period.
Managing pain during perimenopause and menopause can involve a variety of approaches. A good start would be to book in with a GP with an interest in women’s health. You can discuss symptoms and explore options like hormone replacement therapy (HRT) or other medications.
Dr Sloan’s top tips for managing pain
- Managing pain effectively is essential for maintaining a healthy, active lifestyle, especially as aches and discomforts can arise at different stages of life.
- Book an appointment with your GP. It’s essential to get a proper diagnosis to determine the underlying cause of the pain and discuss treatment options. Pain that doesn’t go away should be investigated.
- Engage in low-impact exercises like walking, swimming, or cycling to maintain joint mobility and strengthen muscles around the joints. Stretching and flexibility exercises, like yoga or Pilates, can also help.
- Maintaining a healthy weight can reduce stress on weight-bearing joints, such as hips and knees.
- Applying heat (like warm baths or heating pads) can relieve stiffness, while cold packs can reduce inflammation and numb sharp pain.
- Over-the-counter pain relievers, such as acetaminophen or NSAIDs (like ibuprofen), can help manage pain. As you get older, it is important to check with your GP that you can still safely take NSAIDs.
- Creams or gels containing ibuprofen or menthol or capsaicin maybe safer alternatives.
- Some find relief with supplements like glucosamine, chondroitin, or omega-3 fatty acids. Consult a healthcare provider before taking any supplements.
- A physical therapist can develop a personalised exercise plan and teach techniques to improve mobility and strength.
- A diet rich in anti-inflammatory foods, such as fruits, vegetables, whole grains, and fatty fish, may help reduce inflammation. Staying hydrated is also crucial.
- Ensure proper rest and recovery for the joints, especially after activity.
- Acupuncture or chiropractic care may provide relief for some individuals.
- Practices like mindfulness, meditation, or relaxation techniques can help manage the perception of pain and improve overall well-being.
Book a Women's Health Check at The McIndoe Centre
We believe preventive care and early detection of health risks are key to long-term wellness. Our comprehensive assessment covers a broad spectrum of women’s health tests, all conducted on the same day, to provide an overview of your health status.
Take charge of your wellbeing and book an appointment with one of our GP and Women's Health Specialists at The McIndoe Centre.
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