Women are less likely to be given pain relief than men, according to a study of almost 22,000 emergency room patients in the United States and Israel.

Researchers found significant disparities between male and female patients, even those who reported identical levels of pain.

Males were more likely to be prescribed medication for their pain, even if they were being treated by female doctors.

The study concluded that the issue of gender bias in pain relief is systemic, and that it persists regardless of the patient’s age, level of pain, the healthcare provider or the gender of the physician.

“In both countries [USA and Israel], we find that physicians are 15-20% less likely to prescribe pain-relief medications to females than to males,” say the research team in an article entitled “Sex Bias in Pain Management Decisions,” posted in the journal Proceedings of the National Academy of Sciences (PNAS).       

“Adequate pain treatment is critical for patients’ physical and mental health. It is therefore essential that healthcare providers extend the appropriate treatment to each and every patient in pain.

“Here we build on findings showing that due to psychological stereotypes, females’ pain tends to be judged as less intense than males’ pain.”

The research team, based at the Hebrew University of Jerusalem-Hadassah Medical Center and Ben-Gurion University (both in Israel) and the University of Missouri and Marshall University in the United States, analyzed electronic discharge notes for 21,851 patients treated at ERs in both countries.

They found female patients are less likely than males to receive a prescription for any type of analgesic medication, either opioid or non-opioid.

Urgent policy interventions

As a result of the study, the team is calling for “urgent policy interventions” to address this bias and to ensure equal pain treatment.

“Our research reveals a troubling bias in how women’s pain is perceived and treated in emergency care settings,” said Prof. Shoham Choshen-Hillel of Hebrew University, who led the study.

“This under-treatment of female patients’ pain could have serious implications for women’s health outcomes, potentially leading to longer recovery times, complications, or chronic pain conditions.”

She says programs should be established to train healthcare professionals to recognize and counteract sex biases.

Pain management protocols should be revisited and standardized to ensure fair and adequate treatment for all patients.

The study also found that female patients stay, on average, for 30 minutes longer than males at the emergency department, likely because their complaints are taken less seriously and they aren’t treated as a priority.

Triage nurses are 10% less likely to record a pain score for female patients, perhaps because they are less likely to take women’s pain seriously.

And in a controlled experiment, 109 nurses rated reported pain as less intense if they believed the patient was female rather than male.