Bridging the Gender Pain Gap
I recently gave a presentation at the ANTA symposium focused on reimagining women’s pain management through a collaborative lens, which is less about individual pain syndromes, and more about the systemic, cultural, and clinical reforms needed in women’s healthcare. The central question I asked was: Why does women’s pain need new conversations? The answer is because the old ones have failed. For generations, women’s reports of pain have been downplayed, psychologised, or dismissed entirely. The underlying problem is systemic bias: women’s pain is too often under-recognised and viewed through a lens of emotion rather than evidence. This minimisation leads to delayed diagnoses, inappropriate treatments, and higher rates of mental health referrals instead of pain management.
Despite chronic pain being more prevalent in women, medical education still offers minimal training in pain conditions that predominantly affect them. The result is a system that overlooks the biological and hormonal nuances of female pain, the psychosocial context in which it occurs, and the cumulative harm of being unheard. Research on endometriosis exemplifies this: in a survey of Australian women, participants described being “dismissed and chastised,” likening the experience to being a “second-class citizen.” Many reported having their pain normalised (“period pain is normal”) or doubted entirely. The consequences extend beyond the clinic, women become reluctant to seek care, risk medical trauma, and often manage complex conditions in isolation.
Dismissed & Chastised
Many women report having their pain normalised (“period pain is normal”) or doubted entirely.
Throughout the talk I emphasise that pain is complex, but also that complexity can be liberating as it provides numerous opportunities for change. Beyond tissue damage, chronic pain often intertwines with neurodivergence, connective tissue disorders, dysautonomia, and immune dysfunction. Studies now show high comorbidity between ADHD, autism, and chronic pain, with overlapping mechanisms involving the stress response, neuroinflammation, and dopamine regulation. Conditions such as hypermobility and POTS (postural orthostatic tachycardia syndrome) frequently co-occur, creating what researchers call the “Super Pentad”, a cluster of interrelated syndromes that require integrated, multidisciplinary approaches.
These patterns expose the inadequacy of fragmented care. Cost, access barriers, and poor coordination all compound the problem. As part of this presentation, I advocated for collaboration across modalities - medical, allied health, and complementary medicine. True collaboration means more than referral; it means co-management, shared language, and joint responsibility for outcomes. Strategies such as case conferencing, direct referral pathways, shared consultations, and clear communication about treatment priorities help dissolve silos. Collaboration does not always require full integration, but integration cannot exist without collaboration.
At the heart of this model is the woman herself. Effective care places her at the centre of decision-making, not at the periphery. When women are supported to understand their health, interpret symptoms, and participate in decisions, outcomes improve. Knowledge and critical health literacy are key: when clinicians share information clearly and meaningfully, they build trust, reduce anxiety, and increase adherence. This process of “sense-making” helps women contextualise symptoms, regain control, and stop chasing elusive single causes.
I concluded by circling back to its opening premise: women’s pain has been pathologised, ignored, or silenced for too long. The path forward requires science that includes women, clinicians who listen, and care models that reflect the intricate interplay of biology, psychology, and social reality. Collaborative care is not simply good practice, it is the ethical foundation of women’s healthcare, and the most direct route to restoring trust, equity, and healing.
NB. I was glad to see the recent Victorian Inquiry into Women’s Pain made positive recommendations change in this space. For more please see the report here