9 Fakten über Schmerzen bei Männern und Frauen

Unterscheiden sich Männer und Frauen, was Schmerzen betrifft? Frauen leiden tatsächlich häufiger unter Schmerzen als Männer. Lange wurde angenommen, Frauen seien generell schmerzempfindlicher. Die aktuelle Forschung zeigt jedoch, es ist ziemlich kompliziert und Studien kommen zu unterschiedlichen Ergebnissen [7]. Neun interessante Fakten über Schmerzen bei Frauen und Männern:

1) Sowohl biologische Unterschiede wie unterschiedliche Hormone, Genetik, Immunreaktionen, Prozesse in Gehirn und Nervensystem, als auch psychosoziale Aspekte wie Coping und unterschiedliche soziale Erwartungen beeinflussen das Schmerzempfinden von Männern und Frauen [3,10].

2) Studien an Mäusen weisen darauf hin, dass es zwei geschlechtsspezifische Wege der Schmerzverarbeitung gibt. Wird im Labor durch eine Nervenverletzung eine erhöhte Schmerzempfindlichkeit erzeugt, sind dabei bei männlichen und weiblichen Mäusen unterschiedliche Immunzellen beteiligt. Das Testosteronlevel bestimmt, welche Art von Immunzelle bzw. welcher Pfad der Schmerzverarbeitung genutzt wird. Trotz Hinweisen auf mögliche Parallelen beim Menschen steht diese Forschung noch an ihrem Anfang [3].

3) Frauen scheinen nur bei bestimmten Schmerzreizen, z. B. bei Druckschmerz eine niedrigere Schmerzschwelle zu haben als Männer. Die Schmerzschwelle kann dabei nicht mit Schmerzempfindlichkeit gleichgesetzt werden, da bei letzterer verschiedene Aspekte eine Rolle spielen [5].

4) Frauen sind auch in anderen Bereichen sensibler für verschiedene sensorische Reize, z.B. beim Tastsinn, Riechen, oder Farbensehen [5].

5) Frauen scheinen bei länger andauernden Schmerzen eine bessere Anpassung und Gewöhnung zu zeigen als Männer [5].

6) Es gibt Hinweise, dass es leichte Unterschiede gibt zwischen Männern und Frauen hinsichtlich der Verschreibung, der Einnahme und der Reaktion auf manche Schmerzmittel. Einflussfaktoren sind dabei u.a. Alter, Gewicht, weitere Erkrankungen und Art des Schmerzmittels. Weitere Studien zu diesem Thema sind notwendig [8].

7) Männer und Frauen nutzen unterschiedliche Coping-Strategien zur Schmerzbewältigung. Männer verwenden eher problemorientiertes Coping und Ablenkung durch Aktivitäten. Frauen nutzen eher soziale Unterstützung, Schmerzakzeptanz, Aufmerksamkeitsumlenkung, emotionsorientiertes und gedankliches/ kognitives Coping [2,9]. Ein Risikofaktor für Frauen könnte sein, dass sie eher zum Katastrophisieren neigen als Männer, was zur Verschlimmerung von Schmerzen führen kann (Infos und Tipps findest du hier). Außerdem haben Frauen oft eine niedrigere Selbstwirksamkeit als Männer, trauen sich weniger zu, was ebenfalls mit mehr Schmerzen und mehr körperlichen Symptomen verbunden ist [2].

8) Eigene Erwartungen und Werte haben einen Einfluss. So gibt es einen Zusammenhang zwischen der eigenen Gender-Rolle und dem Schmerzempfinden. Je stärker eine Person an Geschlechtsunterschiede in der Schmerzempfindung glaubt, desto mehr wird sie sich selbst entsprechend verhalten [1]. Gender-Rollen und Erwartungen bezogen auf das Schmerzempfinden können wiederum je nach Kultur unterschiedlich stark ausgeprägt sein [4].

9) Zuletzt sind auch die Erwartungen und Einstellungen des Umfelds wichtig. In einer Studie mit mehr als 600 Teilnehmern wurden diesen Videos gezeigt von Männern und Frauen, die bei der Arbeit Rückenschmerzen hatten [6]. Es zeigte sich, dass die Schmerzen aller Frauen als geringer eingeschätzt und eher als übertrieben wahrgenommen wurden. Die Schmerzen wurden weniger auf medizinische Ursachen zurückgeführt, und als weniger behandlungsbedürftig (Schmerzmittel, Anpassung des Arbeitsplatzes) eingeschätzt. Die Schmerzen der Frauen wurden mehr auf psychische Faktoren zurückgeführt und eine psychologische Behandlung empfohlen. Andererseits wurde auch gefunden, dass Medizinstudenten bei gleichem Gesichtsausdruck die Schmerzen von Frauen im Vergleich zu Männern als stärker einschätzten [11]. Ebenso wurde eine schmerzbedingte Körperhaltung bei Frauen als schmerzhafter bewertet verglichen mit Männern [12].

Zusammenfassend führen verschiedene Mechanismen zu Geschlechtsunterschieden bei Schmerzen. Insgesamt zeigen die Studien, wie komplex Schmerzen sind und wie viele Einflussfaktoren es geben kann. Diese Erkenntnisse können in Zukunft dazu beitragen, z.B. Schmerzmittel besser an Patientinnen und Patienten anzupassen. Und manche kann man sich selbst zunutze machen, um besser mit Schmerzen umzugehen. Tipps dazu findest du hier.

Referenzen

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