Bridging the gender pain gap in women’s healthcare: 3 myths you need to stop believing

Consultant gynaecologist Miss Natasha Abdul Aziz explains how partnership and frank conversations with your doctor can transform your experience of gynaecological procedures. 

“We have known for a long time that women wait longer to receive a diagnosis and treatment for pain. And this is compounded if you are a woman from the global majority, with studies suggesting this group of women are even more likely to be dismissed,” says Miss Natasha Abdul Aziz,  a consultant at London Gynaecology. 

“The good news is that this pain gap has finally become recognised.”

New 2022 recommendations on pain management

A new report from the Women and Equalities Committee says the NHS has yet to act on key 2022 recommendations around pain. Women are still facing distressing procedures, such as hysteroscopy and coil fitting, without adequate warning or pain relief. It encourages the NHS to enforce guidelines, carry out proper risk assessments and collect data to ensure women’s experiences are safe and informed.

“Modern gynaecology offers far more choice and comfort techniques than many people realise. And the most effective approach is always one where the clinician and patient work together. 

“With the right understanding and the right support, many gynaecological procedures can be made significantly more comfortable,” says Miss Abdul Aziz.

Sometimes, just knowing what to expect can make all the difference. 

In 2025, London Gynaecology proudly won an award for Outstanding Patient Experience, which we like to think was partly down to our commitment to compassionate care and improving the experience for women undergoing gynaecological procedures.

Pain management myths

So before you think that pain is just a given, we’ve broken down the myths that can often keep women suffering unnecessarily… 

MYTH #1: It’s normal for women’s procedures to be painful. That’s just how it is.

As women, we often think we just have to put up with pain. After all, many of us are used to dealing with a range of uncomfortable symptoms every month, which for many, are just a part of life. 

“But, awake procedures such as biopsies, coil insertions (or removals), or polyp removals don’t have to leave you in agony. It’s important for you to know that it’s your body and your choice for how far we proceed and if we stop. And there is no judgement, whatever the outcome,” says Miss Abdul Aziz.

MYTH #2: You either go under general anaesthetic or you suffer through it

General anaesthetic, also known as ‘being put to sleep’ can feel pretty daunting. It involves a hospital stay of a few hours and you need someone to collect you and be at home with you afterwards. 

Sometimes, this may be the right choice for you but too many women assume that the only other pain relief option is to ‘grin and bear it’.

“In reality, there are a number of different pain management options,” says Miss Abdul Aziz.

“Some women dread speculum examinations. That stretching feeling caused by the small plastic duck-like instrument, can be painful for some women. The design hasn’t changed since Edward Cusco developed it in 1870 and interestingly, this was actually an amended and updated version of another  type of speculum developed by a man named J. Marion Sims. He was an American gynaecologist who believed women of colour for instance, didn’t experience pain.”

Local Anaesthetic Options for Gynaecology Treatments

Often, a lubricant gel or spray with local anaesthetic in the vagina can reduce some of the pain caused by a speculum. 

Local anaesthetic can also be used when something is passed through the neck of the womb (the cervix). For some women this is a good choice as it blocks a lot of nerve pathways which can feel painful and even trigger a nerve in your body called the vagus nerve. 

“In addition to innervating the cervix, this nerve controls heart rate and blood pressure. That’s why sometimes when you have a procedure involving the neck of the womb you can end up feeling flushed and lightheaded,” explains Miss Abdul Aziz.

This is an injection around the cervix 2-4 times that feels much like a bee sting you might get at the dentist. Some women feel they would rather have the discomfort of the coil just once rather than a few injections. Sometimes the injection of the vagus nerve branches can also cause a bit of light headedness. 

Cramp-like contractions, caused by your muscles’ automatic response to try and expel whatever is being inserted, can be soothed by a heat pack placed over your abdomen. 

“In most clinics you need to bring your own heat pack with you for health and safety reasons,” says Miss Abdul Aziz.

Pre-emptive Pain Medication

Pain relief taken before procedures, such as ibuprofen, can also help with pain. 

More recently, the British Society of Gynaecology Endoscopists, have developed a guideline for the off-label use of an inhaled anaesthetic called Penthrox.

“In small doses, it provides relief from anxiety and pain equivalent to the effect of morphine, but with fewer side effects. Penthrox is already widely used by paramedics and in A&E for fast relief of moderate to severe pain in conscious adults,” adds Miss Abdul Aziz.

Other options to manage pain include:

• controlled breathing, which works to reduce the effects of the vagus nerve
• music or visual distractions such as VR headsets, stress balls
• playing a simple game on your phone like tetris after the procedure

Research has found these methods can be helpful in reducing fear and anxiety and increasing the comfort levels of patients.

“Often, a successful, comfortable procedure requires more than one single technique with a combination of pain management options being used to support you,” says Miss Abdul Aziz.

“I will be able to discuss all options with you, to find the most suitable pain management techniques based on the procedure and your preference. Setting expectations is important to helping you feel prepared and in control.”

MYTH #3: If you ask for more pain relief, you’re being dramatic.

Enduring pain isn’t a test of toughness, yet women seem to have been dealt the short straw when it comes to how their pain is recognised and treated.

“What I hear most often is women who feel they need to apologise for ‘not being strong enough’ or ‘being drama queens’. Nothing could be further from the truth,” says Miss Abdul Aziz.

It’s hard to judge pain of course, as everyone’s pain threshold will be different. However, research by University College London found that women’s pain reports are systematically underestimated.

Another study by King’s College London found that healthcare providers were less likely to prescribe women with pain relief medication than men and they were also less likely to record their pain score.

“Pain is personal. You’re the only one who knows what you’re feeling. At London Gynaecology we work with you, and will never judge you for your pain relief choices,” says Miss Abdul Aziz.

MYTH #4: If it only lasts a few minutes, the pain doesn’t matter

Procedure duration absolutely does not determine pain intensity. 

“Short procedures can still be intensely uncomfortable. For example, a coil insertion, despite being short, can be painful. For some women, they may be impacted more, perhaps by anxiety, past trauma or another chronic pain condition,” says Miss Abdul Aziz.

Whether a procedure takes five minutes or thirty, at London Gynaecology, we take every procedure seriously, no matter the length.

“To me, a successful procedure is one in which my patient has felt comfortable and in control throughout and if necessary, is going home with a pain relief plan that works for them and their lifestyle,” adds Miss Abdul Aziz.

With accurate information, personalised planning and a supportive clinical team, gynaecological procedures can be made far more comfortable than many people expect. 

At London Gynaecology, our approach is simple. We provide clear communication, shared decision-making and a commitment to helping every patient feel informed, safe and understood. 

/pmc.ncbi.nlm.nih.gov/articles/PMC12616914/#Sec27
https://www.ucl.ac.uk/news/2021/apr/analysis-womens-pain-routinely-underestimated-and-gender-stereotypes-are-blame?
https://www.kcl.ac.uk/news/study-finds-women-less-likely-to-be-prescribed-pain-relief-than-men?