'Difficult reading': Victoria releases report into women's pain

The first inquiry of its kind into women's pain in Australia has found widespread experiences of dismissal, disrespect and inadequate treatment in the health system coupled with limited local and international research into women's health. The inquiry was conducted by the Victorian government's Women's Health Advisory Council and a panel of experts between January and October 2024. It examined barriers to accessing care, the effectiveness of current services and the reforms needed to improve pain management and healthcare outcomes. There were more than 13,000 responses from Victorian women and girls, clinicians, researchers and peak bodies. "The results can make for difficult reading," Health Minister Mary-Anne Thomas said on Sunday while releasing the inquiry's report. "The most common conditions that women are experiencing include period, pain, endometriosis and arthritis. "The report goes on to tell us that the impacts of these are not just the physical pain itself, but this leads to poor mental health, fatigue, poor sleep and low self-esteem." The report found 90 per cent of respondents experienced pain that lasted over a year, with half saying they were experiencing it daily and a third saying they were in pain constantly. Women with disabilities and from the LGBTIQA+ community reported higher rates of prolonged pain. A quarter of respondents rated their pain as a 10 out of 10 in terms of intensity, with menstrual and hormonal conditions affecting 40 per cent of respondents. The report found the health care system was built around "Caucasian male biology", making it difficult for women and girls to access care and support for pain. It said historically low investment in women's health research left many without effective pain relief or treatment, causing their symptoms to worsen and forcing them to spend substantial amounts of money on therapies, some of which may not work. "Many medical models and clinical guidelines overlook sex and gender differences, leading to gaps in diagnosing and treating conditions that affect women, girls and gender diverse people," the report said. "Beyond physical health, pain has widespread impacts on mental health and wellbeing, economic participation, and overall quality of life." More than half of the respondents said their pain affected their recreation and hobbies as well as their intimate relationships, while 44 per cent said it had an impact on their work, studies, or volunteering. An overwhelming majority of women with disabilities — 89 per cent — said their pain also affected their mental wellbeing, sleep, caused feelings of shame, guilt and helplessness, and thoughts of self-harm for some. Women living in regional and rural Victoria often had to travel long distances to access health care, while Aboriginal and Torres Strait Islander women experienced systemic discrimination. "Women want to be heard without bias or judgement, treated with empathy and respect, empowered to make informed decisions about their health, and able to access affordable, effective care easily," the report authors wrote. The report has made 27 recommendations in seven key areas, including: more focus and funding for women's health researchthe development of a women's pain action planimproved education and training for health providersa culture change to reduce gender bias and stigmaclearer referral pathways and cross-sector information sharingattracting and retaining clinicians to regional and rural areasadvocating for the federal government to help make healthcare more affordable and accessible, including an increased investment in women's pain services. "Women and girls told the Victorian government how to put an end to their unnecessary suffering and eradicate the barriers they face when seeking help," the report concluded. "Your voices are now being heard. "We hope that, in time, we can improve pain care and the overall health and wellbeing of all Victorian women and girls." Delayed report release accompanied by IUD pain relief announcement The inquiry's final report has been delayed by more than half a year. It was due to be made public early this year, then an updated release date was given as "mid-2025". It has finally been released on Sunday. Ms Thomas said she did not expect "the breadth of the challenge" faced by Victoria. She said Victoria would develop a new clinical pain standard to help women receive more effective treatment. "What our health professionals have told us is that their greatest barrier to delivering the care that they know that the women and girls that see them need is their own limited knowledge and understanding of options to treat the pain that girls and women are experiencing," she said. "We need to work with our healthcare workforce, with our universities, with the medical colleges to address this issue. "It's a big system issue, so it's going to take some time to change." She also announced the establishment of a women's pain clinic at the Royal Children's Hospital. "Women have been brought up to believe that experiencing pain is normal for them and this is not the case so we need to bust some of these myths," she said. Joining Ms Thomas at the report release was Premier Jacinta Allan, who announced Penthrox — commonly known as the green whistle — would be offered at 20 sexual and reproductive health hubs in Victoria to women receiving IUDs. Frankston Hospital, in Melbourne's south, began trialling the use of the pain relief for the procedure in 2023. "What the green whistle does is give women control over managing their pain but also over their body and their reproductive choices," Ms Allan said. She also revealed the difficulties she had experienced when she was younger as she tried to find help to diagnose and treat her endometriosis and subsequent fertility issues. "Whether it's the heavy periods, the crippling cramps … we're taught we just have to push through it and put up with it," she said. "For too many women and girls, they're not being listened to, which means in turn they're not getting the treatment they need and deserve." Ms Allan said the report would help achieve systemic change.