Last updated: Feb 22, 2008


One size fits all does not apply to painkillers. “Women are not small men when it comes to pain treatment,” says Mark Allen Young, MD.

While many basic medications, from aspirin to Ben-Gay, work equally well in both genders, there are also significant differences. In particular, recent research shows that some of the anti-inflammatory pain drugs known as NSAIDs (ibuprofen and naproxen sodium) dont always bring women the same level of relief they provide men.

And the more serious painkillers, known as opioids (codeine, morphine) often prescribed postsurgery or for short-term relief of extreme pain, cause many more side effects such as nausea, constipation, depression, and itching in women than men. Luckily, other drugs work particularly well for women.

Antidepressants
Used in lower doses than for psychological benefit, some antidepressants work on pain by “modulating the nerve feedback into the brain,” Young says. Theyre prescribed for migraine prevention, fibromyalgia, and lower back pain.

Neuropathic pain relievers
The newest weapon in the pain-killing arsenal, pain relievers such as tramadol, ease irritable bowel syndrome and menstrual pain, probably because they desensitize nerves, says Neil Kirschen, MD, president of the American Association of Orthopedic Medicine.

Trigger-point injections
Used mainly for muscular pain in conditions such as fibromyalgia, trigger-point injections ease pain with lidocaine and other desensitizing drugs. An exciting breakthrough is ultrasound-guided injections, Young says, in which imaging helps place the medication exactly where it needs to go. Another treatment option is lidocaine patches.

Spinal epidurals
Used for sciatica, herniated disks, and other back problems, steroid injections or nerve blocks “block the pain cycle,” says Joseph Shurman, MD. Theyre now used for other parts of the body, too.

The return of oxycontin
Celebrity addiction stories notwithstanding, this morphine-based painkiller is highly effective and not as addictive if used very carefully for a short period of time, on a case by case basis, Shurman says.