Talk to any woman with a difficult-to-diagnose chronic pain condition, such as fibromyalgia or lupus, and she can probably tell you about a doctor who said her pain and other symptoms stemmed from depression or anxiety. She may even have been offered prescriptions for antidepressants or birth control pills (hormone therapy).

The Gate Control Theory was advanced in 1965 in an effort to improve scientific understanding of chronic pain. Read Understanding Chronic Pain: The Gate Control Theory

Unexplained symptoms blamed on hysteria

For hundreds of years, chronic pain in women was associated with hysteria, a term coined by Hippocrates in the 5th century BC. Doctors gave women this convenient diagnosis when they couldn’t identify the source of the pain.

See Acute vs. Chronic Pain

In short, when doctors couldn’t see injuries, swelling, or other signs of medical problems, chronic pain was blamed on a woman’s disposition: she was depressed, stressed, anxious, overcome with a sense of perfectionism, or all of the above.

Identifying the real sources of chronic pain

Medical experts removed hysteria from their diagnostic textbooks in 1980. Over time, they have formally recognized seemingly invisible conditions that cause chronic pain, such as fibromyalgia, chronic migraines, lupus, and interstitial cystitis. Better yet, they have developed diagnostic criteria and medical tests and imaging to help accurately diagnose patients.

See Common Conditions That Cause Chronic Pain

The challenge for female patients

While progress is being made, the underlying idea that pain is all in women’s heads still persists in some doctors’ offices today, and diagnosing many chronic conditions is still frustratingly difficult.

Advocate for yourself
A woman seeking a diagnosis for her chronic pain may need to get second and third opinions. She may need to talk to her doctor about running blood tests or ordering medical imaging to help rule out certain conditions.

Patients should never be afraid to advocate for themselves. Good doctors will not dismiss symptoms and will engage in clear and honest communication.

Don’t ignore recommendations to reduce depression, stress, and anxiety
In turn, female patients (and male patients, too) should not object to doctors' recommendations to reduce depression, stress, and anxiety through activities such as exercise, meditation, and improved diet. While these recommendations may not address the underlying cause of chronic pain, they can help alleviate pain.

Learn more:

Applying Gate Control Theory to Pain Relief

Headache Treatment and Prevention