This is an article I wrote for the Sep/Oct 2015 edition of Osteopathy Today.

Why is women's health significantly worse than men's?

Women globally report significantly worse health than men [1]. Self-reported health is associated with many social factors, including education and economic status. Being in paid employment has a significant positive effect on health for both women and men.

Women and men who have never married and never co-habited tend to report better health than those who are married, who in turn report better health that those who are divorced, separated or widowed. This is effect is greater in women.

Major life events that can affect women's health include pregnancy and childbirth, with some women experiencing persistent pelvic pain after childbirth. Sclerotomal referral and central sensitisation may produce pain in the low back, groin, and lower extremity [2]. A history of physical or sexual abuse may exacerbate pain symptoms but may be more likely to worsen mood disorders such as depression [3]. Domestic violence and abuse may affect over 40% of women in some areas of the UK with even more experiencing some form of controlling behaviour by their partner – yet this problem is consistently underdetected by health practitioners, and poorly managed [4].

Given osteopaths' role as primary care practitioners, and the privilege of privacy with our patients, can we do more to help our female patients?


[1] Hosseinpoor AR, Stewart Williams J, Amin A, Araujo de Carvalho I, Beard J, Boerma T, et al., 2012. Social Determinants of Self-Reported Health in Women and Men: Understanding the Role of Gender in Population Health. PLoS ONE, 7(4):e34799. Available online at

[2] Torstensson T, Butler S, Lindgren A, Peterson M, Eriksson M, Kristiansson P, 2015. Referred Pain Patterns Provoked on Intra-Pelvic Structures among Women with and without Chronic Pelvic Pain: A Descriptive Study. PLoS ONE, 10(3):e0119542. Available online at

[3] As-Sanie S, Clevenger LA, Geisser ME, Williams DA, Roth RS, 2014. History of abuse and its relationship to pain experience and depression in women with chronic pelvic pain. American journal of Obstetric Gynecology, 210(4):317:e1-8. Available online at

[4] Identification and Referral to Improve Safety. Domestic violence and abuse: the role of general practice. [Accessed 8 July 2015] Available online at