Self-Care for Mothers & Gender Differences in Chronic Pain

Brough to you by CHYP’s Parenting Blog

June 21st, 2021

By: Lonnie Zeltzer, MD

Self-Care for Mothers

Do you ever wonder why you feel exhausted by late afternoon? Why your tolerance for stress goes down and your annoyance level goes up?

This is especially true for mothers (or dads in a traditional primary caretaker role). We say we have too much to do, especially if we have a job in addition to caring for our house, kids, and family.

Have we women taken on the role that history has often assigned to us as “the weaker sex?” Yet we know we are not weak and what we do is hard work and exhausting.

History of “Hysteria”

I read an interesting article in the Wall Street Journal about pain in women.

(https://www.wsj.com/articles/medicines-failure-with-women-in-pain-11623470460) The author writes that over the years, her many symptoms were attributed to stress — meaning “not real or organic.”

Throughout history, women’s reports of pain have been seen as something other than real. The pain these women felt was labeled “hysteria,” which comes from the Greek word for uterus. It was often believed that the uterus was the site of women’s symptoms which were “psychological” in nature — meaning not real (or “organic”). This was even before psychology as a field came into being. It gave support for women being thought of as “the weaker sex.”

Even now my female adolescent patients — who come to me because of headaches or any other pain problem — seem surprised when I ask about menstruation and period cramps. They tell me that their neurologists had never asked about their menstruation.

Gender Differences in Prevalence of Chronic Pain

There is a large gender difference in prevalence of chronic pain, with females outnumbering males at most pediatric pain clinics as well as in school-based studies. Certain pain types such as fibromyalgia and irritable bowel syndrome are far more prevalent in females than in males. Studies have shown that over time, from childhood to adolescence, not only do females have more pain but they also have more sites of pain in their bodies.

There are many beliefs about the female prevalence of chronic pain (as well as anxiety, depression, eating disorders, fatigue), including an old theory that females just “complain more than men” or “seek care more than do men.” Another idea is that women are just more “emotional” than men and more “reactive.”

All of those concepts have been disproven.

There is research on the role of female hormones in increasing pain signals, as well as impacting other areas of the brain that relate to emotional centers. Recent studies suggest that early pain exposure from severe menstrual cramps sensitizes the nervous system to become more prone to the development of pain.

I propose that women, mothers in particular, are a pretty hardy group. But, unlike the concept of “hysteria” associated with “female weakness of constitution,” I believe from what I have seen among mothers of my patients that mothers rarely take care of themselves. They often say, “I don’t have time” or “Once my child is better, then I can take care of myself.”

But here’s the problem with that:

  • Stress in anyone in the home moves around to everyone in the home as an unwanted visitor who is there to stay. It invades everyone’s body.

Mothers, in particular, often feel the brunt of the stress. However, as mothers, we often think about our own needs last.

Self-Care is Critical

This is why it is critical for mothers to recognize their own stress signals and find time during the day — every day — to do something kind for themselves. If mothers do not demonstrate self-care, then their children will model likewise, until the entire family unit feels the compounded stress.

What are self-care activities? They can range from walking outside and noticing flowers and other plant life, to just sitting and meditating/breathing without thinking about all the things that need to be done.

Exercise and yoga can be helpful, even if only for 20-30 minutes a day. Cooking can be soothing if it is thought about in a creative way, especially if mothers can invite their children to join them in the process. Listening to music, playing an instrument, or dancing or singing alone are self-help strategies. CHYP recommends that stressed teens do these self-care activities, but parents rarely take advantage of that recommendation for themselves.

My plea with this blog today is for mothers to stop, breathe, and think about what they do each day just for themselves. If you can’t think of anything, then begin to develop strategies for self-care.

This is vital for you, as well as for your family. The more you practice self-care, the more your children will also model this healthful habit.


Lonnie Zeltzer, M.D., is a Distinguished Research Professor of Pediatrics, Anesthesiology, Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA and Immediate Past-Director of the UCLA Pediatric Pain and Palliative Care Program. She is a co-author on the Institute of Medicine report on Transforming Pain in America and is a member of the national steering committee assigned to provide directions for pain research at the National Institutes of Health (NIH).  She has received, among other awards, a Mayday Pain and Policy Fellowship and the 2005 Jeffrey Lawson Award for Advocacy in Children’s Pain Relief from the American Pain Society (APS).  Her UCLA integrative pediatric pain program received a 2009 Clinical Centers of Excellence in Pain Management Award from APS and a 2012 award from the Southern California Cancer Pain Initiative.  She is active in advocacy for pain care and research. She was an invited member of the Institute of Medicine National Expert Panel on pain in American and was a co-author of the IOM publication on the committee findings in 2011. She was an invited member of the Centers for Disease Control (CDC) Special Advisor on The State of Opioids in America. She is also an invited member of the FDA Committee on Analgesia, Anesthesia, and Addiction, where new pain-related drugs are given FDA approval or not, as well as an invited member of the Expert Advisory Committee on Hemoglobinopathies as a pain expert for the National Heart, Lung, and Blood Institute (NHLBI) at NIH.  She is also on an expert panel for the NIH on a national study on a mind-body intervention for teens with fibromyalgia. She is also a member of the national Autism Think Tank as a pain expert in autism. Her research includes yoga, mindfulness, hypnotherapy, and other self-help interventions, including mobile technologies, to help children and adolescents who have chronic pain, as well as understanding biopsychosocial pain mechanisms in irritable bowel syndrome, cancer, sickle cell disease, headaches, dysmenorrhea, and other conditions. She has over 350 research publications on childhood pain and complementary therapies, has written more than 80 chapters, and published her first book for parents on chronic pain in childhood (HarperCollins, 2005) and her second book for parents on chronic pain in children and young adults (Shilysca Press, 2016).