Friday, August 14, 2009

Redheads and Pain Tolerance

Redheads Require More Anesthesia in Surgery

For many years, anesthesiologists have anecdotally observed that redheads required more anesthesia in surgery. In 2004, Dr. Edwin Liem from the University of Louisville, Kentucky, decided to put this theory to the test. He conducted controlled scientific experiments and confirmed that female redheads require 19 percent more anesthesia in surgery. In a follow up study in 2005, he confirmed that female redheads “were significantly more sensitive to cold pain perception, cold pain tolerance, and heat pain tolerance”, and that again they were resistant to injected anesthesia, but not as resistant to topical anesthesia. They restricted the studies to women to eliminate the possible differences in analgesic pathways between men and women. This effect may not be the case for all female redheads so it is important that you discuss these findings with your doctor if you ever have the need for a surgical procedure.

But why? How? In the central nervous system, different hormones work together to create balance in perception of pain: alpha-MSH increases sensitivity to pain via melanocortin receptors, MC3R and MC4R, while opiates decrease sensitivity to pain. Dr. Liem postulates that there is a negative feedback loop from the malfunctioning MC1 receptor in redheads to the pituitary, which induces it to secrete excess circulatory alpha-MSH. The excess alpha-MSH acts on other fully functioning receptors in the central nervous system, MC3R and MC4R, and overpowers the opiate hormones. The result is a hormone imbalance and increased sensitivity to pain. Read more about this negative feedback loop in The Red Hair Factory. Redheads may also be susceptible to altered serotonin secretions from the skin melanocyte cells, which may exacerbate this effect since serotonin is a known modulator of pain. In a personal communication, Dr. Liem mentioned that he has not been able to challenge his hypothesis regarding alpha-MSH secretions in redheads since testing this hormone is expensive and difficult due to circadian rhythms.

Wait, redheads have a higher pain tolerance? Alright, which is it?

It is important to note that the media can often misinterpret information. For instance, in August 2005 there was a media release stating that studies demonstrate that redheads have a higher pain tolerance which would conflict with Dr. Liem’s findings above; however; this information was not put in the correct context by the media. The correct context is that redheads have a higher pain tolerance over others WHEN they are drugged up on an opioid medication called pentazocine. At an August 2005 press briefing Professor Ian Jackson of the Medical Research Council’s Human Genetics Unit in Edinburgh quoted a 2003 study conducted by Jeffrey Mogil et al. In this study, it was concluded that when female redheads were administered the opioid medication pentazocine, they demonstrated a significantly higher pain threshold. This medication was not as effective on red-haired men nor on those individuals with a higher ratio of brown-black pigment. It was postulated that the medication not only stimulates opioid receptors in the central nervous system which reduces pain, but that it may also somehow prevent the pain increasing effect of alpha-MSH (a hormone that may be excessive in redheads) by blocking it from binding with the melanocortin receptors, MC3R and MC4R. The combination of stimulating the opioid receptors and blocking the stimulation of the MC3R and MC4R dramatically increases the effect of the medication.

More simply put, if you are a hot redheaded female in desperate need of an opioid pain killer, you might get a better fix on penatazocine. Of course I'm joking, I do not advocate drug use, as the adverse affects of pentazocine are similar to that of morphine. Also, as with many other opioid medications, pentazocine is addictive.

Dental Pain

On August 6, 2009, an article appeared in the New York Times called The Pain of Being a Redhead by Tara Parker-Popeimes. It highlighted a new study which appeared in The Journal of the American Dental Association. This article brought the whole redhead and pain issue to the forefront again. Participants in the study completed surveys that measured “general and dental care–specific anxiety, fear of dental pain, and previous dental care avoidance.” The authors tested the participants’ blood samples to detect gene variants associated with natural red hair color. The conclusion was that redheads were more than twice as likely to avoid dental care as were the participants without red hair, even after the authors made adjustments for general anxiety and sex.

It's interesting that the results of this study do not distinguish between red-haired males and females as the others do. It indicates that the effect was observed in both sexes. I'd be curious to know what adjustment they made for sex. I guess I'll have to pay to download the full study then! I'll keep you posted.

What's Your Pain?

Pain can manifest in so many different ways and differently in different people. So as a redhead, are these findings true for you, and if so, how does your pain manifest itself? Somebody mentioned to me last weekend that they had a redheaded friend who stated with pride that she went through labor without an epidural. To that, I say……go girl!......are you frickin’ crazy?........And why am I not more like you?

The findings regarding sensitivity to temperature are interesting. I tend to get cold very easily, but that is fairly normal for many women. Female circulation generally runs closer to the organs, while male circulation runs closer to the surface muscles. I’m also very thin and have little insulation. When I’m at one of my friend’s parties on their deck overlooking a glorious Bay Area view, I always seem to be huddled up in a hat, sweater, and gloves, while others are baring their legs. One of those more scantily-clad lassies is often my redheaded friend Sue, who never seems to get cold at all.

As a kid, my dentist drilled into my teeth without any shots or gas at all. I distinctly remember being tortured and pushing his hand away when it hurt, but I would think that would be normal for anyone. My current dentist numbs me up just fine for crown work, but I still hate going. Again, isn’t that normal?

For me, the physical pain that I had to overcome in my life had something to do with why I waited until my thirties to lose my virginity – yes, painful intercourse. It’s not something that I’m particularly excited to advertise to the world on my blog, but after reading a couple posts on the NYT article from a few other female redheads who have had a similar problem, I feel the need to share my journey for their sake and any others who can benefit from this information. Unfortunately, this topic is as shameful to discuss as menopause was many years ago. So it's about time to bring it out in the open for the purpose of healing.

The main cause of painful intercourse is usually a tight vaginal opening. Some women also are born with their urethra closer to the vaginal opening than other women, which also contributes to the discomfort. My advice in this situation is as follows:

1. Treat Infections: Make sure that any urinary or vaginal infections are treated. Drug stores sell test strips for both now. Some great infection prevention techniques are Jarrow's Fem-dophilus supplement and boric acid vaginal suppositories like Vitanica's Yeast Arrest.

2. Hygiene: Soaps can be very drying and irritating to the vagina, urethra, and rectal areas. Wash the vaginal and urethra area with a gentle pH-balanced cleanser like Sweet Spot. A proctologist told me to clean the rectal area with nothing but a good spray of water in the shower and to clean with moistened cotton medallions after bowel movements as toilet paper can be too rough. I remember thinking, really? Hey, it worked! Irritation gone.

3. Diet: Drink lots and lots of water, eat a healthy diet of whole foods, and avoid caffeine and acidic foods, which can irritate and cause discomfort to the bladder and urethra. They always recommend cranberry juice for urinary tract infections, but I find that it can be quite irritating and make you think you have an infection when you don't! Try a D-Mannose supplement to get the benefit of cranberry without so much of the acid. Common bladder irritants are: coffee (even decaffeinated), caffeinated tea, caffeinated soda, alcoholic beverages, medication with caffeine, chocolate (that's a tough one), smoking, acidic foods, citrus juices and fruits, tomatoes and tomato-based products, artificial sweetener, highly spiced foods, milk and milk products, sugar and honey, corn syrup, and cranberry juice. And if you happen to partake in the above (because let's face it, who can refuse chocolate?) just be sure to cut it with water, water, water.....

4. Physical Therapy: Get a referral from your gynecologist to a physical therapist that specializes in vaginal exercises. Yes, they actually have physical therapy for painful intercourse now and thank God! Usually, these types of physical therapists also work with women on incontinence issues.

5. Sex Toys for Stretching and Pleasuring: Purchase Dr. Berman’s vibrator dilator which starts small and can adjust gradually to larger sizes. This vibrator also works well for physical therapy.

6. Exercise: Take a yoga class. Poses such as lunges, triangles, and warriors stretch, open up, and strengthen the hips and the pelvis. Pilates is awesome too!

7. The Best Mate: Find a mate who understands, who is gentle when you need him to be, rough when you want him to be (if this pleases you!), and who loves to give and receive oral sex for variety and more options.

8. Lube up: If needed, transfer your lube into a pump container by the bed for ease of use and spontaneity. My therapist recommended Slippery Stuff, but Collective Well-Being Good Glide is my personal favorite.

9. Topical Lidocaine: Your gynecologist can give you a topical lidocaine gel that you can use a few hours before intercourse or apply a small dose daily. Dr. Liem's experiments indicate that topical lidocaine is effective on redheads.

10. Surgery: Worse comes to worse, you might need to ask your gynecologist to surgically cut your hymen to open up the space, but I encourage you to try the physical therapy first. The cut may cause some scar tissue which is less flexible and could also cause discomfort during intercourse.

I’m very happy to report that I have achieved the elusive vaginal orgasm to my surprise and satisfaction several times. So please know that there is hope out there! My physical therapist said that fairer-skinned individuals tend to have less flexible tissue, yet again one of those anecdotal observations about redheads that I always hear. Another one is from the gynecologist who always tells me that redheads are bleeders, but more on that later. So stretch, stretch, and stretch again! If you can’t get physical therapy, please write me, and I will copy the exercises into a PDF and forward them to you. And remember if I can do it, so can you.

Just for the record, if fate decides to make me a mother one day, screw natural labor - I want the frickin’ epidural and I want to give birth in a tub of water as I hear that can ease the pain too!

19 comments:

  1. This comment has been removed by a blog administrator.

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  2. I've been reading through articles today about redheads and pain and anasthesia and stumbled onto your blog.

    As a natural redhead, I find myself nodding my head in the affirmative to pretty much everything you've written.

    When I was 4, I woke up during a surgery. In the last year, I've had to have 4 surgeries due to a car accident, but the anasthesiologist was the one who told me I'd need more anasthetic.

    I haven't been to the dentist in over 20 years because the last time I was there I told the dentist his drilling hurt and he said, "no it doesn't. stop lying."

    I feel...vindicated! It's the only word I can think to use!

    Thanks for your blog!

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  3. I'm 56, redhead of German descent, have been very active since age 30 (jogging, hiking, bicycling, racquetball). I've developed chronic knee pain the last two years. A doctor told me of "studies" that state cartilage gets softer in women of my profile. Have you heard of that?

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  4. Hi Linda,

    Thank you for your comment. I have never heard this before, but when I googled redheads and cartilage there indeed are a few references stating that Caucasian redheads are more prone to arthrofibrosis, a complication of knee injury or surgery where excessive scar tissue causes painful restriction of knee motion. One of the references states that there is no scientific study, but this was as of 2001 so there may indeed be studies conducted since then. I will have to dig deeper.

    This most definitely will be a subject for a future post! Thank you for sharing! And I sincerely wish you luck with your knee problems.

    Carol

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  5. I am so thankful for all this information! I am 23 and a redhead who faught my parents for years on going to the dentist, when I was 20 I had to have an emergency root canal and still cant seem to go back to the dentist and never understood why I was so frightened im glad to know I am not the only one. I am also glad you shared other information so I can be aware if I ever need surgery, Thank you so much.

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  6. I read this and my mouth dropped open. I am 35 and a redhead and have avoided the dentist as much as possible my whole life but never knew why I couldn't make myself go. I am also a migraine sufferer and have always had a very high tolerance for pain. Thank you so much for all of this information and for bringing this to light!

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  7. Hello,
    As a redhead myself, .. one with chronic pain related to both severe and rare spine condition and auto immune diseases, I am very intrigued to hear about the connection between redheads and inflammatory response. I have been told I have a high pain threshold, but I've been through more medically and physically at the age of 29 than most people experience in their entire lives ... I have found that within the last few years my pain tolerance had lowered quite a bit, ... I don't know if this is related to my auto immune diseases and subsequent inflammation throughout my skeletal system, lymphatic system, etc., compounded with my spine collapse, or simply because I have been on constant pain for over 20 years now, my body is tired and overwhelmed .. or because I am a redhead? I would greatly appreciate any information you may have found on the subject! And as a side note, kudos to you for creating such a wonderful blog page! I post on several on blogspot pages myself, but never thought of the redhead aspect. There's not a lot of information out there on redhead's, hormones and the pain/inflammation connection ... and it's lovely to read research and writing by an intelligent fellow redhead!!! Thank you!!! Brenna

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  8. Thank you for your comment Brenna! I'm sorry to hear about your condition. I'm sending healing thoughts your way. At this point, the only observable phenomenon is that redheads need more anesthesia in surgery and they aren't sure why. Please also read my post and the comments for "Mythbusters: No Pain, No Gain." For the inflammation and autoimmune connection, please read "Redheads, Inflammation, and Celiac Disease." I'm also about to post something about allergies. Good luck!

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  9. Just for the record, I'm a natural redhead, and have three children, and didn't hemorrhage with any of them. The first was a hospital Pitocin induction (pure agony!) that ended in cesarean. The second was a 10 lb son birthed at home 3 years later, after spontaneous natural labor, no drugs, but a wonderful labor pool. That was MUCH less painful. No need for an epidural when there's no Pitocin and unnatural positions such as lying down, to make birthing agonizing. Third, another son 3 years after that, this one only 9 lbs, following a very fast and intense labor.

    I think it's a shame that women hear such negativity all their lives in our culture, about birthing, that they are afraid to try it. Physiological, unhindered, respected birthing is as different from the medically managed, intervention-heavy hospital model, as eating a meal and swallowing on your own would be, from being intubated.

    So don't let being a redhead frighten you about birthing. Remember that you are here because of all the redheads who have given birth successfully for millenia. There are some ways of going about birthing, that make it a lot more difficult and painful, than others, but it's not a foregone conclusion that it's as terrible as you often hear.

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  10. Thank you for your comment. I have heard about labor pools and that sounds like the way to go. And as you mention, us redheads are still here for a reason after all!
    Carolbetty

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  11. I'm a natural redhead and would definately agree that I must feel pain more than others. This is probably tmi but my partner enjoys squeezing pimples and has attempted to do so on myself but I cannot bare the pain!

    I am also able to detect the exact time of my monthly ovulation, I get a sharp pain in my side that lasts a few hours as the egg rupture from the ovary and the associated pain of blood against the inside of the abdominal cavity (this phenomenon is known as mittelschmertz which means middle pain in German) I do not know anyone else who experiences this ovulation pain and thus attribute it to my increased sensitivity to pain. It would be interesting to do a survey in this to see if red heads experience mittelschmertz more commonly than other hair colours.

    As for dental pain, I can't really say as I have no fillings. I did have a supernumerary tooth removed as a child and can remember having pain at the injection sites for weeks on end (it felt as if I was having more injections!)

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  12. I am not sure if the person who posted last will get this response since they posted as "anonymous," but I wanted to say that I too experience this pain you speak of involving ovulation. I wonder if it's not a combination of both being a sensitive redhead, as well as simply having a greater level of intuition and being more in touch with one's body/mind/spirit?

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  13. I am not sure if the person who posted last will get this response since they posted as "anonymous," but I wanted to say that I too experience this pain you speak of involving ovulation. I wonder if it's not a combination of both being a sensitive redhead, as well as simply having a greater level of intuition and being more in touch with one's body/mind/spirit?

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  14. I had never heard of mittelschmertz, but I will keep my eyes and ears open for others with a similar experience. Perhaps your pain with pimple popping is related to my pain about waxing my upper lip? I hate doing this with all my heart and rather grow long whiskers!

    Thank you for your comments. Please also see my post called "Redheads and Pain: A Recap."

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  15. I also experience pain when ovulating. I have found that my sensitivity to pain is high, but so is my tolerance. Also, I have had to ask dentists and oral surgeons to increase dosages as I was able to feel the procedure. Thankfully, I've always had ones that believed me and responded appropriately.

    Thank you for your candid blog.

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  16. I am a natural redhead and can attest to two of the above items. First, nearly every time I go to the dentist I am in such pain that I pass out. This is even with anaesthesia. I am very good about taking care of my teeth, and go to the dentist for everything necessary, but I have to take the entire day off work just to recuperate. It is horrible! Second, I recently had to undergo an EMG, which is an electrical test of nerve function. The doctor basically puts needles in various muscles to stimulate nerves. My doctor was astounded by my high (!)tolerance to the pain. I'm not sure what any of this means, but I can absolutely handle any pain other than dental pain!

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  17. Interestingly enough, I also am a redhead and have also experienced a lot of these things, though not all. I definitely have needed more anasthesia during surgeries and procedures and am desperately terrified of the dentist. I also have a serious sensitivity to having my nails worked on by anyone else but me. Sensitivity to touch in general is extremely heightened.

    Also, after having a caesarean section, I hemmoraged badly and have had issues with bleeding before which is something else I have heard of with being a redhead. Is there a clotting factor missing in our blood or perhaps a mutation as well? Awesome blog....

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  18. My daughter is also a natural redhead. She is experience extreme ear pain. We have been to an ENT and he put tubes in her ears after a CAT scan, we then went to the Neuroautologist and he ordered an MRI, everything was normal. She is 28. She experiences alot more pain than anyone else. When she gets a shot of novacain at the dentist, it takes longer to kick in and lasts up to 2-3 days. When she was a teenager, we had a wart removed from her foot. I had to keep her home from school for 2 days because her foot stayed numb, but took forever to get that way. She also got a mysterious staff infection in her knee and had to have emergency surgery for it then IV antibiotics for 2 months. She did has hip surgery at 2 months. She has become a medical mystery. They have not found any drugs to assist her with the ear pain. You get tired of hearing, oh you must be a whimp, learn to live with it.

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  19. I'm a 55 year old natural redhead; for years I've been given extra novacaine for my dental procedures, never sure if it took more to numb me, or took longer to kick in; I'd then be numb for the rest of the day. When ever I have a procedure with sedation, I always take longer to come out of it; and general anesthesia makes me horribly sick. I used to work in radiology, and remember the head tech telling me she wouldn't want to have to do a IVP (kidney procedure no longer used) on me because she suspected I'd be allergic to the dye; she said most redheads were. And yes, I have a high pain threshold; but with over 40 years of migraines (which have abated, thankfully), and many other chronic conditions; if I didn't have one, I couldn't function.

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