Men and women are different in several ways, which can manifest physically and emotionally. Some of these differences between men and women lie in their biological presentations, like the reproductive system, certain body parts, and biological processes like the ability of women to give birth. Emotionally, women are believed to be more emotional compared to men and are usually more expressive of their feelings.
Another gender difference between men and women is how they experience pain and respond to pain treatments. Several studies state that women are at higher risk for many common pain conditions than men. Other sources also state gender differences in how people respond to pain therapy.
A review published in the National Library of Medicine examined the existing body of knowledge on sex differences in experimental and clinical pain, focusing on several biological mechanisms involved in the observed gender-related differences. We will highlight several interesting insights in this article.
Previous studies revealed a higher female prevalence of several painful diseases. It is said that women report more severe pain levels, more frequent pain in more areas of the body, and longer pain duration than men.
Some painful conditions that are more common in women include:
On the other hand, some common pain conditions are more common in men than women, like cluster headaches, which is a typical male pathology.
Despite several studies examining the relationship between gender and pain, its relationship remains unclear due to conflicting results regarding examining sex differences and pain severity in clinical populations.
The review states that some observed differences in pain experience may occur due to recurring problems over a long period in a woman’s life, including gynecological syndromes, greater female longevity, or those related to diseases that are more prevalent in males than females.
Also, different kinds of pain in both sexes can change across the lifespan. For example, menopause impacts changing pain sensitivity but can also be accompanied by other painful conditions, including osteoporosis and joint inflammation.
The review also found several factors that may affect pain perception, expression, and tolerance among genders, such as gender differences in pain symptoms, signs of some syndromes, and psychological and socio-cultural factors. Still, the researchers stated that most of the findings from different studies suggest that women have a higher risk of many common pain conditions than men.
There are varying results from different studies regarding sex differences in pain response depending on various factors, including the type of stimulus used in the study,
testing, body location, temporal rhythms, reproductive status, age, and the presence of disease or illness.
According to the review, a few other reviews suggest that previous literature did not provide clear evidence on the link between sex difference and human pain sensitivity. However, the National Library of Medicine review states that their analysis found that females have greater pain sensitivity than males, despite the variation in the statistical significance of the sex difference across measures from previous studies.
Interestingly, despite similar behavioral responses by men and women to a painful stimulus, some neurophysiological measurements often show a different or opposite response to the same stimulus. This suggests a different functional involvement of the central nervous system and possibly on areas involved in pain prolongation.
The review suggests that the response to pain therapy, such as drugs, somatic manipulations, and situational adjustment, seems to be sex-related.
According to the review, several studies suggest that the variation in pain treatment between women and men is influenced by the characteristics of both patient and provider, which may lead to disparities in pain management.
Some evidence that demonstrates the differences in pain treatment states that:
Additionally, a study examining the outcomes of an intensive multimodal pain treatment program on different genders found that women benefited greater from the treatment than men and consistently improved more in pain-related disabilities in daily life than men. Based on these findings, the review concluded that gender differences seem to have a clinically relevant impact on the response to pain therapy.
The review states that the specific mechanisms behind gender differences in pain remain unclear, but most studies agree that it is an interaction of biological, psychological, and socio-cultural factors that potentially contributes to these differences.
Studies suggest that androgens and estrogens play a crucial role in the observed sex differences in response to pain and pain treatments. Several conditions, such as TM joint pain and fibromyalgia, are also related to the menstrual cycle phases and rapid estrogen changes, which may also be associated with increased pain.
Pain perception also differs depending on the menstrual cycle phases in women with chronic pain perception, with patients rating pain significantly higher in certain phases of the menstrual cycle than in others.
The review also states that the opioidergic system with gonadal hormones plays a role in sex-based differences in pain sensitivity. Other mechanisms contributing to gender-based differences in pain include genotype and the interactions between the immune and nervous systems that modulate nociception through microglia.
The difference between men and women regarding pain prevalence, sensitivity, offered treatments, and response to it, has long been documented. Several factors, including social, cultural, and biological aspects, play crucial roles in the relationship between gender and pain.
Several studies demonstrate that women perceive more pain than men in clinical and experimental pain. These differences in pain perception based on sex are frequently substantial, varying from moderate to large effect sizes. Multiple factors are considered responsible for sex differences in pain perception and the prevalence of chronic pain conditions in women. Biological factors such as sex hormones are believed to explain sex differences in pain perception.
These findings indicate the need for sex-separated experimental studies and different clinical strategies tailored to optimize pain management in men and women.
Pieretti, S., Di Giannuario, A., Di Giovannandrea, R., Marzoli, F., Piccaro, G., Minosi, P., & Aloisi, A. M. (2016). Gender differences in pain and its relief. Annali dell’Istituto superiore di sanita, 52(2), 184–189. https://doi.org/10.4415/ANN_16_02_09
