Sex-related influences on pain: A review of mechanisms and clinical implications

Objective: To review the literature regarding gender-related influences on the experience of pain. Methods: Medline searches and reference lists were used to locate published articles regarding gender differences in pain. Results: Women are at increased risk for many clinical pain conditions and for increased severity of clinical pain relative to men. Women typically report lower pain threshold and tolerance and higher pain ratings than men in laboratory research. Contributing factors include sex hormones, pain modulatory systems, family history, stereotypic sex roles, and affective/cognitive factors. Conclusions: The clinical implications of gender differences in pain responses are discussed, including gender differences in pain treatment outcomes. Gender-related factors affect pain considerably and merit additional attention in pain research and treatment.