Gender differences in pain ratings and pupil reactions to painful pressure stimuli

Abstract

In order to investigate gender differences in pain perception, the present study employed both a psychophysical and a psychophysiological measure. In experiment 1, 20 subjects rated the painfulness of 4 different levels of tonic pressure applied to their fingers using a verbally anchored categorization procedure. In general agreement with studies of pain threshold and tolerance, female subjects reported greater pain at high levels of stimulation, with no gender difference being evident at low pressure levels. In experiment 2, 16 different subjects were exposed to the same painful pressure stimuli while measuring their pupil reactions using infrared video pupillometry. The pupil dilations seen during the last 10 sec of the 20-sec pressure application turned out to be a highly significant indicator of pain intensity. When female and male subjects were compared on this measure, a similar divergent pattern as in the psychophysical data emerged, with female subjects showing greater pupil dilations at high pressure levels only. The fact that gender differences in pain perception can be demonstrated using an autonomic indicator of pain that is beyond voluntary control suggests that these differences reflect low-level sensory and/or affective components of pain rather than attitudinal or response-bias factors.

Hemispheric‐synchronisation during anaesthesia: a double‐blind randomised trial using audiotapes for intra‐operative nociception control

“…Another potential source of bias in the study arises from the slightly higher (though not statistically significant) frequency of men in the Hemi-Sync group compared with the other groups. Though the widely held belief that women have a higher pain threshold than men has been reported [24], most studies either found no sex difference in pain perception [25] or reported a higher pain threshold for men than for women [26]. We were unable to detect any significant effect of gender on the doses of fentanyl required when our data were analysed both for all study patients and for the Hemi-Sync patients alone.…”

Is there a gender difference in the effect of work-related physical and psychosocial risk factors on musculoskeletal symptoms and related sickness absence?

“…It was also shown that pain-rating behavior could be influenced and that, when a gender-specific expectation of pain tolerance was given before the test, there were no longer significant gender differences in pain tolerance (56). Combined with the results of Ellermeier & Westphal (52), these findings show that women not only detect pain at an earlier stage, but are also more willing to report a stimulus as being painful. For our present study, this finding may imply that women simply more often report (relatively small) symptoms that are unrelated to exposure, while men report the more severe symptoms caused by exposure.…”

“…Many laboratory studies have been performed to examine gender differences in pain perception. Women were found to have a lower pain threshold, independent of the exact stimulus, for example, thermal stimuli (hot and cold) (48)(49)(50), electrocutaneous stimulation (51), and pressure (52). This difference in pain perception has been attributed to the influence of sex hormones (53) and gender role expectations (54).…”

Sex Differences in Predictors of Outcome in Selected Physical Therapy Interventions for Acute Low Back Pain

“…20,57 In addition to measures that rely on subjective response, sex differences have been observed in physiological measures of pain response. Women experienced greater pupil dilation in response to a mechanical stimulus 16 and the spinal cord mediated nociceptive flexion reflex was elicited at lower intensity of electrical stimuli for women. 21 Collectively, this literature provides strong evidence that women have a greater response to pain, at least when stimuli are applied in a standard manner.…”