Gender Expression, Sexual Orientation and Pain Sensitivity in Women

Vigil, Jacob M.; Rowell, Lauren N.; Lutz, Charlotte

doi:10.1155/2014/297060

Cited by 14 publications

(6 citation statements)

References 69 publications

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“…Hence, previous research on sex differences in pain functioning (e.g., neurocognitive and behavioral processes) that did not include concurrent measurements of individuals’ relationship experiences may have missed corollary components of the nexus between biological sex and pain perception. The current findings are also important for highlighting potential within-sex correlates of social psychological functioning, such as gender identity [57-59], which may partly influence external pain perception irrespective of biological sex. Finally, the findings may be especially relevant for understanding sex differences in felt pain caused by extrinsic painful stimuli (e.g., surface, skin tissue damage).…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in How Social Networks and Relationship Quality Influence Experimental Pain Sensitivity

et al. 2013

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This is the first study to examine how both structural and functional components of individuals’ social networks may moderate the association between biological sex and experimental pain sensitivity. One hundred and fifty-two healthy adults (mean age = 22yrs., 53% males) were measured for cold pressor task (CPT) pain sensitivity (i.e., intensity ratings) and core aspects of social networks (e.g., proportion of friends vs. family, affection, affirmation, and aid). Results showed consistent sex differences in how social network structures and intimate relationship functioning modulated pain sensitivity. Females showed higher pain sensitivity when their social networks consisted of a higher proportion of intimate types of relationship partners (e.g., kin vs. non kin), when they had known their network partners for a longer period of time, and when they reported higher levels of logistical support from their significant other (e.g., romantic partner). Conversely, males showed distinct patterns in the opposite direction, including an association between higher levels of logistical support from one’s significant other and lower CPT pain intensity. These findings show for the first time that the direction of sex differences in exogenous pain sensitivity is likely dependent on fundamental components of the individual’s social environment. The utility of a social-signaling perspective of pain behaviors for examining, comparing, and interpreting individual and group differences in experimental and clinical pain reports is discussed.

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Section: Discussionmentioning

confidence: 99%

Sex Differences in How Social Networks and Relationship Quality Influence Experimental Pain Sensitivity

et al. 2013

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“…According to Franconi et al (2012), female patients are traditionally underrepresented in clinical studies, for different reasons not to elucidate here (e.g., Pinnow et al, 2009). On the other hand specifically in the area on pain, sex differences are well established, both for clinical and for experimental setting (Paller et al, 2009), but also have been found to be variable with sexual orientation and identity (Vigil et al, 2014). In the following sections we will review advances in research over the last decade, with respect to pain and placebo analgesia.…”

Section: The Short History Of Placebo Researchmentioning

confidence: 99%

Does Sex/Gender Play a Role in Placebo and Nocebo Effects? Conflicting Evidence From Clinical Trials and Experimental Studies

Enck¹,

Klosterhalfen²

2019

Front. Neurosci.

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Sex has been speculated to be a predictor of the placebo and nocebo effect for many years, but whether this holds true or not has rarely been investigated. We utilized a placebo literature database on various aspects of the genuine placebo/nocebo response. In 2015, we had extracted 75 systematic reviews, meta-analyses, and meta-regressions performed in major medical areas (neurology, psychiatry, internal medicine). These meta-analyses were screened for whether sex/gender differences had been noted to contribute to the placebo/nocebo effect: in only 3 such analyses female sex was associated with a higher placebo effect, indicating poor evidence for a contribution of sex to it in RCTs. This was updated with another set of meta-analyses for the current review, but did not change the overall conclusion. The same holds true for 18 meta-analyses investigating adverse event (nocebo) reporting in RCT in the placebo arm of trials. We also screened our database for papers referring to sex/gender and the placebo effect in experimental studies, and identified 28 papers reporting 29 experiments. Their results can be summarized as follows: (a) Despite higher sensitivity of pain in females, placebo analgesia is easier to elicit in males; (b) It appears that conditioning is effective specifically eliciting nocebo effects; (c) Conditioning works specifically well to elicit placebo and nocebo effects in females and with nausea; (d) Verbal suggestions are not sufficient to induce analgesia in women, but work in men. These results will be discussed with respect to the question why nausea and pain may be prone to be responsive to sex/gender differences, while other symptoms are less. Lastly, we will discuss the apparent discrepancy between RCT with low relevance of sex, and higher relevance of sex in specific experimental settings. We argue that the placebo response is predominantly the result of a conditioning (learning) response in females, while in males it predominantly may be generated via (verbal) manipulating of expectancies. In RCT therefore, the net outcome of the intervention may be the same despite different mechanisms generating the placebo effect between the sexes, while in experimental work when both pathways are separated and explicitly explored, such differences may surface.

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“…This hypothesis is consistent with the currently observed correlations between women's subjective body impressions and variability in pain reporting. Numerous previous studies have likewise shown that variability in gender expression (e.g., trait masculinity/femininity and sexual orientation) and the manipulation of gender role expectations influence pain reporting (e.g., Defrin et al 2009;Robinson et al 2003;Vigil et al 2014b).…”

Section: Discussionmentioning

confidence: 88%

The Curse of Curves

Vigil

Strenth

Mueller

et al. 2015

Hum Nat

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This study examines the associations between objective and subjective measurements and impressions of body shape and cold pressor pain reporting in healthy adults. On the basis of sexual selection theory (SST), we hypothesized that body characteristics that are universally preferred by the opposite sex-specifically, lower waist-to-hip ratios (WHR) in women and higher shoulder-to-hip ratios (SHR) in men-and characteristics (e.g., proportion of body fat in women) that infer attractiveness differently across cultures will correspond to higher experimental pain reporting in women and lower pain reporting in males. A convenience sample of young adults (n= 96, 58 females, 18-24 years; mean age=19.4) was measured for body mass index (BMI), WHR, SHR, and subjective body impressions (SBI), along with cold pressor pain reporting. The findings showed that BMI was positively associated with WHR and less-positive SBI in both sexes. Consistent with SST, however, only BMI and WHR predicted variability in pain expression in women, whereas only SHR predicted variability in men. Subjective body impressions were positively associated with SHR among males and unrelated to WHR among females, yet only females showed a positive association between SBI and higher pain reporting. The findings suggest that sexually selected physical characteristics (WHR and SHR) and culturally influenced somatic (BMI) and psychological (SBI) indicators of attractiveness correspond with variability in pain reporting, potentially reflecting the general tendency for people to express clusters of sexually selected and culturally influenced traits that may include differential pain perception.Hum Nat

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Gender Expression, Sexual Orientation and Pain Sensitivity in Women

Abstract: Larger investigations of the psychophysiological relationships among sexual orientation, gender expression and pain sensitivity are warranted. These findings may have implications for differences in clinical pain sensitivity of lesbian and bisexual women compared with heterosexual women.

Cited by 14 publications

References 69 publications

Sex Differences in How Social Networks and Relationship Quality Influence Experimental Pain Sensitivity

Sex Differences in How Social Networks and Relationship Quality Influence Experimental Pain Sensitivity

Does Sex/Gender Play a Role in Placebo and Nocebo Effects? Conflicting Evidence From Clinical Trials and Experimental Studies

The Curse of Curves

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