Sex differences in the perception of noxious experimental stimuli: a meta-analysis

Abstract

Fillingim and Maixner (Fillingim, R.B. and Maixner, W., Pain Forum, 4(4) (1995) 209-221) recently reviewed the body of literature examining possible sex differences in responses to experimentally induced noxious stimulation. Using a 'box score' methodology, they concluded the literature supports sex differences in response to noxious stimuli, with females displaying greater sensitivity. However, Berkley (Berkley, K.J., Pain Forum, 4(4) (1995) 225-227) suggested the failure of a number of studies to reach statistical significance suggests the effect may be small and of little practical significance. This study used meta-analytic methodology to provide quantitative evidence to address the question of the magnitude of these sex differences in response to experimentally induced pain. We found the effect size to range from large to moderate, depending on whether threshold or tolerance were measured and which method of stimulus administration was used. The values for pressure pain and electrical stimulation, for both threshold and tolerance measures, were the largest. For studies employing a threshold measure, the effect for thermal pain was smaller and more variable. The failures to reject the null hypothesis in a number of these studies appear to have been a function of lack of power from an insufficient number of subjects. Given the estimated effect size of 0.55 threshold or 0.57 for tolerance, 41 subjects per group are necessary to provide adequate power (0.70) to test for this difference. Of the 34 studies reviewed by Fillingim and Maixner, only seven were conducted with groups of this magnitude. The results of this study compels to caution authors to obtain adequate sample sizes and hope that this meta-analytic review can aid in the determination of sample size for future studies.

Pain-related quality of life related to mental health and sociodemographic indicators in adolescents

“…Previous studies have also reported sex differences in pain experience 35,36 . Compared with men, women usually reported more frequent, severe, and persisting pain 36 .…”

“…Previous studies have also reported sex differences in pain experience 35,36 . Compared with men, women usually reported more frequent, severe, and persisting pain 36 . A study reported differences in central pain processing, including the magnitudes and locations of μ-opioid system activation, between men and women 37 .…”

“…In women, the various phases of the menstrual cycle may exert different effects on pain. A study reported that the luteal phase of the menstrual cycle is related to higher pain sensitivity, and higher rates of back pain, temporomandibular joint pain, and migraines occur at the end of the luteal phase 36 . Another study indicated that the reproductive status of women may influence the overall function of central opioid systems 39 .…”

Pain in workers with shoulder impingement syndrome: an assessment using the DASH and McGill pain questionnaires

“…Other studies have also demonstrated that women are more sensitive to pain and more inclined to report greater pain in relation to experimentally controlled muscle pain conditions 24,25 . On the other hand, no gender differences have been found in relation to the development of delayed-onset muscle soreness in the neck and shoulder muscles 26 .…”

Diferenças de gênero no limiar sensitivo para estimulação elétrica nervosa em adultos jovens

“…[1][2][3][4] The discovery that the circulating levels of sex hormones (SH), especially estrogen E2 and progesterone P2, besides the reproductive 8 and cardioprotective 9 roles, can exercise modulatory effects on the neuronal functions and alter the superficial cutaneous sensitivity 1,2 , gave rise to intriguing questions about the parameters of conformation/therapeutic modulation in analgesia in both genders, particularly in associations with thermal resources. [5][6][7][8][9][10][11] Considering that transcutaneous electrical nerve stimulation (TENS) appears as one of the most reliable and effective non-pharmacological resources for analgesia [3][4][5][6][7][10][11][12][13][14][15] , it became worth investigating the variations of the NSS between genders, and whether previous changes in skin temperature induced by heating/cooling would interfere in the adjustment/peripheral control of the NSS. Recently, experimental and clinical investigations showed that there are differences in the perception of the nociceptive stimulus, in the pain tolerance threshold and in cutaneous sensitivity to electrical stimuli between genders.…”