Sex differences and hormonal modulation of deep tissue pain

Abstract

Women disproportionately suffer from many deep tissue pain conditions. Experimental studies show that women have lower pain thresholds, higher pain ratings and less tolerance to a range of painful stimuli. Most clinical and epidemiological reports suggest female gonadal hormones modulate pain for some, but not all, conditions. Similarly, animal studies support greater nociceptive sensitivity in females in many deep tissue pain models. Gonadal hormones modulate responses in primary afferents, dorsal horn neurons and supraspinal sites, but the direction of modulation is variable. This review will examine sex differences in deep tissue pain in humans and animals focusing on the role of gonadal hormones (mainly estradiol) as an underlying component of the modulation of pain sensitivity.

Predictors of Health-Related Quality of Life over Time Among Adolescents and Young Adults with Sickle Cell Disease

“…Women report greater deep tissue pain sensitivity than men across multiple chronic pain conditions, which may be modulated by hormonal differences (Traub & Ji, 2013). More trips to the hospital and/or ED, and longer hospital stays would suggest greater physical impact of the disease.…”

Outcome of surgical treatment for displaced acetabular fractures: a prospective study

“…Although we had few female patients, however, their HHS was obviously lower than men. This inferiority can be partially explained by lower pain threshold in women, which can influence their function and HHS 22, 23Table 6Comparison of results.Author(s)CasesMean follow-upExcellent/goodBucher 13 16111.373Madhu et al 14 2372.976Deo et al 15 742.674Fica et al 16 845.568Rommens et al 17 175276Matta et al 18 255676Mayo 19 1633.775Ruesch et al 20 53183Brueton 21 26261Qadir Ri et al 22 19184Present study462.582.60…”

Administration of somatostatin analog octreotide in the ventrolateral orbital cortex produces sex-related antinociceptive effects on acute and formalin-induced nociceptive behavior in rats

“…Numerous studies have reported that sex difference in pain perception and modulation in female and male rodents and human subjects (Palmeira et al, 2011;Traub and Ji, 2013). However, little is known about OCT and sex difference in the cerebral higher centers.…”

“…Because more reports indicate that sex differences in antinociception in preclinical animals and clinical patients (Mogil and Bailey, 2010;Palmeira et al, 2011;Traub and Ji, 2013), another aim of this study was to determine whether there was a sexrelated antinociceptive effects of OCT in the VLO.…”