Sex and Gender Effects in Pain

Pfleiderer B, Ritzkat A, Pogatzki-Zahn E

Abstract

Even though it has been accepted that sex (biological factors) and gender (social roles and environmental factors) effects do exist in pain perception and response, papers assessing sex and gender effects in biomedical and clinical research, as well as clinical practice are scarce. There are even fewer imaging papers investigating sex and gender effects in neural responses to pain. This chapter reviews the existing literature and provides a comprehensive summary of the role of sex and gender in (i) pain syndromes, (ii) psychological factors in pain, (iii) the efficacy of opioid analgesics , (iv) regarding effects of the menstrual cycle and sexual hormones in pain perception, (v) pain perception and modulation under experimental conditions and (vi) imaging studies related to pain syndromes (healthy subjects, patients with fibromyalgia and irritable bowel syndrome) . We hope that this overview will stimulate the inclusion of sex and gender aspects in future research designs and will lead to an increase in the number of imaging papers accordingly. Understanding the impact of sex and gender factors in pain pathophysiology and processing in more detail has the potential to lead to discoveries of new targets for treatment of pain.