Sex, gender, and pain: a review of recent clinical and experimental findings

Fillingim, Roger B.; King, Christopher D.; Ribeiro-Dasilva, Margarete C.; Rahim-Williams, Bridgett; Riley, Joseph L.

doi:10.1016/j.jpain.2008.12.001

Cited by 2,766Sex and Gender in HealthcarePain Mechanisms and TreatmentsPain Management and Placebo Effect

Sex, gender, and pain: a review of recent clinical and experimental findings

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Fillingim, Roger B., King, Christopher D., Ribeiro-Dasilva, Margarete C., Rahim-Williams, Bridgett, Riley, Joseph L.·2009·The Journal of Pain

DOI 10.1016/j.jpain.2008.12.001PMC PMC2677686

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Abstract

Unlabelled Sex-related influences on pain and analgesia have become a topic of tremendous scientific and clinical interest, especially in the last 10 to 15 years. Members of our research group published reviews of this literature more than a decade ago, and the intervening time period has witnessed robust growth in research regarding sex, gender, and pain. Therefore, it seems timely to revisit this literature. Abundant evidence from recent epidemiologic studies clearly demonstrates that women are at substantially greater risk for many clinical pain conditions, and there is some suggestion that postoperative and procedural pain may be more severe among women than men. Consistent with our previous reviews, current human findings regarding sex differences in experimental pain indicate greater pain sensitivity among females compared with males for most pain modalities, including more recently implemented clinically relevant pain models such as temporal summation of pain and intramuscular injection of algesic substances. The evidence regarding sex differences in laboratory measures of endogenous pain modulation is mixed, as are findings from studies using functional brain imaging to ascertain sex differences in pain-related cerebral activation. Also inconsistent are findings regarding sex differences in responses to pharmacologic and non-pharmacologic pain treatments. The article concludes with a discussion of potential biopsychosocial mechanisms that may underlie sex differences in pain, and considerations for future research are discussed.Perspective This article reviews the recent literature regarding sex, gender, and pain. The growing body of evidence that has accumulated in the past 10 to 15 years continues to indicate substantial sex differences in clinical and experimental pain responses, and some evidence suggests that pain treatment responses may differ for women versus men.

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Based on literature supporting gender differences in a range of painful conditions such as headache, chronic pain syndromes, and musculoskeletal pain, sex differences in post-traumatic pain may also exist.
“Based on literature supporting gender differences in a range of painful conditions such as headache, CP syndromes, and musculoskeletal pain,65 sex differences in post-traumatic pain may also exist.66”
From <p>Pain and Evil: From Local Nociception to Misery Following Social Harm</p> (2020) · cites this paper as [65]
Women are more sensitive to both dosage and type of analgesic medication than men.
“and are more sensitive to both dosage and type of medication [22–24]”
From Chronic pain and sex-differences; women accept and move, while men feel blue (2017) · cites this paper as [22]

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Authors: Fillingim, R. B., King, C. D., Ribeiro-Dasilva, M. C., Rahim-Williams, B., & Riley, J. L.
Affiliations: University of Florida (US)
University of Florida Health (US)
Corresponding author: Fillingim, Roger B.
ORCID: Fillingim, Roger B.
King, Christopher D.
Ribeiro-Dasilva, Margarete C.
Rahim-Williams, Bridgett
Riley, Joseph L.
Venue: The Journal of Pain
Publisher: Elsevier BV
Published: 2009-05
Volume: 10
Issue: 5
Pages: 447-485
ISSN: 1526-5900 (ISSN-L)
DOI: 10.1016/j.jpain.2008.12.001
PMC: PMC2677686
OpenAlex: W2000492372
Cited by: 2,766
References: 463
Citations by year: 2026: 149 · 2025: 192 · 2024: 179 · 2023: 161 · 2022: 191 · 2021: 194 · 2020: 216 · 2019: 196 · 2018: 197 · 2017: 156 · 2016: 180 · 2015: 140 · 2014: 148 · 2013: 153 · 2012: 121
FWCI: 13.93
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 5246 d)
Locations: Journal of Pain (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Neurological Disorders and Stroke (NS41670, R01NS041670, T32NS045551)
National Institute of Dental and Craniofacial Research (U01DE017018)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Keywords: sex differences in pain, gender differences, experimental pain, pain sensitivity, postoperative pain, temporal summation of pain, endogenous pain modulation, biopsychosocial mechanisms, sex hormones
MeSH terms: Adolescent, Analgesics, Animals, Mental Disorders, Child, Female, Hormones, Humans, Male, Pain, Pain Measurement, Sex Characteristics, Social Environment, Pain Management

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