Cited by 93Pain Mechanisms and TreatmentsSex and Gender in HealthcareMusculoskeletal pain and rehabilitation

Pain: sex differences and implications for treatment

Manson, JoAnn E.·2010·Metabolism

Abstract

Women have a higher prevalence than men of several clinical pain conditions and of inflammation-mediated disorders. There is also increasing evidence for sex differences in sensitivity to experimental pain and in the response to analgesics. Estrogen, progesterone, and other gonadal hormones have a complex role in inflammatory processes and the pain response. Microglia cells in the central nervous system, which have sex hormone receptors, become activated in response to inflammatory stimuli, releasing cytokines and other mediators that are pronociceptive and can amplify the pain response. Although the mechanisms underlying sex differences in pain and analgesia have not been fully elucidated, both peripheral and central nervous systems pathways may be involved. Sex differences in the opioid, dopaminergic, serotoninergic, and other pain-related systems have been documented; and some evidence suggests that differences are most pronounced during the peak reproductive years. Psychosocial factors also play an important role. Given the important role of inflammation in mediating pain, nutritional factors that modulate the inflammatory response offer a promising and exciting new avenue for the prevention and treatment of chronic pain disorders. Of particular interest is the potential role of moderate- to high-dose vitamin D and omega-3 fatty acid supplements, both of which have powerful anti-inflammatory effects. These nutritional interventions, which influence cytokine, leukotriene, and prostaglandin pathways, may be of particular benefit to women due to their higher prevalence of inflammatory chronic pain disorders. The recent launch of a new large-scale randomized trial of these nutritional supplements provides an opportunity to assess their potential antinociceptive role. Additional research is needed to clarify the mechanisms for sex differences in pain and to develop new treatment modalities that improve pain management for both men and women.

Integrity signals

Registry

Crossref · 10.1016/j.metabol.2010.07.013

Cites

50 of 50 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

1 of the 51 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Authors
Manson, J. E.
Affiliations
Brigham and Women's Hospital (US)
Corresponding author
Manson, JoAnn E.
Venue
Metabolism
Publisher
Elsevier BV
Published
2010-10
Volume
59
Pages
S16-S20
ISSN
0026-0495 (ISSN-L)
OpenAlex
W2169749273
Cited by
93
References
51
Citations by year
2026: 2 · 2025: 5 · 2024: 9 · 2023: 1 · 2022: 6 · 2021: 5 · 2020: 5 · 2019: 3 · 2018: 5 · 2017: 5 · 2016: 5 · 2015: 10 · 2014: 6 · 2013: 9 · 2012: 8
FWCI
0.84
Type
journal article
Language
en
Open access
closed
Locations
  • Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Heart, Lung, and Blood Institute
  • National Cancer Institute
  • National Institutes of Health
Topics
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
sex differences in pain, chronic pain, inflammatory pain, estrogen, progesterone, gonadal hormones, microglia, cytokines, analgesic response, opioid system, dopaminergic system, serotonin, psychosocial factors, vitamin D supplementation, omega-3 fatty acids, women's health
MeSH terms
Cholecalciferol, Female, Humans, Male, Pain, Sex Characteristics, Gonadal Steroid Hormones, Fatty Acids, Omega-3, Prevalence, Randomized Controlled Trials as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review