A systematic literature review of 10 years of research on sex/gender and pain perception – Part 2: Do biopsychosocial factors alter pain sensitivity differently in women and men?
Abstract
This systematic review summarizes the results of 10 years of laboratory research on pain and sex/gender. An electronic search strategy was designed by a medical librarian to access multiple databases. A total of 172 articles published between 1998 and 2008 were retrieved, analyzed, and synthesized. The second set of results presented in this review (129 articles) examined various biopsychosocial factors that may contribute to differences in pain sensitivity between healthy women and men. The results revealed that the involvement of hormonal and physiological factors is either inconsistent or absent. Some studies suggest that temporal summation, allodynia, and secondary hyperalgesia may be more pronounced in women than in men. The evidence to support less efficient endogenous pain inhibitory systems in women is mixed and does not necessarily apply to all pain modalities. With regard to psychological factors, depression may not mediate sex differences in pain perception, while the role of anxiety is ambiguous. Cognitive and social factors appear to partly explain some sex-related differences. Finally, past individual history may be influential in female pain responses. However, these conclusions must be treated with much circumspection for various methodological reasons. Furthermore, some factors/mechanisms remain understudied in the field. There is also a need to assess and improve the ecological validity of findings from laboratory studies on healthy subjects, and perhaps a change of paradigm needs to be considered at this point in time to better understand the factors that influence the experience of women and men who suffer from acute or chronic pain.
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A consistent pattern of sex differences in pain sensitivity, expression and impact has not yet emerged from laboratory-based research.
“However, despite a large volume of laboratory-based research in this area, a consistent pattern of sex differences in pain sensitivity, expression and impact has not yet emerged [20].”
From Chronic pain and sex-differences; women accept and move, while men feel blue (2017) · cites this paper as [20]
There is inconsistency regarding the extent of sex differences in psychological factors.
“An inconsistency is also found regarding what extent there are sex differences with respect to different psychological factors [20, 26].”
From Chronic pain and sex-differences; women accept and move, while men feel blue (2017) · cites this paper as [20]
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- Authors
- Racine, M., Tousignant-Laflamme, Y., Kloda, L. A., Dion, D., Dupuis, G., & Choinière, M.
- Affiliations
- Université de Sherbrooke (CA)
- McGill University (CA)
- Université de Montréal (CA)
- Université du Québec à Montréal (CA)
- Centre Hospitalier de l’Université de Montréal (CA)
- Corresponding author
- Choinière, Manon
- Venue
- Pain
- Published
- 2012-03
- Volume
- 153
- Issue
- 3
- Pages
- 619-635
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2066329882
- Cited by
- 451
- References
- 210
- Citations by year
- 2026: 15 · 2025: 23 · 2024: 26 · 2023: 37 · 2022: 34 · 2021: 30 · 2020: 39 · 2019: 34 · 2018: 42 · 2017: 29 · 2016: 45 · 2015: 25 · 2014: 25 · 2013: 37 · 2012: 10
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- 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 perception, gender differences, pain sensitivity, biopsychosocial model, temporal summation, allodynia, secondary hyperalgesia, endogenous pain inhibition, depression, anxiety, cognitive factors, social factors, history of pain, hormonal factors, women's pain
- MeSH terms
- Biological Factors, Female, Humans, Longitudinal Studies, Male, Nervous System, Pain, Psychology, Sex Characteristics, Stress, Psychological, Databases, Bibliographic, Pain Threshold, Biomedical Research, Pain Perception
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