Cited by 554Pain Mechanisms and TreatmentsSex and Gender in HealthcarePain Management and Placebo Effect

Sex-related hormonal influences on pain and analgesic responses

Fillingim, R.B., Ness, T.J.·2000·Neuroscience & Biobehavioral Reviews

Abstract

Considerable evidence indicates sex-related differences in pain responses and in the effectiveness of various analgesic agents. Specifically, females are at greater risk for experiencing many forms of clinical pain and are more sensitive to experimentally induced pain relative to males. Regarding analgesic responses, nonhuman animal studies indicate greater opioid analgesia for males, while a limited human literature suggests the opposite. Though the mechanisms underlying these effects remain unclear, the influence of gonadal hormones on nociceptive processing represents one plausible pathway whereby such sex differences could emerge. The present article reviews the complex literature concerning sex steroid effects on pain responses and analgesia. First, nonhuman animal research related to hormonal effects on nociceptive sensitivity and analgesic responses is presented. Next, human studies regarding gonadal hormonal influences on experimental pain responses are reviewed. Several potential mechanisms underlying hormonal effects on nociceptive processing are discussed, including hormonal effects to both peripheral and central nervous system pathways involved in pain transmission. Finally, based on these findings we draw several conclusions and make specific recommendations that will guide future research as it attempts to elucidate the magnitude and importance of sex-related hormonal effects on the experience of pain.

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Crossref · 10.1016/s0149-7634(00)00017-8

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182 of 182 references verified0 citation errors · 0 not checkable

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  • Considerable evidence indicates that greater solicitousness in response to pain behaviors predicts more pain-related disability.

    “there is considerable evidence that a higher degree of solicitousness in response to pain behaviors predicts increased pain-related disability 85, 106–108.”
  • Both solicitous and punishing responses to pain are associated with higher pain intensity and increased depressive symptoms.

    “both solicitous and punishing responses to pain are associated with higher pain intensity 108 and increased depressive symptoms 106, 340, suggesting these social factors may be a mechanism by which catastrophizing affects pain outcomes.”

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Authors
Fillingim, R. B., & Ness, T. J.
Affiliations
University of Alabama at Birmingham (US)
Corresponding author
Fillingim, R.B.
Venue
Neuroscience & Biobehavioral Reviews
Publisher
Elsevier BV
Published
2000-06
Volume
24
Issue
4
Pages
485-501
ISSN
0149-7634 (ISSN-L)
OpenAlex
W2073214521
Cited by
554
References
182
Citations by year
2026: 5 · 2025: 21 · 2024: 13 · 2023: 12 · 2022: 24 · 2021: 18 · 2020: 11 · 2019: 12 · 2018: 15 · 2017: 14 · 2016: 25 · 2015: 16 · 2014: 30 · 2013: 19 · 2012: 22
FWCI
2.62
Type
journal article
Language
en
Open access
closed
Locations
  • Neuroscience & Biobehavioral Reviews (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute of Diabetes and Digestive and Kidney Diseases (DK51413, R01DK051413)
  • National Institute of Dental and Craniofacial Research (DE 12261, R29DE012261)
Topics
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Keywords
sex differences, gonadal hormones, sex steroids, pain sensitivity, analgesia, opioid analgesia, nociception, pain transmission
MeSH terms
Analgesics, Animals, Humans, Pain, Sex Characteristics

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