An investigation of gender-dependent perception of thermal and pain: a quantitative sensory testing study

Abstract

Background: Pain is the most common health problem in the world and requires quantitative sensory testing (QST). The consequences of gender inequality with respect to sensations such as pain need to be identified. Purpose: To examine the thermal and pain of health subjects with QST, and to explore the gender differences. Methods: Healthy adults were tested on the perception of temperature change and pain, the pain tolerance, by thermal QST. A 30× 30mm Peltier type thermode (TSA-2001, Medoc Inc., Israel) was placed on the middle part of left medial arm of subjects. The thermode was used to induce temperature changes and pain by increase or decrease temperature, the baseline temperature was set at 32 ◦C. The testing parameters included the cold detection threshold (CDT), warmth detection threshold (WDT), cold pain threshold (CPT), heat pain threshold (HPT), cold pain tolerance (CPTol) and heat pain tolerance (HPTol). The Student’s t test was used to assess the differences between men and women. Results: Two hundred eighteen (114 female) healthy adults, 41.3± 17.0 years (range 18–80) participated the study. The cold change was detected after the temperature decrease 1.9± 1.4 ◦C, and the warm change was detected after temperature increase 2.4± 1.2 ◦C of all participants. However, the values of CPT, HPT, CPTol, and HPTol were greater variation among participants. The cold pain was detected after the temperature decrease 13.6± 9.1 ◦C, heat pain was detected after temperature increase 8.0± 3.8 ◦C, cold pain cannot be tolerated after the temperature decrease 23.7± 7.7 ◦C, and heat pain cannot be tolerance after temperature increase 13.9± 3.3 ◦C. Only WDT, HPT and HPTol were significant different between men and women (p= 0.001, 0.003, and 0.001 respectively). Women perceived the temperature change of warm earlier (women vs. men 2.1 ◦C and 2.7 ◦C respectively), perceived the pain of heat earlier (women vs. men 7.3 ◦C and 8.8 ◦C respectively) and unable to tolerance heat pain earlier than men (women vs. men 13.2 ◦C and 14.8 ◦C respectively) after temperature increase from32 ◦C. Conclusion(s):Although the value of CDT andWDT are more consistent, the threshold and tolerance of pain induced by cold seems to be varied among general population. In sensory perception behavior, especially the values of WDT, HPT and HPTol, Women are more sensitive to temperature increase and less tolerance of the heat pain. Implications: Women are sensitive to detect warm or heat pain sensation. No different was found of cold detection, cold pain detection, and cold pain tolerance for men and women. For those QST parameters, the CDT and WDT are well indicators for differential the normal and abnormal detection ability of a person.