Gender Differences In Pain Perception Research Articles

Gender differences in pain perception among burning mouth syndrome patients: a cross-sectional study of 242 men and 242 women

Several orofacial painful conditions are influenced by gender-related factors, but no studies are available with regard to Burning Mouth Syndrome (BMS). The present study aimed at investigating gender differences among BMS patients and their influence on pain perception. 242 BMS males (BMSm) and 242 BMS females (BMSf) matched for age were consecutively enrolled. Sociodemographic and clinical characteristics were recorded and the numeric rating scale (NRS), the Total Pain Rating Index (T-PRI), the Hamilton rating scale for anxiety and depression (HAM-A, HAM-D), the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale (ESS) were administered. The BMSm presented statistically significant higher levels of education and rate of employment compared to the BMSf (p-values: 0.001**). Moreover, the BMSm were greater consumers of alcohol and had a higher BMI than the BMSf (p-values: < 0.001**, 0.034*). With respect to systemic comorbidities, cardiovascular diseases were statistically more prevalent among the BMSm, while hypothyroidism was more frequent in the BMSf (p-vales: < 0.001**). No differences were noted between the two groups in terms of oral symptoms and in the median scores of NRS, T-PRI, HAM-A, HAM-D, PSQI and ESS. Interestingly, the multivariate regression analysis revealed that, while anxiety, high BMI, poor sleep and high level of T-PRI were correlated to the intensity of pain (NRS) in both groups, low education was additional predictor of pain in BMSf. Further, depression, alcohol and intensity of pain were factors positively associated to the quality of pain (T-PRI) in the BMSm, whereas low education, non-married status and NRS were correlated to the T-PRI, in the BMSf. Surprisingly, smoking was inversely correlated to the intensity of pain and quality of pain respectively in BMSf and BMSm. Sociodemographic and risk factors were found to differently influence pain perception in BMSm and BMSf. Therefore, clinicians should take into account gender differences in the assessment of BMS patients to better tailor the overall pain management.

Gender Differences in Pain Threshold, Unpleasantness, and Descending Pain Modulatory Activation Across the Adult Life Span: A Cross Sectional Study

The neurobiological underpinnings of gender differences in pain perception, and how these differences may be modified by age, are incompletely understood, placing patients at risk of suboptimal pain management. Using functional magnetic resonance imaging, we examined brain responses in the descending pain modulatory system (DPMS, specifically, dorsolateral prefrontal cortex, anterior cingulate cortex, insula, hypothalamus, amygdala, and periaqueductal gray, during an evoked pain task. We investigated the interaction of age and gender in our sample of healthy adults (27 females, 32 males, 30–86 years) on DPMS response. In a perceptually matched thermal pain paradigm, we investigated pain unpleasantness and neural responses for 3 heat pain percepts: just noticeable pain, weak pain, and moderate pain (MP). Females reported just noticeable pain at a lower temperature, but reported less unpleasantness at weak pain and MP percepts, compared to males. There was a significant age-by-gender interaction during moderate pain in the right anterior cingulate cortex and bilateral insula, such that, males had a stronger positive relationship between DPMS response and age compared to females in these regions. Our results indicate that differences in DPMS responses may explain some gender differences in pain perception and that this effect may change across the adult lifespan. PerspectiveGender differences in pain have been well-documented but the brain mechanisms for these differences are still unclear. This article describes potential differences in brain functioning during different levels of pain that could explain differences in pain responses between men and women across the adult lifespan.

Effect of Sex Difference on the Analgesic Response of Nalbuphine after Major Orthopedic Surgery in One Egyptian Intensive Care

Abstract Background Several reviews on the topic of gender differences in pain mechanisms, control and treatments have been published in the last two decades. The increasing literature refers to a broad range of topics, including preclinical studies on mechanisms underlying male and female diffelences in nociception and its control, clinical lesearch on gender differences in pain perception and modulation, epidemiological investigations of sex differences in pain prevalence and a growing number of studies examining sex differences in responses to pain therapies. Aim of the Work To compare Egyptian male and female response to Nalbuphine as analgesia after major orthopedic surgery in the intensive care unit, as regards dose effectiveness and adverse effects, in the first postoperative 24 hours. Patients and Method: This comparative prospective analytical study was performed at Ain Shams University Hospitals. The study enrolled 100 Egyptian postoperative patients admitted to ICU after major orthopedic surgery; including 50 females and 50 males. Results The mean age of the participants was 48.81 ± 8.99 years. Regarding the primary outcome, the current study showed that males required a higher dose of nalbuphine than females with a pvalue &amp;lt; 0.001. There was no statistically significant in the VAS score of pain intensity between males and females at all times. Conclusion The results of this study suggest that postoperative nalbuphine requirements differ between Egyptian female and male patients undergoing major orthopedic surgeries. Males require a higher dose than females. But there was no statistically significant difference between females and males regarding postoperative analgesia complications. Nevertheless, funher studies on the ICIationship between the analgesic effect and other factors like comorbid mental disorders are required.

No Gender Differences in Pain Perception and Medication after Lumbar Spine Sequestrectomy—A Reanalysis of a Randomized Controlled Clinical Trial

Background: Gender issues have received increasing attention in clinical research of the past years, and biological sex has been introduced as a moderating variable in experimental pain perception. However, in clinical studies of acute pain and gender, there are conflicting results. In particular, there are limited data on the impact of gender differences after spinal sequestrectomy. The aim of this work is to examine gender differences in postoperative pain and pain medication consumption in an inpatient clinical setting. Methods: Data of a completed double-blind RCT was subdivided by gender and reanalyzed by means of an analysis of variance in repeated measures. Outcomes included pain severity measured on a VAS, affective (SES-A) and sensory pain perception (SES-S) and morphine equivalent doses (MED) of analgesics after spinal sequestrectomy. Results: In total, 42 female (47.73%) and 46 male (52.27%) patients were analyzed. No differences in pain severity (VAS: Gender × Time F = 0.35; (df = 2, 86); p = 0.708), affective and sensory pain perception (SES-A: Gender × Time F = 0.08; (df = 2, 86); p = 0.919; SES-S: Gender × Time F = 0.06; (df = 2, 86); p = 0.939) or post-operative opioid use between men and women (MEDs: Gender × Time F = 1.44; (df = 2, 86); p = 0.227) could be observed. Conclusions: This reanalysis of an RCT with respect to gender differences is to our knowledge the first attempt to investigate the role of gender in pain perception and medication after lumbar spine sequestrectomy. In contrast to other studies, we were not able to show significant differences between male and female patients in all pain-related outcomes. Apart from well-established pain management, psychological reasons such as gender-specific response biases or the observer effect might explain our results. Trial registration: The study was registered as a regulatory phase IV study at the German Clinical Trials Register (DRKS), an open-access online register for clinical trials conducted in Germany (Reg-No: DRKS00007913).

Are there any gender differences in pain perception? Clinical and experimental studies in oncology

The review considers and analyzes scientific literature on gender differences in the incidence of pain syndromes, perception of clinical pain, including that in cancer patients and in experimental oncology. The literature highlights theoretical basis, some biological mechanisms and practical results associated with gender differences. Chronic pain no longer performs a protective function and is not biologically appropriate. The review presents results of experimental studies demonstrating the important role of sex hormones and regulatory systems of a living organism in the mechanisms of development, distribution and perception of pain. Some aspects of sexual dimorphism in the processes of nociception and antinociception are covered. We present the data on the causes of chronic pain syndrome and its perception in cancer patients of both sexes indicating genetically determined sexual reactivity of the body which causes an imbalance in the function of peripheral nervous system and CNS under the influence of prolonged permanent pain in a living organism. Various pain effects have been shown to cause changes in the main types of metabolism, mobilization of adaptive metabolic mechanisms, and tissue damage. Conclusions. The high prevalence of chronic pain in both women and men with cancer, heavy humanitarian and social and economic burden explains a significant increase in fundamental and clinical research in this direction.&#x0D; &#x0D; &#x0D;

Gender differences in pain perception during experimentally induced pain

BACKGROUND:There are multiple biopsychosocial mechanisms which influence the pain responses between genders. Even though there are enough literature that describe the perception of pain, no consensus has made which gender is more sensitive or tolerance to pain. The study evaluates the difference in pain threshold (PThr), pain tolerance (PTol), and intensity of pain between individuals of both genders and to find which gender is more sensitive to pain.METHODOLOGY:The study was conducted on 106 participants (53 males and 53 females) with age 18–25 years. The participants had undergone cold-induced test (CIT) and tourniquet pressure test (TPT). The PThr, PTol, and pain intensity were recorded and the data were analyzed by Mann–Whitney test.RESULTS:The results also found a significant difference in PThr between both genders (P= 0.001). However, males have taken longer time to perceive PThr in both TPT and CIT as compared to females. In the case of PTol, females had a less tolerable level of both TP and CIT as compared to males.CONCLUSION:The differences in the pain perception between genders can vary greatly because of different factors, thus we can say that males have higher PThr and PTol than females.

Influence of gender on postoperative pain in percutaneous nephrolithotomy: A prospective observational study.

Background and Aims:Percutaneous nephrolithotomy (PCNL) is the procedure of choice for managing large renal calculi. Although minimally invasive, it is associated with pain due to dilatation of renal capsule, parenchymal tract, and nephrostomy tube placement. Gender differences in pain perception and analgesic requirement have not been studied in PCNL surgeries. This study was done to evaluate the influence of gender on pain.Material and Methods:It was a prospective observational study including 60 ASA physical status I and II patients. The number of males and females were 29 and 31, respectively. Analgesic requirement and postoperative pain score were assessed by visual and dynamic visual analog scales (VAS, DVAS) score fourth hourly for first 24 h. Rescue analgesia was IV paracetamol 1 g when pain score exceeded four. VAS scores were assessed using Mann–Whitney test. Rescue analgesia was calculated as frequency and proportions. A P value of <0.05 was considered statistically significant.Results:The mean pain score values (VAS P = 0.361; DVAS P = 0.332) and postoperative fentanyl (P = 0.703) did not show a statistically significant difference in males and females. The requirement of rescue paracetamol was higher in females with 30 out of 31 females demanding a rescue analgesic in comparison to 15 out of 29 male patients (P = 0.001).Conclusion:No significant difference was observed in postoperative pain among males and females in patients undergoing PCNL surgery. The analgesic requirement, however, was found to be more in females than in males.

Gender differences in pain perception and endogenous pain inhibitory pathway among healthy nigerian subjects

Gender differences in pain perception and endogenous pain inhibitory pathway among healthy nigerian subjects

The impact of aging on pressure pain thresholds: are men less sensitive than women also in older age?

Men have generally demonstrated higher pressure pain thresholds (PPT) than women. However, the possible impact of aging on the gender differences in pain perception has not been fully evaluated. In this study, we aimed to investigate the gender differences in PPT over the life course, in young, middle-aged and older adults. This cross-sectional study involved 355 pain-free healthy individuals aged 19-95years, divided into < 45, 45-64 and ≥ 65years age groups. PPT were measured using Fisher's algometer. Data on anthropometry, formal education and occupation were collected for each participant, and a multidimensional geriatric assessment was performed in older individuals. Lower PPT values were observed in old vs young adults (21.8 ± 8.7N/cm2 vs 59.5 ± 31.6, p < 0.0001) and in women vs men (16.3 ± 6.1 vs 42.8 ± 19.6N/cm2, p = 0.0003). A significant interaction emerged between age and sex in influencing PPT (pinteraction = 0.03). Although women had lower mean PPT values than men in all age groups, such gender difference diminished with aging, from 42.8 ± 19.6 vs 59.5 ± 31.6N/cm2 (p = 0.001) to 16.3 ± 6.1 vs 21.8 ± 8.7 vs N/cm2 (p = 0.003) in younger and older women vs men, respectively. Female gender and older age are associated with lower PPT, but such gender difference seems to decrease with aging.

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Gender, Positive and Negative Emotions Predictors for the Self-perceived Pain at Undergraduate Students at Psychology – A Pilot Study

The objective is to investigate gender differences in pain perception in young students from psychology, the second objective is to highlight gender differences in the perception of positive and negative emotions in young students at psychology. Participants in this research are a total of 65 students of the Faculty of Psychology and Educational Sciences, University of Bucharest. After the results are noticed as pain depends on gender and female subjects even if they are in school psychology are more susceptible than male subjects.

Effect of Sub-maximal Exercise Stress on Cold Pressor Pain: A Gender Based Study

Analgesic effect of exercise is a well established fact; however available reports are contradictory on gender differences in pain perception following exercise stress test. The current study is prospectively designed to evaluate and compare the effect of acute bout of sub-maximal exercise stress on cold pressor pain in normal adult males and females. The experimental study design involved healthy adults (n= 41); females (n = 18) and males (n=23) aged between 18 to 25 years and included them into four sets of experiments: SET I (Control), "resting blood pressure, radial pulse and respiratory rate were recorded after 15 minutes of complete supine relaxation. SET II (Cold Pressor Pain Test): Pain Threshold, Pain Tolerance, and Pain Duration in seconds were taken. SET III (Exercise Stress Test): Sub-maximal exercise of 70 to 75% of maximum predicted heart rate was given for 6 minutes. SET IV (Cold Pressor Pain Test immediately after Exercise Stress Test): At 0 minute of recovery again the pain parameters; Pain Threshold, Pain Tolerance, and Pain Duration in seconds were taken. SET I, SET II were performed in order on the first day and SET III and SET IV on the second day to ensure only a single Cold Pressor Pain Test is performed in each day. The data (Mean ± SD) analysis showed significant increased in pain threshold (males: 14.36 ± 10.6 Vs 21.47 ± 13 seconds, p< 0.001, females: 14.1 ± 11.5 Vs 23.81 ± 20.22 seconds, p<0.001) and pain tolerance time (males: 41.3 ± 19.31 Vs 54.1 ± 21.7 seconds, p<0.001) in both sexes after 6 min of acute bout of sub-maximal exercise stress test with comparable age, BMI and baseline resting values of pain parameters and pulse rate and blood pressure. The percentage increment pain tolerance time following the exercise stress in female is higher than male (78.6 Vs 68.9%). The result suggests that pain sensation decreases immediately after a brief period of exercise challenge irrespective of gender, and the analgesic effect of the acute bout of exercise in terms of pain tolerant time is more enhanced in females than males.

AB0787 In Patients with Knee Osteoarthritis, Women HAD More Severe Pain despite Lower COX-2 Enzyme Expressed by Synovial Fluid Monocytes than Men

BackgroundKnee osteoarthritis is more frequently found in women than men. Osteoarthritis pathophysiology is based on inflammatory and degenerative process. The role of inflammation in osteoarthritic pain is varied time over...

An active supply of analgesics during pulmonary vein isolation reduces pain

Aim. Pulmonary vein isolation (PVI) is an established method for treatment of drug refractory atrial fibrillation. The aim of this study was to evaluate whether a more active regular supply of analgesic and sedative drugs reduces pain and discomfort. We also wanted to evaluate gender differences in pain perception and to compare standard radiofrequency (RF) with cryo balloon ablation (Cryo) from this perspective. Methods. A total of 80 patients, 40 men, median age 58 (range 23–76) years, who underwent PVI under conscious sedation were studied. They were randomized to either standard treatment with morphine and diazepam (control group, C) or to a more active analgesic strategy (A) with pre-medication with oral midazolam mixture and intravenous alfentanil and midazolam regularly administrated during the procedure. Forty patients were treated with RF and 40 with Cryo. Results. The majority of the patients experienced pain during the procedure. The maximal pain assessed with numerical rating scale (NRS), was lower in the active group compared with that in controls (p = 0.02). Women experienced more pain than men (p = 0.01). RF was more painful than Cryo (p < 0.001). Conclusion. An active regular supply of analgesic and sedative drugs reduce pain and discomfort during PVI. Women experience more pain than men during this procedure and PVI performed with Cryo is less painful than with RF.

Gender Difference of Symptom Severity in Lumbar Spinal Stenosis: Role of Pain Sensitivity

Background: Given that there are gender differences in pain perception, it is likely that there are differences in pain responses between men and women with lumbar spinal stenosis (LSS). Furthermore, these differences may lead to different degrees of impairment in both daily activities and quality of life between men and women. Objective: To elucidate the difference of LSS symptom severity between genders in relation to pain sensitivity. Study Design: Retrospective analysis of prospectively collected data. Methods: A total of 160 patients who had symptomatic degenerative lumbar spinal stenosis completed a series of questionnaires on their first visit in the outpatient clinic, including a pain sensitivity questionnaire (PSQ) (total PSQ and PSQ-minor), Oswestry Disability Index (ODI), visual analog scale (VAS) for back pain, and Short Form-36 (SF-36). Using magnetic resonance images, the degree of canal stenosis and disc degeneration were graded based on the method by Schizas and the Pfirrmann classification, respectively. Symptom severity, pain sensitivity, and radiologic findings were compared between men and women. In each gender group analysis, the correlation between pain sensitivity and symptom severity was analyzed. Results: After adjustment for age and the grade of disc degeneration, the pain sensitivity represented by total PSQ and PSQ-minor was significantly higher in women than in men. Moreover, there was a higher VAS for back pain/leg pain and ODI in women compared to men after adjustment for body mass index (BMI), age, and the grades of canal stenosis and disc degeneration. After additional adjustment for pain sensitivity including total PSQ and PSQminor, there was no difference in VAS for back pain/leg pain between genders. On the SF36 women demonstrated a lower quality of life than men in terms of Physical Function, Role Physical, Bodily Pain, General Health, and Physical Component Summary. Each gender group analysis showed that pain sensitivity was associated with symptom severity and disability caused by LSS in both women and men. Limitations: The present study did not evaluate psychological factors including catastrophizing and/or undiagnosed personal traits which possibly can influence the severity of symptoms from LSS. Conclusions: Women showed increased low back pain and leg pain due to degenerative LSS compared to men. The current study demonstrates that this difference in symptom severity may be partly mediated by pain sensitivity. Key words: Lumbar spinal stenosis, gender difference, visual analog scale, Oswestry Disability Index, Short Form-36, pain sensitivity

Gender differences in pain perception and functional ability in subjects with knee osteoarthritis.

Background. There is no consensus regarding gender-related differences in pain intensity and functional abilities among patients with knee osteoarthritis (OA). Objective. Determine gender-related differences in pain intensity and functional ability among subjects with knee OA, as assessed by a self-report questionnaire and by performance-based tests. Methods. Sixty-three subjects with symptomatic knee pain due to OA were included in this study. The outcome measures were self-reported knee pain intensity and physical function (WOMAC), as well as three performance-based functional assessments: time up and go test, a 10-meter walk test, and stair negotiation. Independent sample t-tests were performed to determine gender differences. Level of significance was set at P ≤ 0.05. Results. Female subjects reported higher levels of knee pain and lower functional performance. In contrast, no significant gender-related differences were determined in any of the performance-based measures. Conclusion. The results indicate that the two types of functional ability measures may address different constructs of functional ability. Self-reported ability, particularly in the female subjects, may be influenced by psychological aspects associated with chronic pain. Rehabilitation programs should consider the underlying mechanisms of the patients' performance limitations in order to address the specific needs of each individual patient.

Effect of gender and hand laterality on pain processing in human neonates

Background Previous studies in adults have reported that handedness and gender can affect pain perception. However, it is currently unclear when these differences emerge in human development. Therefore, we examined prefrontal responses to pain stimulation among newborns during their first acute pain experience after birth. Methods Forty newborns at 4–6 days postnatal age were observed during clinically required blood sampling while prefrontal activation was measured with near infrared spectroscopy. Blood sampling in this study was the first experience of a procedure involving skin breaking for these infants. We divided subjects into a right-hand stimulation group (n = 21) and a left-hand stimulation group (n = 19), depending on whether blood was sampled from the right or the left hand. A three-way analysis of variance (ANOVA) was conducted to examine the effects of several variables on the magnitude of the oxy-Hb value in response to pain stimulus, including stimulus side (right hand or left hand), gender (male or female), recording side (right prefrontal area or left prefrontal area) and interactions between these variables. Results The data revealed a significant effect of stimulus side (F (1, 72) = 9.892, P = 0.002), showing that the right-hand stimulation induced a greater prefrontal activation than the left-hand stimulation. No significant gender difference or interactions were found. Conclusion Our findings suggest that hand laterality affects pain perception even in neonates. However, gender differences in pain perception did not appear to occur during the neonatal period. Further investigations using brain-imaging techniques are required to identify laterality- or gender-related differences in pain processing in humans.

Sex differences in pain modulation during puberty

Diffuse noxious inhibitory control (DNIC) is a pain modulatory mechanism where nociceptive stimuli induce descending pain inhibition, not limited to the stimulated region. Several studies have shown that women are overrepresented in a number of different chronic pain conditions (e.g. fibromyalgia) which are associated with a DNIC deficit. Women also tend to exhibit greater sensitivity to pain than men. However these sex differences are not found before puberty. This study investigated gender differences in pain perception and modulation during puberty.

Pain management in adult acute sickle cell pain crisis: a view point

The acute pain crisis of sickle cell disease is inadequately treated in many countries. To present a simple protocol that controls acute pain in most adult patients within 72 hours, based on our experience in an area where sickle cell disease is highly prevalent. Patients aged 14 years and above with sickle cell disease presenting with pain crisis are treated initially in the Emergency Room. Those responding adequately are discharged home on oral analgesics while those with persisting pain after 6 hours are treated further, for up to 72 hours, in an Observation Unit attached to the Emergency Room. Narcotic analgesics are administered regularly for the first 24 hours. Using this protocol, acute pain crisis could be terminated or controlled in over 80% of patients within 72 hours. Regular intravenous narcotic analgesia for the initial 24 hours, supplemented by oral analgesia, is useful for adult patients with severe acute sickle cell pain crisis when the pain is inadequately controlled by initial Emergency Room treatment. There may be gender differences in pain perception and response in acute sickle cell pain crisis.

The hazards to practitioners of obstetric and gynecological ultrasound

To investigate the specific complaints of physicians and technicians performing obstetric and gynecological ultrasound. This was a cross-sectional retrospective survey. Questionnaires were distributed to members of the Israeli Society of Gynecological Ultrasound, including questions on gender and profession, number and type of scans performed, pain related to profession and any therapy undergone. Statistical analysis included chi-square or Fisher's exact test, Student's t-test, Pearson's correlation coefficient and logistic regression. Joint pain was reported by 51.7% (30/58) of the technicians compared with 25.3% (19/75) of the physicians (P = 0.002). It was more common in females than in males (P = 0.05) and it was more common among those who performed transabdominal sonography more frequently than they did transvaginal sonography (P = 0.004). There was a significant association between performing transabdominal ultrasound and back pain (P = 0.05). Although females reported pain more frequently, the rate of surgical procedures was higher among males (P < 0.05). A technician is 3.5 times more likely to report joint pain than is a physician. Transabdominal sonography is a risk for both joint and back pain. There may be gender differences in pain perception.