Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-hfldf Total loading time: 0 Render date: 2024-06-03T01:02:52.063Z Has data issue: false hasContentIssue false

Chapter 9 - Are Women More Sensitive? Sex and Gender Differences in Pain Perception, Clinical Evaluation and Treatment

Published online by Cambridge University Press:  05 May 2016

Alyson J. McGregor
Affiliation:
Warren Alpert School of Medicine, Brown University
Esther K. Choo
Affiliation:
Warren Alpert School of Medicine, Brown University
Bruce M. Becker
Affiliation:
Warren Alpert School of Medicine, Brown University
Get access
Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2016

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Green, C.R. et al., The unequal burden of pain: Confronting racial and ethnic disparities in pain. Pain Medicine, 2003. 4(3): 277–94.CrossRefGoogle ScholarPubMed
Todd, K.H. et al., Pain in the emergency department: Results of the Pain and Emergency Medicine Initiative (PEMI) multicenter study. Journal of Pain, 2007. 8(6): 460–6.CrossRefGoogle ScholarPubMed
Arendts, G. and Fry, M., Factors associated with delay to opiate analgesia in emergency departments. Journal of Pain, 2006. 7(9): 682–6.CrossRefGoogle ScholarPubMed
Bijur, P.E., et al., Lack of influence of patient self-report of pain intensity on administration of opioids for suspected long-bone fractures. Journal of Pain, 2006. 7(6): 438–44.CrossRefGoogle ScholarPubMed
Fosnocht, D.E., Swanson, E.R., and Barton, E.D., Changing attitudes about pain and pain control in emergency medicine. Emergency Medicine Clinics of North America, 2005. 23(2): 297306.CrossRefGoogle ScholarPubMed
Neighbor, M.L., Honner, S., and Kohn, M.A., Factors affecting emergency department opioid administration to severely injured patients. Academic Emergency Medicine, 2004. 11(12): 1290–6.CrossRefGoogle ScholarPubMed
Todd, K.H., et al., Survey of pain etiology, management practices and patient satisfaction in two urban emergency departments. Canadian Journal of Emergency Medicine, 2002. 4(4): 252–6.CrossRefGoogle ScholarPubMed
Uri, O., et al., No gender-related bias in acute musculoskeletal pain management in the emergency department. Emergency Medicine Journal, 2013, doi:10.1136/emermed-2013-202716.CrossRefGoogle Scholar
Miner, J., et al., Patient and physician perceptions as risk factors for oligoanalgesia: A prospective observational study of the relief of pain in the emergency department. Academic Emergency Medicine, 2006. 13(2): 140–6.CrossRefGoogle ScholarPubMed
Jackson, T., Wang, Y., and Fan, H., Associations between pain appraisals and pain outcomes: Meta-analyses of laboratory pain and chronic pain literatures. Journal of Pain, 2014. 15(6): 586601.CrossRefGoogle ScholarPubMed
Fosnocht, D.E., Hollifield, M.B., and Swanson, E.R., Patient preference for route of pain medication delivery. Journal of Emergency Medicine, 2004. 26(1): 711.CrossRefGoogle ScholarPubMed
Fosnocht, D.E., Swanson, E.R., and Bossart, P., Patient expectations for pain medication delivery. American Journal of Emergency Medicine, 2001. 19(5): 399402.CrossRefGoogle ScholarPubMed
Robinson, M.E., et al., Gender role expectations of pain: Relationship to sex differences in pain. Journal of Pain, 2001. 2(5): 251–7.CrossRefGoogle ScholarPubMed
Bodnar, R.J. and Kest, B., Sex differences in opioid analgesia, hyperalgesia, tolerance and withdrawal: Central mechanisms of action and roles of gonadal hormones. Hormones and Behavior, 2010. 58(1): 7281.CrossRefGoogle ScholarPubMed
Sobel, R.M. and Todd, K.H., Risk factors in oligoanalgesia. American Journal of Emergency Medicine, 2002. 20(2): 126.CrossRefGoogle ScholarPubMed
Robinson, M.E., et al., Altering gender role expectations: Effects on pain tolerance, pain threshold, and pain ratings. Journal of Pain, 2003. 4(5): 284–8.CrossRefGoogle ScholarPubMed
Robinson, M.E., et al., Influences of gender role and anxiety on sex differences in temporal summation of pain. Journal of Pain, 2004. 5(2): 7782.CrossRefGoogle ScholarPubMed
Niesters, M., et al., Do sex differences exist in opioid analgesia? A systematic review and meta-analysis of human experimental and clinical studies. Pain, 2010. 151(1): 61–8.CrossRefGoogle ScholarPubMed
Todd, K.H., et al., Chronic or recurrent pain in the emergency department: National telephone survey of patient experience. Western Journal of Emergency Medicine, 2010. 11(5): 408–15.Google ScholarPubMed
Fosnocht, D.E., et al., Correlation of change in visual analog scale with pain relief in the ED. American Journal of Emergency Medicine, 2005. 23(1): 55–9.CrossRefGoogle ScholarPubMed
Kelly, A.M., Does the clinically significant difference in visual analog scale pain scores vary with gender, age, or cause of pain? Academic Emergency Medicine, 1998. 5(11): 1086–90.CrossRefGoogle ScholarPubMed
Raftery, K.A., Smith-Coggins, R., and Chen, A.H., Gender-associated differences in emergency department pain management. Annals of Emergency Medicine, 1995. 26(4): 414–21.CrossRefGoogle ScholarPubMed
Brown, J.C., et al., Emergency department analgesia for fracture pain. Annals of Emergency Medicine, 2003. 42(2): 197205.CrossRefGoogle ScholarPubMed
Crandall, M., et al., The pain experience of adolescents after acute blunt traumatic injury. Pain Management Nursing, 2002. 3(3): 104–14.CrossRefGoogle ScholarPubMed
Decosterd, I., et al., Oligoanalgesia in the emergency department: Short-term beneficial effects of an education program on acute pain. Annals of Emergency Medicine, 2007. 50(4): 462–71.CrossRefGoogle ScholarPubMed
Ducharme, J. and Gutman, J., Pain management in the emergency department. Academic Emergency Medicine, 1995. 2(9): 850–2.CrossRefGoogle ScholarPubMed
Jantos, T.J., et al., Analgesic practice for acute orthopedic trauma pain in Costa Rican emergency departments. Annals of Emergency Medicine, 1996. 28(2): 145–50.CrossRefGoogle ScholarPubMed
Jones, J.S., Johnson, K., and McNinch, M., Age as a risk factor for inadequate emergency department analgesia. American Journal of Emergency Medicine, 1996. 14(2): 157–60.CrossRefGoogle ScholarPubMed
Marquie, L., et al., Pain rating by patients and physicians: Evidence of systematic pain miscalibration. Pain, 2003. 102(3): 289–96.CrossRefGoogle ScholarPubMed
Nguyen, N.L., et al., The importance of initial management: A case series of childhood burns in Vietnam. Burns, 2002. 28(2): 167–72.Google ScholarPubMed
Perry, S. and Heidrich, G., Management of pain during debridement: A survey of U.S. burn units. Pain, 1982. 13(3): 267–80.CrossRefGoogle ScholarPubMed
Perry, S.W., Undermedication for pain on a burn unit. General Hospital Psychiatry, 1984. 6(4): 308–16.CrossRefGoogle ScholarPubMed
Pines, J.M. and Perron, A.D., Oligoanalgesia in ED patients with isolated extremity injury without documented fracture. American Journal of Emergency Medicine, 2005. 23(4): 580.CrossRefGoogle ScholarPubMed
Rupp, T. and Delaney, K.A., Inadequate analgesia in emergency medicine. Annals of Emergency Medicine, 2004. 43(4): 494503.CrossRefGoogle ScholarPubMed
Silka, P.A., Roth, M.M., and Geiderman, J.M., Patterns of analgesic use in trauma patients in the ED. American Journal of Emergency Medicine, 2002. 20(4): 298302.CrossRefGoogle ScholarPubMed
Wilson, J.E. and Pendleton, J.M., Oligoanalgesia in the emergency department. American Journal of Emergency Medicine, 1989. 7(6): 620–3.CrossRefGoogle ScholarPubMed
Todd, K.H., Influence of ethnicity on emergency department pain management. Emergency Medicine (Fremantle), 2001. 13(3): 274–8.CrossRefGoogle ScholarPubMed
Banz, V.M., et al., Gender, age and ethnic aspects of analgesia in acute abdominal pain: Is analgesia even across the groups? Internal Medicine Journal, 2012. 42(3): 281–8.CrossRefGoogle ScholarPubMed
Hurley, R.W. and Adams, M.C., Sex, gender, and pain: An overview of a complex field. Anesthesia & Analgesia, 2008. 107(1): 309–17.CrossRefGoogle ScholarPubMed
Chen, E.H., et al., Gender disparity in analgesic treatment of emergency department patients with acute abdominal pain. Academic Emergency Medicine, 2008. 15(5): 414–8.CrossRefGoogle ScholarPubMed
Bayer, B.M., et al., Enhanced susceptibility of the immune system to stress in morphine-tolerant rats. Brain, Behavior, and Immunity, 1994. 8(3): 173–84.CrossRefGoogle ScholarPubMed
Beilin, B., et al., The effects of postoperative pain management on immune response to surgery. Anesthesia & Analgesia, 2003. 97(3): 822–7.Google ScholarPubMed
Charmandari, E., et al., Pediatric stress: Hormonal mediators and human development. Hormone Research, 2003. 59(4): 161–79.Google ScholarPubMed
Koga, C., et al., Anxiety and pain suppress the natural killer cell activity in oral surgery outpatients. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2001. 91(6): 654–8.CrossRefGoogle ScholarPubMed
Lyte, M. and Bailey, M.T., Neuroendocrine-bacterial interactions in a neurotoxin-induced model of trauma. Journal of Surgical Research, 1997. 70(2): 195201.CrossRefGoogle Scholar
Lyte, M., et al., Stimulation of Staphylococcus epidermidis growth and biofilm formation by catecholamine inotropes. Lancet, 2003. 361(9352): 130–5.CrossRefGoogle ScholarPubMed
Morrison, R.S., et al., The impact of post-operative pain on outcomes following hip fracture. Pain, 2003. 103(3): 303–11.CrossRefGoogle ScholarPubMed
Taddio, A., et al., Effect of neonatal circumcision on pain responses during vaccination in boys. Lancet, 1995. 345(8945): 291–2.CrossRefGoogle ScholarPubMed
Weisman, S.J., Bernstein, B., and Schechter, N.L., Consequences of inadequate analgesia during painful procedures in children. Archives of Pediatrics and Adolescent Medicine, 1998. 152(2): 147–9.CrossRefGoogle ScholarPubMed
Nichols, M.L., et al., Transmission of chronic nociception by spinal neurons expressing the substance P receptor. Science, 1999. 286(5444): 1558–61.CrossRefGoogle ScholarPubMed
Berkley, K.J., Sex differences in pain. Behav Brain Sci, 1997. 20(3): 371–80; discussion 435–513.CrossRefGoogle ScholarPubMed
Riley, J.L., 3rd, et al., Sex differences in the perception of noxious experimental stimuli: a meta-analysis. Pain, 1998. 74(2–3): 181–7.CrossRefGoogle ScholarPubMed
Frew, A.K. and Drummond, P.D., Negative affect, pain and sex: The role of endogenous opioids. Pain, 2007. 132 Suppl 1: S7785.CrossRefGoogle ScholarPubMed
Fillingim, R.B., et al., Sex, gender, and pain: A review of recent clinical and experimental findings. Journal of Pain, 2009. 10(5): 447–85.CrossRefGoogle Scholar
McClelland, L.E. and McCubbin, J.A., Social influence and pain response in women and men. Journal of Behavioral Medicine, 2008. 31(5): 413–20.CrossRefGoogle ScholarPubMed
Moettus, A., Sklar, D., and Tandberg, D., The effect of physician gender on women’s perceived pain and embarrassment during pelvic examination. American Journal of Emergency Medicine, 1999. 17(7): 635–7.CrossRefGoogle ScholarPubMed
Ozawa, M., et al., Effect of gender and hand laterality on pain processing in human neonates. Early Human Development, 2011. 87(1): 45–8.CrossRefGoogle ScholarPubMed
Pokhrel, B.R., et al., Effect of sub-maximal exercise stress on cold pressor pain: A gender based study. Kathmandu University Medical Journal (KUMJ), 2013. 11(41): 54–9.Google Scholar
Racine, M., et al., 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? Pain, 2012. 153(3): 619–35.Google ScholarPubMed
Ravn, P., et al., Prediction of pain sensitivity in healthy volunteers. Journal of Pain Research, 2012. 5: 313–26.Google ScholarPubMed
Walton, D.M., et al., A descriptive study of pressure pain threshold at 2 standardized sites in people with acute or subacute neck pain. Journal of Orthopaedic and Sports Physical Therapy, 2011. 41(9): 651–7.CrossRefGoogle ScholarPubMed
Gilman, S. In Manter, J. and Gates, A. (eds), Clinical Neuroanatomy and Neurophysiology, 10th ed. Pain and Temperature. Philadelphia: FA Davis, 1992, pp. 4855.Google Scholar
Donello, J.E., et al., A peripheral adrenoceptor-mediated sympathetic mechanism can transform stress-induced analgesia into hyperalgesia. Anesthesiology, 2011. 114(6): 1403–16.CrossRefGoogle ScholarPubMed
Romero, M.T. and Bodnar, R.J., Gender differences in two forms of cold-water swim analgesia. Physiological Behavior, 1986. 37(6): 893–7.CrossRefGoogle ScholarPubMed
Romero, M.T., et al., Modulation of gender-specific effects upon swim analgesia in gonadectomized rats. Physiology and Behavior, 1987. 40(1): 3945.CrossRefGoogle ScholarPubMed
Ryan, S.M. and Maier, S.F., The estrous cycle and estrogen modulate stress-induced analgesia. Behavioral Neuroscience, 1988. 102(3): 371–80.CrossRefGoogle ScholarPubMed
Smith, Y.R., et al., Pronociceptive and antinociceptive effects of estradiol through endogenous opioid neurotransmission in women. Journal of Neuroscience, 2006. 26(21): 5777–85.CrossRefGoogle ScholarPubMed
Bartfield, J.M., Janikas, J.S., and Lee, R.S., Heart rate response to intravenous catheter placement. Academic Emergency Medicine, 2003. 10(9): 1005–8.CrossRefGoogle ScholarPubMed
Marco, C.A., et al., Self-reported pain scores in the emergency department: Lack of association with vital signs. Academic Emergency Medicine, 2006. 13(9): 974–9.CrossRefGoogle ScholarPubMed
Bellamy, N., Campbell, J., and Syrotuik, J., Comparative study of self-rating pain scales in rheumatoid arthritis patients. Current Medical Research and Opinion, 1999. 15(2): 121–7.Google ScholarPubMed
Bossart, P., Fosnocht, D., and Swanson, E., Changes in heart rate do not correlate with changes in pain intensity in emergency department patients. Journal of Emergency Medicine, 2007. 32(1): 1922.CrossRefGoogle Scholar
Davies, G.M., Watson, D.J., and Bellamy, N., Comparison of the responsiveness and relative effect size of the Western Ontario and McMaster Universities Osteoarthritis Index and the short-form Medical Outcomes Study Survey in a randomized, clinical trial of osteoarthritis patients. Arthritis Care Research, 1999. 12(3): 172–9.3.0.CO;2-Y>CrossRefGoogle Scholar
Huiku, M., et al., Assessment of surgical stress during general anaesthesia. British Journal of Anaesthesia, 2007. 98(4): 447–55.CrossRefGoogle ScholarPubMed
Miner, J.R. and Kapella, K.C., Variations in perceived pain measurements within and between subjects using a standard painful stimulus. Academic Emergency Medicine 2007. 14(5): s283.CrossRefGoogle Scholar
Todd, K.H., et al., Clinical significance of reported changes in pain severity. Annals of Emergency Medicine, 1996. 27(4): 485–9.CrossRefGoogle ScholarPubMed
Gj, H., Assesment, measurement, history, and examination. In Rowbotham, DJ, and Macintyre, PE (eds), Clinical Pain Management: Acute Pain. New York: Oxford University Press, 2003: 93112.Google Scholar
Safdar, B., et al., Impact of physician and patient gender on pain management in the emergency department – a multicenter study. Pain Medicine, 2009. 10(2): 364–72.CrossRefGoogle ScholarPubMed
Coll, M.P., et al., The role of gender in the interaction between self-pain and the perception of pain in others. Journal of Pain, 2012. 13(7): 695703.CrossRefGoogle ScholarPubMed
Gardner, R.L., et al., Does gender influence emergency department management and outcomes in geriatric abdominal pain? Journal of Emergency Medicine, 2010. 39(3): 275–81.CrossRefGoogle ScholarPubMed
Leresche, L., Defining gender disparities in pain management. Clinical Orthopaedics and Related Research, 2011. 469(7): 1871–7.CrossRefGoogle ScholarPubMed
Marco, C.A., et al., Pain perception among Emergency Department patients with headache: Responses to standardized painful stimuli. Journal of Emergency Medicine, 2007. 32(1): 16.CrossRefGoogle ScholarPubMed
McClish, D.K., et al., Gender differences in pain and healthcare utilization for adult sickle cell patients: The PiSCES Project. Journal of Womens Health (Larchmont), 2006. 15(2): 146–54.Google Scholar
Daoust, R., et al., Estimation of pain intensity in emergency medicine: A validation study. Pain 2008. 61(11): 8891.Google Scholar
Berthier, F., et al., Comparative study of methods of measuring acute pain intensity in an ED. American Journal of Emergency Medicine, 1998. 16(2): 132–6.CrossRefGoogle Scholar
Bijur, P.E., Latimer, C.T., and Gallagher, E.J., Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department. Academic Emergency Medicine, 2003. 10(4): 390–2.CrossRefGoogle ScholarPubMed
Bijur, P.E., Silver, W., and Gallagher, E.J., Reliability of the visual analog scale for measurement of acute pain. Academic Emergency Medicine, 2001. 8(12): 1153–7.CrossRefGoogle ScholarPubMed
Silka, P.A., et al., Pain scores improve analgesic administration patterns for trauma patients in the emergency department. Academic Emergency Medicine, 2004. 11(3): 264–70.CrossRefGoogle ScholarPubMed
Emshoff, R., Bertram, S., and Emshoff, I., Clinically important difference thresholds of the visual analog scale: A conceptual model for identifying meaningful intraindividual changes for pain intensity. Pain, 2011. 152(10): 2277–82.CrossRefGoogle ScholarPubMed
Fillingim, R.B., et al., Clinical characteristics of chronic back pain as a function of gender and oral opioid use. Spine 2003. 28(2): 143–50.CrossRefGoogle ScholarPubMed
Platts-Mills, T.F., et al., More educated emergency department patients are less likely to receive opioids for acute pain. Pain, 2012. 153(5): 967–73.CrossRefGoogle ScholarPubMed
Schnabel, A., et al., Sex-related differences of patient-controlled epidural analgesia for postoperative pain. Pain, 2012. 153(1): 238–44.CrossRefGoogle ScholarPubMed
Fosnocht, D.E., Heaps, N.D., and Swanson, E.R., Patient expectations for pain relief in the ED. American Journal of Emergency Medicine, 2004. 22(4): 286–8.CrossRefGoogle ScholarPubMed
Behzadnia, M.J., Javadzadeh, H.R., and Saboori, F., Time of admission, gender and age: Challenging factors in emergency renal colic – a preliminary study. Trauma Monthly, 2012. 17(3): 329–32.CrossRefGoogle ScholarPubMed
Zun, L.S., et al., Gender differences in narcotic-induced emesis in the ED. American Journal of Emergency Medicine, 2002. 20(3): 151–4.CrossRefGoogle ScholarPubMed
Hudson, T.J., et al., Epidemiology of regular prescribed opioid use: Results from a national, population-based survey. Journal of Pain Symptom Management, 2008. 36(3): 280–8.CrossRefGoogle ScholarPubMed
Campbell, C.I., et al., Age and gender trends in long-term opioid analgesic use for noncancer pain. American Journal of Public Health, 2010. 100(12): 2541–7.CrossRefGoogle ScholarPubMed
Parsells Kelly, J., et al., Prevalence and characteristics of opioid use in the US adult population. Pain, 2008. 138(3): 507–13.Google Scholar
Logan, D.E. and Rose, J.B., Gender differences in post-operative pain and patient controlled analgesia use among adolescent surgical patients. Pain, 2004. 109(3): 481–7.CrossRefGoogle ScholarPubMed
Logan, J., et al., Opioid prescribing in emergency departments: The prevalence of potentially inappropriate prescribing and misuse. Medical Care, 2013. 51(8): 646–53.CrossRefGoogle ScholarPubMed
Sjors, A., et al., An increased response to experimental muscle pain is related to psychological status in women with chronic non-traumatic neck-shoulder pain. BMC Musculoskeletal Disorders, 2011. 12: 230.CrossRefGoogle ScholarPubMed
Lewis, G.C., et al., Incidence and Predictors of Acute Psychological Distress and Dissociation after Motor Vehicle Collision: a Cross-Sectional Study. Journal of Trauma and Dissociation, 2014. 76(3): 561–75.Google Scholar
Severeijns, R., et al., Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. The Clinical Journal of Pain, 2001. 17(2): 165–72.Google ScholarPubMed
Pincus, T., et al., A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine, 2002. 27(5): E109–20.CrossRefGoogle ScholarPubMed
Feyer, A.M., et al., The role of physical and psychological factors in occupational low back pain: A prospective cohort study. Occupational and Environmental Medicine, 2000. 57(2): 116–20.CrossRefGoogle ScholarPubMed
Anderson, E.A., Preoperative preparation for cardiac surgery facilitates recovery, reduces psychological distress, and reduces the incidence of acute postoperative hypertension. Journal of Consulting and Clinical Psychology, 1987. 55(4): 513–20.CrossRefGoogle ScholarPubMed
Holbrook, T.L., et al., Morphine use after combat injury in Iraq and post-traumatic stress disorder. New England Journal of Medicine, 2010. 362(2): 110–7.CrossRefGoogle ScholarPubMed
Greenspan, J.D., et al., Studying sex and gender differences in pain and analgesia: A consensus report. Pain, 2007. 132 Suppl 1: S2645.CrossRefGoogle ScholarPubMed
Keogh, E., McCracken, L.M., and Eccleston, C., Do men and women differ in their response to interdisciplinary chronic pain management? Pain, 2005. 114(1–2): 3746.CrossRefGoogle ScholarPubMed
Burton, A.K., et al., Information and advice to patients with back pain can have a positive effect. A randomized controlled trial of a novel educational booklet in primary care. Spine, 1999. 24(23): 2484–91.CrossRefGoogle ScholarPubMed
Craft, R.M., Modulation of pain by estrogens. Pain, 2007. 132 Suppl 1: S312.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×