Pain affects everyone, but research published in NIH, shows that men and women experience it differently. Despite common myths suggesting women are more tolerant due to childbirth or menstrual cramps, studies reveal that women are generally more sensitive to pain than men. Biological, hormonal, and neurological differences contribute to these variations, influencing everything from chronic pain prevalence to treatment response. Understanding how men and women perceive pain is critical for developing more effective, personalised approaches to pain management. By exploring the role of hormones, brain circuitry, immune responses, and genetic factors, we can uncover why pain feels different across sexes.
Why men and women feel pain differently: Insights into male and female biology
Pain is a complex phenomenon influenced by hormones, brain circuitry, immune system responses, and genetics. About one in four adults experience chronic pain—lasting longer than three months or beyond expected healing. Women are more likely than men to develop chronic pain, highlighting biological and social differences that researchers are still investigating.Brain wiring, immune cell function, and sensory neuron activity differ significantly between men and women. These differences suggest that pain management and treatment strategies may need to be sex-specific for optimal effectiveness.
How hormones influence pain in men and women
Sex hormones such as estrogen and testosterone play a major role in pain perception. During puberty, dramatic hormonal changes coincide with differences in pain prevalence. For instance, migraines affect boys and girls similarly before puberty, but after puberty, women are twice as likely to experience them. Chronic pain severity in women also fluctuates throughout the menstrual cycle, while men tend to have more stable patterns.Hormones alone don’t explain everything. Brain imaging studies reveal structural and functional differences in regions that process pain. The subgenual anterior cingulate cortex (sgACC), key to the body’s natural pain relief system, shows stronger connectivity in women with chronic conditions compared with men, which may contribute to higher pain intensity and lower treatment response in women.
Pain biology beyond the brain in men and women
Sex differences extend beyond hormones and brain structure. Genes influence pain perception differently in men and women. Immune cells respond differently to pain, and nociceptors, the sensory neurons transmitting pain signals from body to brain, function differently between sexes.From the first sensation of pain to perception in the brain, men and women process pain differently. Understanding these distinctions is crucial for tailoring treatment and improving outcomes for both sexes.
Chronic pain prevalence and treatment differences in men and women
About half of chronic pain conditions, including migraines, fibromyalgia, rheumatoid arthritis, osteoarthritis, and irritable bowel syndrome—are more common in women, while only 20% are more prevalent in men. Clinical trials often fail to report sex-specific responses or include sufficient numbers of female participants. Historically, preclinical studies predominantly used male animals, limiting knowledge about female-specific mechanisms. This study published in NIH, reviewed clinical and preclinical studies, noting that women generally exhibit increased pain sensitivity and a higher risk for clinical pain conditions. It also discusses how sex hormones and genetic factors contribute to these differences.For example, the protein calcitonin gene-related peptide (CGRP) was initially studied in male rodents and considered irrelevant to migraines. Later studies including both men and women showed that CGRP triggers strong pain responses in women but not men. This research eventually led to FDA-approved drugs effective for women but less so for men, demonstrating the importance of sex-specific research.
Managing chronic pain: Practical tips for women and men
Women experience more chronic pain and often face conditions that are difficult to diagnose. Advocacy and proactive care are essential:
- Document symptoms: Track pain, triggers, and patterns before seeing a doctor.
- Communicate clearly: Describe how pain affects daily life and treatment preferences.
- Bring support: A friend or family member can provide emotional support and help take notes.
- Find the right provider: If a healthcare professional dismisses concerns, seek another who listens.
Awareness of sex differences in pain biology helps improve personalised care for men and women. Hormones, brain wiring, immune responses, and genetics all contribute to why women generally experience higher pain sensitivity. Understanding these differences enables healthcare providers to reduce suffering and improve quality of life for everyone.Disclaimer: This article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider regarding any medical condition or lifestyle change.Also Read: Do hair loss medications affect male fertility? Risks and safer alternatives for men
