Untangling the relationship between gender and chronic pain is no small feat. It is easy enough for the statisticians to tell us that women are at a significantly increased risk for chronic musculoskeletal pain, widespread pain (including fibromyalgia), osteoarthritis, rheumatoid arthritis, headache (including migraine) and temporomandibular joint (TMJ) dysfunction.
But what are the biologic, psychologic and social factors that might explain this pain burden women seem to bear to a much greater degree compared to men?
Experimental pain studies have shown that women display a greater sensitivity to pressure, electrical and thermal stimuli. Positron emission tomography studies have shown that when a stimulus is adjusted to elicit the same pain report in men and women, men show an imaging pattern consistent with sensory process dominance; in contrast, women showed an imaging pattern suggestive of a more emotional integration of the same noxious input.
And what would a discussion of the differences between men and women be without at least a brief mention of hormones?
Girls do experience an increased incidence of migraine and TMJ disorders at puberty. In addition, fluctuating estrogen levels during the menstrual cycle appear to worsen musculoskeletal pain and migraine symptoms. Estrogen may also negatively affect the body’s natural opiate system.