Does biological sex influence the mechanisms, assessment and treatment of pain? Disproportions in modern pain medicine

Reumatologia · 2024 · vol. 62(3) , pp. 147–149 · doi:10.5114/reum/191123 · PMID:39055729 · PMC11267654
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This paper discusses how biological sex influences the mechanisms, assessment, and treatment of pain, highlighting disproportions in modern pain medicine.

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Experimental and clinical studies indicate that biological sex significantly influences pain perception, necessitating distinct approaches for diagnosis and treatment. However, the paper highlights that existing biological differences often lead to prejudices and discrimination against women, resulting in the underestimation of their pain intensity and neglect of conditions such as dysmenorrhea. Inadequate management of both acute and chronic pain synders is identified as a major consequence of this systemic bias in modern medicine. The authors argue that raising awareness of these sex differences at both clinical and societal levels is the essential first step toward counteracting such disparities. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Conclusions

Experimental and clinical studies indicate that there are significant differences in the perception of pain depending on biological sex, which is important in the diagnosis and treatment of pain. However, existing and relatively well-known biological differences cannot translate into prejudices, stereotypes and symptoms of discrimination against women in relation to the assessment and underestimation of pain intensity, neglect of the treatment of pain syndromes characteristic of women, for example dysmenorrhea or childbirth pain, and inadequate treatment of acute and chronic pain syndromes. The first step to counteracting sex bias is to raise awareness of sex differences in clinical practice and at the level of society.

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europepmc
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pubmed
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