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Anesth Analg 2008; 107:309-317
© 2008 International Anesthesia Research Society
doi: 10.1213/01.ane.0b013e31816ba437
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PAIN MECHANISMS

Sex, Gender, and Pain: An Overview of a Complex Field

Robert W. Hurley, MD, PhD, and Meredith C. B. Adams, MD

From the Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland.

Address correspondence and reprint requests to Robert W. Hurley, MD, PhD, Anesthesiology and Critical Care Medicine, 600 N. Wolfe St., Osler 292, Baltimore, MD 21287. Address e-mail to rwhurley{at}hotmail.com.

Abstract

Traditionally, biomedical research in the field of pain has been conducted with male animals and subjects. Over the past 20–30 yr, it has been increasingly recognized that this narrow approach has missed an important variable: sex. An ever-increasing number of studies have established sex differences in response to pain and analgesics. These studies have demonstrated that the differences between the sexes appear to have a biological and psychological basis. We will provide brief review of the epidemiology, rodent, and human experimental findings. The controversies and widespread disagreement in the literature highlight the need for a progressive approach to the questions involving collaborative efforts between those trained in the basic and clinical biomedical sciences and those in the epidemiological and social sciences. In order for patients suffering from acute and/or chronic pain to benefit from this work, the approach has to involve the use or development of clinically relevant models of nociception or pain to answer the basic, but complex, question. The present state of the literature allows no translation of the work to our clinical decision-making.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.