Sex differences in pain reports may be smaller than previously thought

Reports of significant differences in how women and men perceive pain may be exaggerated, according to a study by University of Florida researchers examining perceptions of disease-related pain.

This is the first study to examine sex differences in pain perception in a clinical setting, according to Michael E. Robinson, PhD, director of the University's Pain Research Laboratory and one of the study authors. He and his colleagues found that female chronic pain patients report three to 10 percent more pain than men do. This is far less than the 20 percent difference reported in previous studies examining pain tolerance in laboratory settings.

The discrepancy between the new findings and findings from the lab indicates that the sex difference may be less biologically based and more a product of differences in how men and women are socialized to respond to pain, says Robinson.

For example, men are taught to "tough out" pain. So in the lab they endure discomfort, such as having their hand in cold water, longer because they know it's temporary. Women feel little pressure to endure unnecessary pain and therefore have no trouble admitting when something hurts.

"It's my belief that women in the lab give a more unbiased report of their pain," says Robinson. Men, on the other hand, feel there's a social cost to admitting publicly that something hurts.

In contrast, chronic pain patients want relief, so they're less likely to be concerned with appearing tough, says Robinson. These findings may have implications for a trend to fund research into the biology of the sex difference in pain perception.

"It's not all biology," says Robinson. "It's also your willingness to say 'Ow!'"

All the empirical evidence isn't in yet to prove this theory. But, if correct, such a finding would have major implications for treatment in terms of needing to admit account for people's willingness to admit they hurt, says Robinson. His study is published in The Journal of Clinical Psychology in Medical Settings (Vol. 5, No. 4, p. 413424).



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