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The Globe and Mail

Do the sexes experience pain differently?

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Question: Do men and women differ in their tolerance to pain?

Answer: The short answer is yes, they do, because all individuals differ in their tolerance of pain. That is because pain is a subjective experience, difficult to measure and therefore compare between genders - or individuals.

Pain, as defined by the International Association for the Study of Pain, "is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage." By this definition, we see that pain is not just a physical occurrence, but also an emotional one. When we are in pain, our nerves send a signal to the emotional part of our brain - because the purpose of pain is to alert the body that something is wrong.

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Recent research has shown that genetic and gender differences play a role in pain tolerance. For example, studies show that women experience lower pain thresholds during the post-ovulation phase of the menstrual cycle and higher thresholds in late pregnancy and prior to delivery. This is connected to estrogen levels in the body during these particular times.

Gender also plays a role in the relative frequency of certain disease conditions. For example, women are eight times more likely to have fibromyalgia than men, and twice as likely to suffer from rheumatoid arthritis.

In studies involving pain induced experimentally in the lab, women reported higher pain severity at lower thresholds and were less tolerant to harmful stimulations than men. This doesn't mean the pain is only physiologically based; there are subjective psychosocial influences at play as well. It is important to note that while the gender differences in pain experience are statistically measurable, the effect is neither universal nor large.

Beyond the physical and emotional aspects, there are several other factors that influence how we feel pain and therefore our perceived tolerance of it. How long we have had the pain, how it affects our life, social issues and cultural influence all play a part in how an individual experiences pain. Gender, or gender stereotypes, also plays a role in this, as women may feel more comfortable reporting their pain than men.

Dr. Ted Robinson is the director of the Pain Management Program at Bridgepoint Health in Toronto.

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