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Sex, gender, and pain - the science

December 18 2009 at 11:04 PM

KK 

 
Jenny seems especially keen on girls getting caned. To some this seems to be a misogynist view. It is not clear why boys and girls should not treated differently in some regards when there are clear biological differences between the genders. Children are treated very differently depending on the wealth and social standing of their parents so why should there be much concern if they are treatedly a little differently on the basis of gender if there is a biological basis for doing so?

The medical literature is replete with reports dealing with gender differences, for example:


J Pain. 2009 May;10(5):447-85.
Sex, gender, and pain: a review of recent clinical and experimental findings
Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL 3rd.
University of Florida, College of Dentistry, Gainesville, Florida 32610-3628, USA.
RFilling@ufl.edu

Sex-related influences on pain and analgesia have become a topic of tremendous scientific and clinical interest, especially in the last 10 to 15 years. Members of our research group published reviews of this literature more than a decade ago, and the intervening time period has witnessed robust growth in research regarding sex, gender, and pain. Therefore, it seems timely to revisit this literature.

Abundant evidence from recent epidemiologic studies clearly demonstrates that women are at substantially greater risk for many clinical pain conditions, and there is some suggestion that postoperative and procedural pain may be more severe among women than men. Consistent with our previous reviews, current human findings regarding sex differences in experimental pain indicate greater pain sensitivity among females compared with males for most pain modalities, including more recently implemented clinically relevant pain models such as temporal summation of pain and intramuscular injection of algesic substances.

The evidence regarding sex differences in laboratory measures of endogenous pain modulation is mixed, as are findings from studies using functional brain imaging to ascertain sex differences in pain-related cerebral activation. Also inconsistent are findings regarding sex differences in responses to pharmacologic and non-pharmacologic pain treatments.

The article concludes with a discussion of potential biopsychosocial mechanisms that may underlie sex differences in pain, and considerations for future research are discussed.

PERSPECTIVE: This article reviews the recent literature regarding sex, gender, and pain. The growing body of evidence that has accumulated in the past 10 to 15 years continues to indicate substantial sex differences in clinical and experimental pain responses, and some evidence suggests that pain treatment responses may differ for women versus men.


There are many other similar papers available online.

Some girls might benefit from caning but they are not the same as boys.

 
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AuthorReply

KK

Sex differences in pain perception

December 18 2009, 11:52 PM 

Gend Med. 2005 Sep;2(3):137-45.
Sex differences in pain perception
Wiesenfeld-Hallin Z.
Division of Clinical Neurophysiology, Karolinska Institutet, Stockholm, Sweden.
Zsuzsanna.Wiesenfeld-Hallin@labmed.ki.se

BACKGROUND: A number of studies have demonstrated a higher prevalence of chronic pain states and greater pain sensitivity among women compared with men. Pain sensitivity is thought to be mediated by sociocultural, psychological, and biological factors.

OBJECTIVE: This article reviews laboratory studies that provide evidence of sex differences in pain sensitivity and the response to analgesic drugs in animals and humans. The biological basis of such differences is emphasized.

METHODS: The literature from this relatively new field was surveyed, and studies that clearly illustrate the differences in pain mechanisms between the sexes are presented. Using the search terms sex, gender, and pain, a review was conducted of English-language literature published on MEDLINE between January 1980 and August 2004.

RESULTS: Although differences in pain sensitivity between women and men are partly attributable to social conditioning and to psychosocial factors, many laboratory studies of humans have described sex differences in sensitivity to noxious stimuli, suggesting that biological mechanisms underlie such differences. In addition, sex hormones influence pain sensitivity; pain threshold and pain tolerance in women vary with the stage of the menstrual cycle. Imaging studies of the brain have shown differences between men and women in the spatial pattern and intensity of response to acute pain.

Among rodents, females are more sensitive than males to noxious stimuli and have lower levels of stress-induced analgesia. Male rodents generally have stronger analgesic response to mu-opioid receptor agonists than females. Research on transgenic mice suggests that normal males have a higher level of activity in the endogenous analgesic system compared with normal females, and a human study has found that mu-receptors in the healthy female brain are activated differently from those in the healthy male brain. The response to kappa-opioids, which is mediated by the melanocortin-1 receptor gene in both mice and humans, is also different for each sex.

CONCLUSION: Continued research at the genetic and receptor levels may support the need to develop gender-specific drug therapies.
PMID: 16290886 [PubMed - indexed for MEDLINE]

 
 
Jenny

Sex, gender, and pain - the science

December 19 2009, 11:31 PM 

Hi KK

Jenny seems especially keen on girls getting caned. To some this seems to be a misogynist view.

If you read my posts, you'll see I actually advocate equality. I'm not really concerned whether, in matters of punishment, this is achieved by making girls liable to be caned or abolishing it for boys too - either is acceptable although my preference is for the former. If advocating girls be liable to be caned just the same as boys makes me a misogynist, then those whose advocate boys be liable to be caned, regardless of whether girls are, must definitely be misandrists.


 
 

KK

Inputs and outputs

December 20 2009, 1:10 AM 

If you read my posts, you'll see I actually advocate equality. I'm not really concerned whether, in matters of punishment, this is achieved by making girls liable to be caned or abolishing it for boys too - either is acceptable although my preference is for the former. If advocating girls be liable to be caned just the same as boys makes me a misogynist, then those whose advocate boys be liable to be caned, regardless of whether girls are, must definitely be misandrists.
But girls are not equal - they feel pain more than boys and are more distressed by it, if we believe the scientists.

 
 

KK

Pain research - Boys versus girls

December 23 2009, 6:20 PM 

PubMed is a free on-line service of the US National Library of Medicine that includes over 18 million citations from MEDLINE and other life science journals.
http://www.ncbi.nlm.nih.gov/pubmed/

PubMed Central (PMC) is a free on-line digital archive of biomedical and life sciences journal literature.
http://www.ncbi.nlm.nih.gov/pmc/

Most recently published papers describing US government funded research are available free on-line.

 
 

KK

Hyperlink for recent review

December 24 2009, 12:54 AM 


 
 

KK

Somatotypes and dealing with pain

December 28 2009, 11:56 PM 

Does body type, and physical activity and competence, correlate with the ability to cope well with corporal punishment?

I live in a rural town with a high proportion of young families and a lot of adventure activities nearby. My impression is that fit active boys feel much less fear and pain than the rest of the population. They are much into risk taking. They seem very accepting of the consequences of crashes and misjudgments. Girls are conspicuous by the absence when it comes to riding bicycles down flights of steps or threatening low lying aircraft while using a trampoline, or spending hours and hours playing cricket in the street.

The physically active boys are generally well behaved and there is no legal CP in homes or schools here. However, I can imagine them coping well with a caning should one be earned.

 
 
a reader

Re: Sex, gender, and pain - the science

December 31 2009, 4:14 AM 

so then we can conclude that cp especially in moderate doses may be much more effective on girls who really want to avoid it than fit boys who aren't afraid of it.

 
 
willyeckaslike

reply to a reader

December 31 2009, 12:08 PM 

yay verrily ! logical and very succinctly put. This gives credence to Jenny's point of view.

 
 

KK

Context

January 1 2010, 7:53 PM 

a reader and willyeckaslike please read the hyperlinked document above rather than just my personal observation add on. I think you may have taken the latter out of context.

The hyperlinked document is a little heavy going but not impossible. It is a review of all the recent studies of gender related responses to pain. It seems fairly clear that men and women experience and process pain differently.

A further personal observation of apparent gender differences. Recently, I was told off by a female nurse for not requiring pain relief after surgery. Apparently, men are silly to put up with pain when there is no need to. The fact was that I was not in pain and the minor soreness was useful for helping me protect my wound. Because it was useful to me, and had a known origin, the soreness was not troubling nor causing me any distress.

 
 

Another_Lurker

Re: Sex, gender, and pain - the science

January 2 2010, 1:41 AM 

Hi KK. You say:

Recently, I was told off by a female nurse for not requiring pain relief after surgery. Apparently, men are silly to put up with pain when there is no need to. The fact was that I was not in pain and the minor soreness was useful for helping me protect my wound. Because it was useful to me, and had a known origin, the soreness was not troubling nor causing me any distress.

My own experience a few years ago. I woke up plumbed into an elaborate machine which supposedly enabled me to grade my pain from 1 to 10, whatever that meant, and self-administer some noxious chemical accordingly. As the evening progressed nurses arrived, first singly, and then mob handed, urging me with increasing stridency to use it.

I explained that I'd taken the precaution of engaging a good surgeon, and hence had no pain. I also explained something which had obviously been omitted from their medical training, that pain is a signal that something is wrong and may need attention, and unless severe enough to interfer with an essential task in hand shouldn't be ruthlessly suppressed.

Happily for them, my attitude, coupled with the fact that I was reading a book called 'The Mammoth Book of Mountain Disasters - True Accounts Of Rescue From The Brink Of Death' enabled them to categorise me as some sort of lunatic, and it was quite obvious to me that that was what they did. However, they had the good grace to unplumb me and take away the machine after a few hours, much to my relief, as it looked expensive and I was concerned that I might overturn and damage it if I moved the plumbed arm without thinking! happy.gif

BTW, any chance of a response on the dapper Rex and the delectable Darlene? No ......... ah well, I thought not, I'll try again in 2011! wink.gif

 
 
Alan Turing

What do we mean by pain?

January 2 2010, 11:37 AM 

No, I'm not being facetious -- this is meant to be a serious question (despite the rather jokey discussion I had with prof.n some time ago about whether different people feel pain in the same way).

So let me tell you about my hospital experience. About twenty years ago I dislocated my elbow (apparently that's quite hard to do, but I did it). In the hospital, I was told that it would be a straightforward procedure to reinstate the joint. I was asked whether I wanted a proper anaesthetic, which would mean waiting several hours as I had recently had a meal, or whether I would prefer to be pumped full of Valium (Diazepam) so that the procedure could be carried out straight away. I chose the latter.

Afterwards, I was told that I was screaming my head off during the procedure -- but I have no recollection of that at all. So, was I in pain at the time? From the point of view of "pain as punishment", I guess I wasn't. Yet the pain must have been registering in some part of my brain, in order to trigger the reaction. I don't know anything about neuroscience, but according to Wikipedia

Diazepam affects the emotional-motivational component of the pain experience, but not the sensory discriminative component or the central control of pain.

It's also known that chemicals created in the body under conditions of stress can affect the perception of pain. So when, for example, the paper cited by KK states:

the use of neuroimaging is a promising tool that may reveal sex differences in central representations of pain

I wonder what precautions the researchers take in order to ensure that what they are measuring is a genuine sensation which will be remembered?

 
 

KK

Two aspects of pain

January 2 2010, 7:06 PM 

AT is correct in suggesting pain is complex. The nerve endings (nociceptors) at the site of the noxious stimulus (cane stroke across the buttocks, or whatever) are probably much the same in everyone although they may be stimulated to different degrees depending on anatomy and the amount of mechanical disturbance. The big difference between individuals and genders is likely to in how the brain processes and interprets the signals.

 
 
a reader

Re: Sex, gender, and pain - the science

January 3 2010, 12:35 PM 

what does all of this have to do with the fact that most girls respond very well to the threat of cp and will usually fall into line if they know it's a consequence?

 
 

KK

Re: Sex, gender, and pain - the science

January 3 2010, 8:43 PM 

Dr. Dominium has suggested, more than once, that Nothing is more unequal than the equal treatment of unequal people. I think this is self evident. But what has it to do with gender?

Males and females were once considered very different and they were treated very differently, with very different expectations of each. Then the pendulun swung with some claiming (almost) no significant differences between male and female and demanding equal rights and equal treatment. The truth is probably somewhere between the two extremes.

This topic was started to provide access to recent scientific research on the matter of gender and pain. The matter has not been finally resolved but the evidence to date suggests there are differences between how males and females perceive and deal with pain. Dr Dominum has suggested girls and boys tend to respond differently to corporal punishment. The research cited above explains why this might be so. Equal treatment of boys and girls may be very unequal in its effects.

More than deterrence needs to be taken into account.

A reader , why do you want girls caned? Is it because women have taken mens jobs and abandoned their wifely duties? Do you want them to take the bad with the good?

 
 
a reader

Re: Sex, gender, and pain - the science

January 3 2010, 9:16 PM 

because they behave much better if they know it's a potential consequence.

age is a much greater factor than sex in terms of ability to withstand pain. an underdeveloped 12-year-old boy will easily break down before a tough 16-year-old girl. should they be subject to different rules and consequences because of this?

oh well, go on thinking by your neo-victorian illogic. i'm sure it'll get your nation far and produce very wonderful young people.

 
 
Jenny

Re: Sex, gender, and pain - the science

January 3 2010, 10:17 PM 

Hi a reader

because they behave much better if they know it's a potential consequence.

Exactly. That's the reason given for using corporal punishment on boys - it works on girls just as well.

age is a much greater factor than sex in terms of ability to withstand pain. an underdeveloped 12-year-old boy will easily break down before a tough 16-year-old girl. should they be subject to different rules and consequences because of this?

Right again. A blanket "don't cane girls" policy totally ignores the facts. Not all girls are weak delicate creatures unable to withstand the slightest touch. Remind me, which sex is it that copes with childbirth?


 
 

KK

Child birth

January 5 2010, 6:49 PM 

Jenny: Remind me, which sex is it that copes with childbirth?

I am not at all sure that reference to child birth advances the case that females cope well with pain. It might equally undermine it, if it does anything at all. Giving birth is a natural process common to all mammals. Most seem to deal with it well excepts for (some) humans. Perhaps this is because they are sensitive? Those with kidney stones or broken bones cope with the pain - they have no choice. The same for women giving birth. Getting kidney stones is not an indicator of hardiness. Nor is giving birth. It tells us little or nothing about gender differences.

A Reader, please read what I have written above and in other posts and tell be where I say what you claim I have said. You misrepresent my views. All my comments have been qualified. I have challenged unsubstantiated claims that boys and girls are the same and have drawn attention to some recent research on the matter.

 
 
Jenny

Re: Child birth

January 6 2010, 12:43 AM 

Hi KK


I am not at all sure that reference to child birth advances the case that females cope well with pain.

It's not only a matter of pain, it's also the associated stresses. A woman's body isn't as fragile as some people like to make out. For other examples, take a look at female body builders and boxers. Are they really the feeble creatures women are supposed to be? They may have trained especially to develop their bodies but they are still female and, therefore, by some peoples definition, weaker than a young boy.

Those with kidney stones or broken bones cope with the pain - they have no choice. The same for women giving birth. Getting kidney stones is not an indicator of hardiness. Nor is giving birth. It tells us little or nothing about gender differences.

The pain from broken bones and kidney stones is a warning that something is wrong - the body wasn't intended to suffer from either. Childbirth is a natural process which a woman's body is intended to undergo.


 
 
Ketta

Re: Sex, gender, and pain - the science

January 6 2010, 6:21 PM 

KK


Most of these studies have been performed on adults although some research with children seems less proven. If we accept the studies, that females experience different tolerances and levels of pain than males, are the findings so condemning we needed treat girls differently when it comes to CP. I don't think so. Boys are conditioned at quite an early age to accept pain in different ways than girls. A boy falls hurts himself, cries, he is told to be brave, stop crying like a sissy, don't make a fuss, on the other hand girls were more likely to be comforted, given some distraction. We tend to wrap girls in cotton wool discouraged them from robust activities incase they get hurt.

There is suggestion that hormones play a part in deciding pain tolerance. If hormones do play a part, and we cane boys and girls between 11-17 years, during that age range both girls and boys can be subject to various hormonal changes . Boys and girls of the same age and gender could feel pain at different levels, this could be more or less, or boys feeling pain at a higher level than girls at some stage depending on their sexual development .

Researchers believe that it is the fear of anxiety-related sensations and an increased tendency to negatively interpret such sensations, both of which are more predominant in women than men that influences women's experiences of pain. Anxiety and fear before a caning are present in both sexes,not just girls, repeated offended or not. Im not sure that girls have developed such high anxiety levels as possible when adults.

The scientific experiment of placing a hand in ice for two minutes. Although females are recorded feeling pain earlier, sometimes lasting longer, the difference is very marginal but not intolerable. The cane is meant to hurt but not severe enough to be unbearable, . I can't think of an incidence where a girl found the pain level so intolerable over that expereinced by a boy that they had to be held down forcibly to continue or abandon the caning. Both boys and girls seem to take their punishment with little fuss, tears and the few audible sounds of discomfort are not just common to girls. Resulting discomfort might be felt for a while, but pain produces endorphins triggered by both genders, its the bodys natural pain killer. The intensity of pain soon forgotten, in reality is it is over and finished quickly, Dr D's six of the best doesn't last much over one minute at worse, a shorter duration than our scientists experiments.

http://www.utoronto.ca/pain/Publications-Articles/Women%20feel%20it%20worse%20-%20oct%2006.pdf



 
 
 
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