Новое исследование выявило биологическую причину, по которой женщины чаще страдают от хронической боли

Chronic pain has been an increasingly researched area of study for over 20 years. Both clinical and scientific studies are looking more closely at how pain is experienced differently between men and women. The pain differences between men and women are found in many health care settings and women have been shown to experience both greater pain sensitivity and intensity, a lower pain threshold, but greater pain tolerance than men. Women suffer more from pain disability and have a greater risk of developing chronic pain syndromes. These differences are driven by a multitude of factors including sex hormones, pain pathways and psychosocial factors such as individual coping strategies and traditional gender roles and stereotypes. An early study, published in The Journal of Pain, Oct. 9, 2008, examined 85,000 people in 17 countries and showed that the occurrence of chronic pain is higher among females than males. This study examined primarily musculoskeletal pain which included whole body pain, back pain, fibromyalgia and the pain of osteoarthritis. It also noted that as women age, they are at greater risk of painful compression and other fractures due to the loss of bone mass. This study also found that chronic pain was prevalent in 45% of women and 31% in men. Several studies over the past years have shown that more women suffer from abdominal pain and the National Institutes of Health (NIH) reports that women outnumber men 3-to-1 in the prevalence of irritable bowel syndrome. Headaches are one of the most common pain conditions. The journal Headache, July-August 2001, published the NIH American Migraine Study 2 of 29,000 adults in the United States. It found that a one-year prevalence of migraines is 18% in women and 7% in men. Migraines are most common in women between 20 and 45 and more women than men report longer lasting headaches with more associated symptoms such as nausea and vomiting. Though women experience more pain than men, they receive less effective treatment overall for their pain according to research published in Policy Insights from the Behavioral and Brain Sciences, Oct. 1, 2020. While most study and discussion looked at biological differences, some research has focused on social determinants related to the pain differences. Gender stereotypes such as women’s emotionality and beliefs that women may overdramatize leads some health care providers to not acknowledge legitimate pain or its severity. Equality of care can become compromised, patient-provider relationships become strained, and adverse health outcomes can (and do) occur. This gender discrimination is stressful and may exacerbate the chronic pain until it interferes with daily activities. This social discrimination, along with biological differences, must be addressed when looking at pain statistics comparing women and men. Estrogen is a strong factor in pain sensitivity as it amplifies pain signals. There are estrogen receptors that are involved with both pain processing and modulating pain-relieving neurotransmitters. The International Journal of Molecular Sciences, Jan. 18, 2023, published a study on the role of sex hormones in pain-related conditions. It showed that testosterone shows protective factors in males and that estrogen fluctuations lower the pain threshold in females. They found this estrogen factor especially true in postmenopausal females who have more hormonal fluctuations and in some younger women at different times of their menstrual cycles. A new biological study from the University of Calgary in Canada examined another reason why women are more likely to experience chronic pain. This research was published in Neuron, March 19, 2025. The study authors identified a possible hormonal factor that contributes to pain experiences. The research was done on rodents, but results can translate to human physiological responses, too. The focus was on neuropathic pain, which is caused by damage to nerves leading to an intense burning and shooting sensation. This nerve damage can also lead to allodynia, where usually nonpainful stimuli becomes uncomfortable to quite painful. A simple example might be the sensation of raindrops falling on skin that should not hurt but does. The researchers found that both male and female rodents process pain through pannexin channels. These are specialized proteins that help to regulate inflammation. But the female and male rodents process pain via different immune cells. In the females, activation of these pannexin channels led to the release of leptin, a hormone associated with an increased sensitivity to pain. Leptin also helps to regulate appetite, body weight and how we use our energy stores. It also helps to control the immune system and inflammation. Past research has shown that women with chronic pain have higher leptin levels and this study suggests this hormone is a factor in how pain sensations are processed. This Calgary study emphasizes a need for personalized pain management with a focus on patient care rather than just pain/disease management. Most pain research in the past has been done with male subjects so treatments have been based on a “male-based understanding of pain” according to this study. Lori Montgomery M.D., clinical associate at the University of Calgary and pain specialist, said of this research: “Both sex and gender are important factors that need a lot more investigation, but this latest research might prove to be one of the ways that we can personalize treatment for patients so that it’s more likely to be effective.” While further study is warranted to see if these findings can be used in clinical settings, we can see that there is a potential for more individualized and effective treatments for chronic pain in women. We need to recognize and appreciate our differences.