Men and Women Process Pain Differently, So Why Are They Treated the Same?

Pain is subjective. Chronic low back pain might be debilitating for some and merely a nuisance to others. Turns out there's a biological component to how men and women ameliorate pain, according to new research from the University of California San Diego School of Medicine reveals men and women utilize different biological systems to relieve pain.

The study, published in the journal PNAS Nexus, utilized a double-blind, counterbalanced study design comprising two distinct clinical trials. The trials involved a total of 98 patients—51 females and 47 males—some who were healthy and others who experienced chronic low-back pain. 

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Participants underwent a meditation training program, then practiced meditation while receiving either a high-dose of naloxone, a medication that attaches to opioid receptors and is used to reverse an opioid overdose, or saline, which served as the placebo. Then they were exposed to a painful (but harmless) heat stimulus to the back of the leg.

Researchers found that while the meditation reduced pain in both men and women, the naloxone administration to women was significantly less effective at controlling pain. The findings suggest that while men's bodies are more likely to rely on opioids to reduce pain, women rely more on non-opioid mechanisms. 

"These results underscore the need for more sex-specific pain therapies because many of the treatments we use don't work nearly as well for women as they do for men," said Fadel Zeidan, Ph.D., a professor of anesthesiology and Empathy and Compassion Research at UC San Diego Sanford Institute for Empathy and Compassion.

It underscores a stark reality that women are more at risk of dependence and addiction since they'd need a greater amount of morphine and fentanyl to experience the same relief.

"This study provides the first clear evidence that sex-based differences in pain processing are real and need to be taken more seriously when developing and prescribing treatment for pain."

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This research, as well as others, conclude that by tailoring pain treatment to an individual's sex rather than taking a one-size-fits-all approach to pain management we can better improve patient outcomes.