Qualitative sex differences in pain processing: emerging evidence of a biased literature

• Published in: Nature reviews. Neuroscience Vol. 21; no. 7; pp. 353 - 365
• Main Author: Mogil, Jeffrey S.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.07.2020; Nature Publishing Group
• Subjects: 631/378/1689/2610; 706/648/179; Analgesia; Animal Genetics and Genomics; Animals; Behavioral Sciences; Biological Techniques; Biomedical and Life Sciences; Biomedicine; Chronic pain; Female; Gender differences; Humans; Male; Neurobiology; Neurosciences; Pain; Pain - genetics; Pain - immunology; Pain - physiopathology; Pain - psychology; Pain Management; Pain perception; Pain Perception - physiology; Review Article; Sex; Sex Characteristics; Sex differences; Trends
• ISSN: 1471-003X; 1471-0048; 1471-0048; 1469-3178
• DOI: 10.1038/s41583-020-0310-6

Although most patients with chronic pain are women, the preclinical literature regarding pain processing and the pathophysiology of chronic pain has historically been derived overwhelmingly from the study of male rodents. This Review describes how the recent adoption by a number of funding agencies of policies mandating the incorporation of sex as a biological variable into preclinical research has correlated with an increase in the number of studies investigating sex differences in pain and analgesia. Trends in the field are analysed, with a focus on newly published findings of qualitative sex differences: that is, those findings that are suggestive of differential processing mechanisms in each sex. It is becoming increasingly clear that robust differences exist in the genetic, molecular, cellular and systems-level mechanisms of acute and chronic pain processing in male and female rodents and humans. Historically, preclinical pain research has been dominated by studies in male subjects. Jeffrey Mogil describes recent trends towards the inclusion of male and female subjects in research and the subsequent identification of qualitative sex differences in the mechanisms of pain processing.