Pain experience is determined by many factors including age, disease states, sex, socioeconomic status and several co-morbidities. Women are particularly overrepresented in specific pain conditions, such as low back pain, fibromyalgia, osteoarthritis, temporomandibular joint dysfunction, migraine, and irritable bowel syndrome among other factors.1-3 Also, literature pertaining to biological pathways, psychosocial influences and behavioral factors suggests sex differences in underlying pain mechanisms.

In this study, the authors aimed to quantify sex differences in pain prevalence and intensity reported by participants in different disease states in 10 large international clinical trials involving 33,957 participants (38% women, age range 50-74 years).4 Individual participant data meta-analysis was conducted using EuroQol-5 Dimension (EQ-5D) questionnaire pain data from randomized controlled trials published between January 2000 and January 2020 and undertaken by investigators at the George Institute for Global Health.

Pain was reported more frequently by women compared with men (47% vs 37%; P < 0.001). Women also reported greater levels of pain than men (adjusted odds ratio 1.41, 95% CI 1.24-1.61; P < 0.001). Differences in pain by disease group were identified (P for heterogeneity <0.001), but not by age group or region of recruitment. Women were more likely to report pain, and at a higher level, compared with men across diverse diseases, all ages, and geographical regions.

The researchers conclude that their findings reinforce the importance of reporting sex-disaggregated analysis to identify similarities and differences between women and men that reflect variable biology and may affect disease profiles with implications for management. They note that knowledge of the presence and magnitude of sex differences in pain might direct further study of underlying pain mechanisms and improve the diagnosis and treatment of pain for all patients.

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