What is the basis for the observed higher pain tolerance in females?

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From the Guidelines

Women do not consistently have a higher pain tolerance than men, and research suggests that women generally have lower pain thresholds and may experience pain more intensely. The notion that women have a higher pain tolerance is likely a misconception that stems from their experiences with childbirth and menstruation, which can involve significant pain management 1. Pain perception varies widely among individuals regardless of gender, influenced by biological factors like hormonal differences, psychological factors, and sociocultural influences. Some key factors to consider include:

  • Biological factors: Hormonal differences, such as the effects of estrogen and testosterone on pain processing, can influence pain perception 1.
  • Psychological factors: Coping strategies and expectations can impact how individuals experience and report pain.
  • Sociocultural influences: Gender norms about pain expression can also play a role in shaping individual differences in pain tolerance. The relationship between gender and pain is complex, with both biological and psychosocial factors contributing to individual differences in pain tolerance rather than a simple gender-based advantage 1.

From the Research

Pain Tolerance in Women

  • Women are reported to have lower pain thresholds and lower pain tolerance than men 2.
  • However, some studies suggest that women have a higher prevalence of painful disorders compared to men, with women having more than twice the prevalence of men in painful disorders 3.
  • The relationship between sex and pain tolerance is complex, and is influenced by a variety of factors including genetic, anatomical, physiological, neuronal, hormonal, psychological, and social factors 4.

Factors Influencing Pain Tolerance

  • Sex hormones and the endogenous opioid system are thought to play a role in pain sensitivity, with differences in these systems between men and women potentially contributing to differences in pain tolerance 4.
  • Perceived ability to tolerate pain may also influence pain tolerance, with traditional gender roles potentially leading to sex differences in perceived ability 5.
  • Cognitive behavioral therapy (CBT) has been shown to be effective in reducing pain intensity in some individuals with chronic pain, although the efficacy of CBT may vary depending on the specific delivery method and population being treated 6.

Sex Differences in Pain

  • Men and women differ in their responses to pain, with women typically showing increased pain sensitivity and a higher prevalence of painful diseases 3, 4.
  • Women are more likely to report pain and have a higher prevalence of chronic pain conditions compared to men 3, 2.
  • The exact mechanisms underlying sex differences in pain are not fully understood, but are thought to involve a complex interplay of biological and psychological factors 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Gender differences in pain.

Image--the journal of nursing scholarship, 1995

Research

Pain in women.

Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology, 2017

Research

Gender differences in pain and its relief.

Annali dell'Istituto superiore di sanita, 2016

Research

Chronic Pain and Cognitive Behavioral Therapy: An Integrative Review.

Western journal of nursing research, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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