1. A female university student complained of recurrent facial pain to her dentist, who said there were no identifiable signs of disease and that the type of pain she experienced was common among women and "could be psychosomatic". 2. While some pain complaints in female patients are difficult to quantify, many recurrent pain disorders have higher prevalence among women of unknown origin. 3. Anatomical and hormonal differences often result in pains in women that are non-pathological, and several chronic pain conditions like temporomandibular disorders are more prevalent among women.

1. Sex Differences in Pain
RIYADH COLLEGES
OF DENTISTRYAND PHARMACY
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Reviewed by:
Al-Waleed F. Abushanan, BDS
Dr. Thuan Dao, DMD, MSc, Dip Prostho, PhD, FRCD
Journal of the American Dental Association
July 2012, Vol. 143:7

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Dr. Thuan Dao, DMD, MSc, Dip Prostho, PhD, FRCD (c)
Associate Professor Prosthodontics, Department of Clinical Sciences,
Faculty of Dentistry, University of Toronto

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4. • A 28-year-old female university student complained
to her dentist of recurrent pain in her face.
• Her dentist told her:
– There were no identifiable signs of disease.
– The type of pain she’s experiencing is common among
women.
– The pain “could be psychosomatic”.
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5. • Allegations that some pain experienced by female
patients is psychosomatic could be because certain
complaints of pain are difficult to substantiate
quantitatively.
• Many recurrent pain disorders with higher female
prevalence are of unknown origin.
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6. • Many sex-specific pains due to anatomical, and
hormonal differences, more often are non-
pathological in women.
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7. • Several chronic pain conditions including
temporomandibular disorders (TMDs) are more
prevalent in women than in men.
• In addition, sex differences in orofacial pain emerge
at puberty, peak during reproductive years, and
decline at menopause.
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8. • Analysis of medical records of 11,000 patients, for
several diagnoses, women's average pain score was
at least one point higher than men’s, a clinically
meaningful difference.
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9. • A study involving 160 patients (89 men, 71 women)
found that the level of pain felt by patients during
endodontic treatment is "significantly correlated"
with gender and pulp status, and that practitioners
should be prepared to use supplemental local
anesthesia in women.
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10. • Investigators in a large number of psychophysical
studies concluded that female participants exhibited
greater sensitivity to laboratory pain than did male
participants.
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11. • While the evidence suggests that women and men
do not experience pain in the same way or to the
same degree, and that there is an overrepresentat-
tion of women with chronic orofacial pain, questions
remain as to why.
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12. • Women may seek treatment more readily than men
when they have a physical problem.
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13. • Men have been socialized to be more stoic, with
some societies regarding pain endurance as a sign of
virility.
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14. • Differences in sex hormones, notably estrogen.
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15. • Differences in the structural organization and
function of the nervous system.
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16. • Distinct anatomical, physiological, and hormonal
features in women and men provide important clues
about how their pains might be modulated in a
different manner by a number of biological factors.
• These observations should help counteract
prejudicial attitudes toward female patients, which
can lead to inadequate care.
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