Sex and gender differences in pain perception and management in clinical settings

Chronic pain, which is described as pain lasting for greater than 3 months, accounts for a large percentage of economic debt in the United States, with approximately 20% of Americans experiencing a form of chronic pain. Despite the current pharmacologic recommendations for pain treatment, there are differences in how medications are prescribed to patients. Gender and sex are common variables when discussing biases in both pain perception and treatment. Pain perception can differ amongst the sexes based on a myriad of reasons such as differences in gonadal hormones or chronic pain syndromes. The purpose of this narrative literature review is to report physiologic and pharmacokinetic differences between the sexes and highlight the possible biases in pain treatment amongst men and women. By bringing awareness to differences in pain perception and treatment experienced by men and women, clinically, we can increase the efficacy of pain management amongst the sexes.