Publications
APS Bulletin • Volume 11, Number 1, January/February 2001
Resource Reviews
John D. Loeser, MD, Department Editor
Sex, Gender, and Pain Progress in Pain Research and Management (Vol. 17)
Reviewed by Judith A. Turner, PhD
R.B. Fillingim (Ed.), IASP Press, Seattle, 2000, 393 pages, $55 (IASP members) $79 (IASP nonmembers) (hardcover), ISBN 0-931092-35-3
This edited volume contains 18 chapters that summarize findings from a wide range of clinical and experimental studies on the relationships among sex, gender, and pain. The chapters are written by an impressive international group of experts and are consistently thorough and well-written, as well as understandable to readers unfamiliar with the area of research.
The volume is divided into four parts. The first section, “Basic Considerations for Sex, Gender, and Pain Research,” includes chapters on sensory effects of gonadal hormones, interactions between sex and genotype in the mediation and modulation of nociception in rodents, and psychosocial contributions to sex-related differences in pain responses. The first chapter, written by Roger Fillingim, provides a concise summary of the relevant historical events preceding the publication of this book and an overview of the important issues covered in the book (i.e., the magnitude of sex differences in pain, mechanisms underlying sex differences, and clinical relevance). The other chapters in this section are provocative and suggest interesting directions for future research.
Part II, “Sex-Related Differences in Experimental Pain Responses,” reviews findings from a variety of experimental pain research areas (i.e., nociceptive responses in nonhuman animal research, ovarian sex steroids, vaginal stimulation, visceral pain, responses to experimental pain in humans, the menstrual cycle and sex hormones in humans, analgesic responses). Individually and as a group, these chapters illustrate the complexity of sex-related differences in pain responses and the multiple factors that may interact to influence these differences.
The third section is titled “Sex-Related Factors in Clinical Pain Conditions.” A chapter on epidemiological perspectives provides a very useful table summarizing gender prevalence ratios found in different studies for a variety of pain conditions; this table nicely illustrates the female predominance across conditions as well as the variability in findings across studies. This chapter also points out the complex interactions among gender, age, and pain condition. Another chapter provides a comprehensive summary of recurrent headache disorders and gender differences in headache prevalence, symptoms, impact, and healthcare use. Chapters on fibromyalgia, temporomandibular disorders, irritable bowel syndrome, and female genital pain are similarly comprehensive and well-written, and will be a useful resource to anyone with interest in these areas.
The final section, “Conclusions,” contains a single chapter by Karen Berkley, with the provocative title, “Female Pain Versus Male Pain?” This chapter provides a useful summary for the entire volume, illustrates how basic and clinical research can inform each other, and suggests a framework for future research in the area.
I believe this book deserves a place on the bookshelf of every pain researcher, basic or clinical. It provides a thorough, comprehensive, and up-to-date review of this important topic. Reading (or even skimming through) this volume should heighten the sensitivity of every researcher to the importance of attention to sex- and gender-related issues in pain studies, as well as the importance of continued integration of basic and clinical research.
Judith Turner is the Hughes M. and Katherine G. Blake Professor of health psychology, departments of psychiatry and behavioral sciences and rehabilitation medicine, at the University of Washington in Seattle.