Most of the studies reviewed above address quantitative differences, which refers to whether females and males display different amounts of pain or analgesia. In contrast, qualitative sex differences are present when a given variable influences pain or analgesia differently in women versus men. Because qualitative differences may indicate sex-specific pain mechanisms they represent the most compelling rationale for the development of sex-specific pain treatments. Thus, even in the absence of quantitative sex differences, researchers should conduct analyses to uncover potential qualitative sex differences, which simply involves including sex as a moderator in the statistical model. Responses to the TRPV1 agonist capsaicin have been compared across sexes, and three of these five studies reveal significant sex-related differences in subjective pain ratings, suggesting higher sensitivity in females (Table 8).
- In contrast, Robinson and colleagues333 found that sex differences in cold pain tolerance were nonsignificant when participants were given gender-specific expectations for pain tolerance.
- Sex hormones may influence multiple central nervous system pathways, including effects on the functioning of endogenous opioid systems, dopaminergic function, serotonergic activity, and other endogenous components involved in the nociceptive processing, as discussed below.
- While masturbation is the formal word for this practice, many other expressions are in common use.
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Sex hormones may influence multiple central nervous system pathways, including effects on the functioning of endogenous opioid systems, dopaminergic function, serotonergic activity, and other endogenous components involved in the nociceptive processing, as discussed below. Free testosterone (T) is transported into the cytoplasm of target tissue cells, where it can bind to the androgen receptor, or can be reduced to 5α-dihydrotestosterone (5α-DHT) by the cytoplasmic enzyme 5α-reductase. 5α-DHT binds to the same androgen receptor even more strongly than testosterone, so that its androgenic potency is about 5 times that of T.[147] The T-receptor or DHT-receptor complex undergoes a structural change that allows it to move into the cell nucleus and bind directly to specific nucleotide sequences of the chromosomal DNA.
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The SRY gene plays a critical role in the initiation of testicular differentiation in males18). In XY embryos, SRY, which is normally located on the Y chromosome, induces the gonadal primordia to develop into testes. If a fetus is conceived from a sperm with an SRY-bearing X chromosome, it will develop as a male despite not having a Y chromosome.
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Two studies reported that sex differences in temporal summation to heat156 and mechanical361 stimulation persisted in clinical pain populations with low back pain and temporomandibular disorders, respectively. Thus, on balance, the evidence supports the conclusion that temporal summation is greater among females than males. A recent meta-analysis on sex differences in osteoarthritis using clinical markers as the case definition (not pain) indicated that females are at significantly increased risk for osteoarthritis (OA) in the knee and hand compared with males.382 Several studies have documented sex differences in pain prevalence, ratings, and depression in OA, and we will review selected studies below. NSFW Character AI represents a groundbreaking advancement in traditional AI chat technology, introducing a nsfw chat bot specifically designed for users to explore their NSFW character fantasies without restraint. This advanced platform not only facilitates a liberating space for expression but also comes equipped with sophisticated character creation tools and an intuitive interface, making it an ideal adult AI companion. As a safer and more appropriate option, platforms explicitly designed to host NSFW content should be sought.
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These sex differences may be due to increased activation of C-fibers among women, as vasomotor responses (eg, axon flare) produced by capsaicin were more pronounced in females.143 Also, sex differences in capsaicin pain appear to be dependent on the menstrual cycle. Females reported less pain during the luteal versus the follicular phase.143 Jensen and Petersen198 used a model with both heat and capsaicin found that females exhibited greater dynamic tactile allodynia but responded similarly to males in subjective ratings of capsaicin pain and secondary hyperalgesia. In response to intraoral capsaicin, women using oral contraceptives provided lower pain ratings than men, whereas normally cycling women and men did not differ.20 Thus, capsaicin-evoked pain does not differ consistently across sex. The results from 9 studies that examined sex differences in experimental pressure pain are presented in the upper portion of Table 5. In the meta-analysis by Riley et al,327 pressure pain was determined to produce the largest sex difference. The studies published since that time support the conclusions of the meta-analysis.
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