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Women May Feel Pain More Intensely Than Men

Study: Women's Skin Has More Nerve Fibers
By
WebMD Health News
Reviewed by Louise Chang, MD

Oct. 27, 2005 - Women really are more sensitive than men, a new study suggests.

Women's skin -- at least a small section near a nerve in the cheek -- has twice as many nerve fibers as men's skin, report Bradon J. Wilhelmi, MD, of Southern Illinois University and colleagues.

That may explain why a number of studies -- including some animal studies -- find that women feel pain more intensely than do men.

"There may indeed be a physical explanation for why some people have more pain than others," Wilhelmi tells WebMD. "It is not just cultural or social influences on how people perceive pain."

Wilhelmi, Arian Mowlavi, MD, and colleagues report the findings in the October issue of Plastic and Reconstructive Surgery.

Women Have a Lot of Nerve

While previous researchers have found that women feel pain more intensely, those studies remain controversial. Certainly there are social expectations -- and cultural training -- for men to deny their pain. Several researchers have argued that social and cultural factors are much more important than biological factors in determining women's apparently greater pain sensitivity.

Wilhelmi, a plastic surgeon, doesn't give women more pain medication than men. But he and his colleagues became interested in the question of whether women actually are able to sense pain better than men.

From cadavers donated to science, the research team cut small skin samples from the upper cheeks of 10 women and 10 men. Using a microscope, they then counted the nerve fibers in a one-square- centimeter area of skin.

Women's skin averaged 34 nerve fibers per square centimeter (although individual samples may have had 19 more or fewer fibers). Men's skin averaged half as many nerve fibers: 17 per square centimeter (plus or minus eight fibers in individual samples).

"Although preliminary and limited in scope, these findings favor a physical rather than a psychosocial explanation for more pronounced pain perception in female patients," the researchers conclude.

Wilhelmi is quick to point out that his team had no way of telling whether women's extra nerve fibers were actually sensory nerves. And they don't know whether they might get different results in different parts of the body.

Jury Still Out

Wilhelmi notes that the study is far from conclusive. It adds to a growing body of research on the subject -- a body of research that has yet to yield definitive answers, says pain researcher April Hazard Vallerand, PhD, RN, of Detroit's Wayne State University College of Nursing.

"It does look like females have some differences in pain in some areas," Vallerand tells WebMD. "Women can detect heat more easily. But women also acknowledge pain more frequently. What underlies all this is that women are more willing to discuss their symptoms in the first place. If a person is more aware of symptoms and is more willing to discuss them, that person is more likely to be seen as more sensitive to pain."

Vallerand notes that pain researchers have in the past used male-oriented questions (such as "Does your pain keep you from working on your car or mowing the lawn?") to evaluate pain severity. Even a question such as "Does your pain make you stay at home?" may have a gender bias, because women who stay home are more likely than men to care for small children.

"We don't have good research on why, and whether, certain types of pain really are more common in women or whether women might be more aware of their symptoms," Vallerand says. "There are some types of pain that occur more frequently in women. But we don't have good reasons why."

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