Carlos Goicoechea García
This article reinforces what is already known—not only through common wisdom but also through scientific evidence: there are significant differences in pain responses between men and women, involving both sensory and emotional aspects.
It is a high-quality article that not only describes the epidemiological situation but also analyzes differences at the cellular, molecular, and immunological levels.
The study reinforces findings dating back to the mid-20th century, when research began into pain response differences between males and females in animal experiments, as well as between men and women in clinical studies. These differences involve purely sensory aspects—such as pain response thresholds and pain tolerance, which are higher in men than in women—as well as emotional differences linked to gender, that is, the roles of men and women in society.
The implication is that we should not treat pain generically; instead, treatment should be tailored to the individual's sex (regarding pharmacological and physiotherapeutic approaches) and gender (regarding psychological approaches).
Although research is becoming increasingly specific, the consistent translation of these findings into therapeutic practice has not yet occurred.
The study's main limitations stem not from the article itself, but from the very concept of chronic pain. It is a condition with both sensory and emotional components. The emotional component varies greatly among patients, regardless of whether they are men or women. Indeed, we must recognize that every instance of pain is unique—an expression of a sensation filtered through emotion. Therefore, no two experiences of pain are truly identical. On the other hand, regarding the translation to the treatment of patients with pain, from a pharmacological perspective, clinical trials—while including both men and women—rarely analyze drug response separately by sex, and few studies employ experimental protocols stratified by sex.