People react to pain in different ways. When the stimulation of nociceptors is strong enough to activate them, the perception of pain ensues. An illness with pain as its primary symptom is referred to as a pain disorder. The pain could be quite severe that it impairs activities. Numerous pain diseases affect men and women differently in terms of frequency and severity, according to reports. The occurrence of migraine, fibromyalgia, arthritis, and back pain happens more frequently in females than males. Over the past years, preclinical studies have been carried out to prove significant sex-based differences in the mechanisms underlying chronic pain. The group of people with chronic pain is primarily female, older, and genetically diverse while preclinical pain research has mostly been done on young, male, limited-breed, or inbred strain mice or rats. Some emerging theories state that gender differences in fundamental pain mechanisms may be responsible for the varied effectiveness of pain medications in men and women. Differences at the molecular level in the dorsal root ganglion(DRG) are emerging.
Back Pain
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Females express more PTGDS
A semi-systematic literature review of prostaglandins (PGs), inflammation, and pain were done. Recently, it was discovered that male and female mice displayed different behavioral responses to prostaglandins and PTGDS(prostaglandin D2 synthase) inhibitors because of a sex variation in the expression of the prostaglandin-producing enzyme, PTGDS, in DRG neurons. It has been confirmed that females express PTGDS more than females via a review that was carried out by a group of scientists. It was recommended that more female animals be included in prostaglandin preclinical studies. Prostaglandins are a group of physiologically active lipids derived from arachidonic acid. They have diverse hormone-like effects on the body. They play a critical role in pain and inflammation. They all act on G-protein-coupled receptors to modulate intracellular signaling pathways. Its conversion depends on the action of cyclooxygenase (COX) enzymes. Drugs like Non-steroidal anti-inflammatory drugs(NSAIDs) inhibit the COX pathway.
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Papers were grouped as preclinical(mice or human tissue) and clinical(humans in clinical settings). In numerous preclinical studies, prostaglandin responses to noxious chemical exposure varied between male and female animals. Female rats displayed increased temporomandibular joint (TMJ) sensitivity than male rats in a model of IL-1b-induced(Interleukin 1b induced). TMJ inflammation both before and after a cannula was implanted. In addition, male and female animals may respond differently to COX and COX2 inhibitors. In the clinical studies, experiments were not as radical as desired. Still, it was noticed that in patients receiving treatment for their hips and knees, the analgesic and anti-inflammatory benefits of various coxibs and nonselective COX inhibitors were studied. Ibuprofen caused more of a response in males than women, suggesting that men are more likely to experience an anti-inflammatory effect. Interestingly it was observed that in the DRG neuron, PTGDS is expressed more in females than males.
Clinical significance
The findings above draw our attention to the disparities that appear in preclinical and clinical studies. Knowing how prostaglandins affect pain can have an impact on the creation of future pain therapies.
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Conclusion
The incidence of chronic pain is on the rise. Studies have pointed to the fact that regular NSAIDS may have fewer effects on females. If we are to treat chronic pain disorders effectively in the population that experiences them most frequently, women’s pain mechanisms need to be better understood.
