Pain After Surgery Differed Between the Sexes

Men felt more pain after major surgery while women felt more pain after minor procedures

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Men and women are similar in so many ways. Yet, when it comes to health, there may be some important differences between the sexes, and recovering from surgery may be one of those areas where men and women differ.

A recent study found that men felt more pain after major surgery, while women reported feeling more pain after minor surgery.

"Report any pain you experience after surgery to your doctor."

This research was led by Helmar Bornemann-Cimenti, MD, of the Department of Anesthesiology & Intensive Care at the Medical University of Graz in Austria.

The researchers looked at 10,200 patients who underwent surgery at the University Hospitals of the Ruhr University of Bochum, Germany over a 50-month period. Of the sample, 57.8 percent were female, and 42.1 percent were male. The average age of the patients was 47.5 years old.

Within 24 hours of surgery, the patients were asked to respond to a specially-designed questionnaire meant to gauge their pain. A part of the questionnaire asked about anesthesia, and this part was completed by the attending anesthetist.

When they reviewed the overall responses, the study authors did not find any differences between men and women reporting pain after surgery. However, when they divided the surgeries by type, the researchers found that men reported more pain than women after major surgery, while women experienced more pain after minor surgery.

Major surgeries were defined as operations such as abdominal, major vascular (involving blood vessels) and orthopedic (bone) surgery, and minor surgery included biopsies (sampling of tissue or cells) and diagnostic procedures (those used to diagnose a medical issue).

Men were 27 percent more likely than women to report a greater number of pain episodes after surgery that they described as moderate. Women were 34 percent more likely than men to report more pain after minor procedures.

The study authors did not discuss which pain medications the patients used.

Dr. Bornemann-Cimenti told dailyRx News that reasons for sex-related differences in pain perception may be biological, such as different hormone levels and different distribution of opioid receptors (a protein that alters the perception of pain). He also said that the differences may be psychosocial, such as expectations that men or women have about how much pain they should have after surgery.

"Our results may be explained by previous findings about sex-related differences in perioperative [time around the surgery] fear and anxiety, as well as with social norms in pain behavior," he said.

Dr. Carolyn Dean, a health pioneer with over 25 years of experience with aging, nutrition, diet and women's health issues, said that women are more used to the pain of childbirth or having a cesarian section, and the outcome of those painful experiences tends to be joyful, so the pain is usually quickly forgotten. When they have minor surgery, however, the outcome is not joyful, and the pain is real.

Dr. Dean explained that men, on the other hand, want to be "in charge," and having major surgery makes them vulnerable and dependent on others to help them, which they don’t like. “Men will 'tough it out' through minor surgery because it does not make them feel totally dependent," she said.

This research by Dr. Bornermann-Cimenti and colleagues was presented June 2 at Euroanaesthesia 2014, a congress of the European Society of Anaesthesiology, in Stockholm, Sweden. The research has not yet been published or peer-reviewed.

The authors did not disclose any conflicts of interest.

Review Date: 
June 2, 2014
Last Updated:
June 2, 2014