Stieger Andrea, Asadauskas Auste, Luedi Markus M, Andereggen Lukas
Department of Anaesthesiology, Rescue- and Pain Medicine, Cantonal Hospital of St. Gallen, 9007 St. Gallen, Switzerland.
Department of Neurology, University Hospital of Bern, Inselspital Bern, 3010 Bern, Switzerland.
J Clin Med. 2025 May 14;14(10):3427. doi: 10.3390/jcm14103427.
: Pain perception and management differ by sex, with women frequently experiencing more acute and chronic pain and greater disability than men. Yet, anesthesiology and pain control often overlook the physiological, hormonal, and psychological factors shaping women's pain. : This narrative review explores essential considerations from current literature to optimize pain management in women. We examine evidence about the impact of hormonal changes, reproductive transitions, and psychosocial factors on pain perception and responses to analgesics. By highlighting key insights and practical strategies, we aim to support the development of personalized pain management approaches tailored to women's unique needs. : Hormonal changes, including variations in estrogen and progesterone levels, significantly influence pain thresholds and the effectiveness of analgesics and anesthetics. The menstrual cycle, menopausal transitions, and pregnancy each alter pain responses, necessitating personalized approaches to pain management. Postmenopausal women are particularly vulnerable to chronic pain conditions, such as those associated with osteoporosis, which require adjustments in long-term treatment strategies. Furthermore, psychosocial factors like anxiety and emotional distress can intensify pain, highlighting the need for holistic, integrative care. : The existing gaps in women's pain management across the lifespan highlight the need to revise both anesthesia and pain management protocols to better account for sex-specific biological and psychosocial factors. Addressing the unique biological and psychosocial factors that influence pain in women can enhance both the effectiveness and equity of care. By tailoring treatment strategies in women, clinicians can not only enhance pain management but also greatly improve their overall quality of life.
疼痛感知和管理存在性别差异，女性比男性更容易经历急性和慢性疼痛，且残疾程度更高。然而，麻醉学和疼痛控制往往忽视了影响女性疼痛的生理、激素和心理因素。
本叙述性综述探讨了当前文献中的重要考虑因素，以优化女性的疼痛管理。我们研究了激素变化、生殖转变和社会心理因素对疼痛感知及镇痛药反应的影响证据。通过强调关键见解和实用策略，我们旨在支持开发针对女性独特需求的个性化疼痛管理方法。
激素变化，包括雌激素和孕激素水平的变化，会显著影响疼痛阈值以及镇痛药和麻醉药的效果。月经周期、绝经过渡和怀孕都会改变疼痛反应，因此需要个性化的疼痛管理方法。绝经后女性尤其容易患慢性疼痛疾病，如与骨质疏松症相关的疾病，这需要调整长期治疗策略。此外，焦虑和情绪困扰等社会心理因素会加剧疼痛，凸显了全面、综合护理的必要性。
女性一生疼痛管理中存在的现有差距凸显了修订麻醉和疼痛管理方案的必要性，以便更好地考虑性别特异性的生物学和社会心理因素。解决影响女性疼痛的独特生物学和社会心理因素可以提高护理的有效性和公平性。通过为女性量身定制治疗策略，临床医生不仅可以加强疼痛管理，还可以大大提高她们的整体生活质量。
