We have not understood for decades why chronic pain punishes women more. Finally we have the answer

Historically, medicine has grappled with an undeniable gender gap in which women Women suffer chronic pain more frequently than men, and on top of that their pain flares for much longer. This is something that many doctors have considered ‘normal’ and has been dismissed with psychological biases. But now science has seen that an explanation should not be sought in the mind, but in the immune system.

Against pain. This is the objective that medicine has right now, since it is undoubtedly a situation that for many people can be unbearable. That is why the magazine Science Immunology publish now a new study that offers a paradigm shift in our understanding of the biology of pain.

The result of this is that he has managed to find the key to some types of white blood cells called monocytes and in its direct relationship with testosterone.

What’s happening? When an injury is suffered, such as a blow, the body tries to defend itself with an inflammatory response. One of its components is pain, which is a necessary alarm signal to warn that something is wrong, but once the tissue begins to heal, it is logical that this alarm goes off. But this is where the body’s defense cells come in, monocytes, which act as ‘firefighters’ by releasing proteins called interleukin-10.

Here the research team has been able to see that this interleukin-10, abbreviated as IL-10, acts directly on sensory neurons to “turn off” hypersensitivity and therefore pain. The problem, and here lies the importance between sexes, is that men resolve this inflammatory pain much faster because they produce a greater amount of this protein.

The reason. Testosterone. This male sex hormone stimulates monocytes to produce higher levels of IL-10 after injury, and therefore pain can be better reduced. But in women this level of testosterone is much lower, and therefore the production of this natural ‘painkiller’ is lower, which causes the sensory neurons to take much longer to stop giving the signal that generates pain.

Your demonstration. Beyond doing so in animal models, the research team has been able to validate the experiments with human data from the AURORA studiowhich is a project that evaluates patients who have suffered traffic accidents and severe trauma.

Here the clinical data confirmed the laboratory’s suspicions, since they saw that the elimination or reduction of IL-10 activity in monocytes significantly delays the resolution of pain in both sexes, validating that this hormone-mediated immunological difference is exactly the same in humans.

In the future. This discovery is not just another biological curiosity to close a historical debate, but it has important therapeutic implications. And right now the severe pain crisis has to be treated with opiates on many occasions, which have a long list of side effects. But upon discovering this cellular mechanism, the researchers tried administering Resolvin D1a compound that promotes the resolution of inflammation. Here it was clearly seen how pain was reduced equally in both sexes.

This is why we are at the gateway to a new generation of non-opioid therapies that specifically modulate the immune system. But what is most important about this study is that it highlights the need to leave behind the “one size fits all” model in medicine to move towards more personalized medicine.

Images | Redd Francisco

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