Why Chronic Pain Lasts Longer In Women

…and other items from this week’s health science news:

A real pain in the… monocyte production line

Chronic pain lasts longer in women than men, largely due to differences in hormone-regulated immune cells known to their friends as monocytes.

Specifically, a subset of monocytes produces interleukin-10 (IL-10), a molecule that signals pain-sensing neurons to switch off pain, and androgen signalling (as per testosterone, for example) increases production of IL-10 by monocytes.

It’s not yet established whether female-dominant hormones such as estrogen and progesterone affect IL-10 production in either direction, although it is known that estrogen and progesterone upregulate immune-regulatory T-cells, which can produce opioids (specifically, enkephalin) to block the pain signals before they reach the brain.

You may be thinking: but hang on, wouldn’t this mean that women experience less pain than men?

And the answer is: it depends!

A while back we wrote an article about how Alzheimer’s Sex Differences May Not Be What They Appear, and it’s a similar principle in this case: the female sex hormones are protective… Until they’re not!

In other words: in menopause, for example. And just like Alzheimer’s, chronic pain increasingly affects people the older we get, so the majority of people experiencing it at any time will tend to be postmenopausal. Symptoms get brushed off with “well, you are older now”, and while yes indeed many things may be age-related, in some cases their pathogenesis can be very clearly traced to “this hormone was doing the job for you, and now your levels of that hormone are very low, so you no longer get that protection”.

Read in full: Why chronic pain lasts longer in women: Immune cells offer clues

Related: Unwell Women – by Dr. Elinor Cleghorn ← a highly recommendable read, by the way, and touches on another reason why chronic pain can last longer in women (hint: it’s the medical misogyny)

Spontaneous coronary artery dissection isn’t fun

Firstly, what it is: spontaneous coronary artery dissection (SCAD) is an emergency in which a tear forms between layers of a coronary artery, causing a hematoma that restricts blood flow and can trigger a myocardial infarction (MI), most often affecting otherwise healthy women with few traditional risk factors.

That said, SCAD remains under-diagnosed and under-studied with few randomized trials, and because its mechanism differs from atherosclerotic MI it is often treated (inappropriately) in the same way.

Researchers (Dr. Svetlana Apostolović et al.) created a national prospective registry to understand more about SCAD, and its treatment practices and outcomes.

Putting those in numbers:

• Demographics: 85.4% were women with a mean age of 47.5 years, 6.7% were pregnant or postpartum, 36.2% were menopausal, and common risk factors included hypertension at 49.6% and dyslipidemia at 46.3%, while mental stress at 38.5% and physical stress at 10.7% were the most frequent triggers.
• Treatments given: percutaneous coronary intervention was performed in 41.5% of patients with stents implanted in 28.5%, while 58.5% received medical therapy alone and over half were treated with dual antiplatelet therapy at 58.5% and low-molecular-weight heparin at 56.9%.
• In-hospital outcomes: 23.6% experienced a major adverse cardiovascular event and 8.1% died during hospitalization.

The biggest takeaway from this is that stents are not usually beneficial in such cases:

Read in full: New insights on spontaneous coronary artery dissection in young patients

Related: Is Chiropractic All It’s Cracked Up To Be? ← we didn’t have an article about spontaneous arterial dissections, but one of the main causes of chiropractor-mediated death is accidents involving the (non-spontaneous) dissection of a vertebral artery.

Biomarkers in the blood for IBS/UC risk-spotting

Researchers (Dr. Eleftheria Pertsinidou et al.) have identified blood biomarkers that can signal a future risk of ulcerative colitis years before symptoms appear.

In few words: Dr. Pertsinidou and her team analysed large population blood samples, and found that the antibody anti-integrin αvβ6 appears more frequently in people who later develop ulcerative colitis, many years before diagnosis.

Which is important, because this kind of advance notice gives much better chances of early intervention, and avoiding all the woes in the first place!

Read in full: Blood markers can indicate people at risk of developing ulcerative colitis

Related: Avoid This Food To Avoid IBS ← about that early intervention!

Take care!