Adrenocortical and hemodynamic predictors of pain perception in men and women

Mustafa N al'Absi, Karen L. Petersen, Lorentz E. Wittmers

Research output: Contribution to journalArticlepeer-review

130 Scopus citations


Research has demonstrated that women report more pain than men, and clinical observations suggest that attenuated adrenocortical activity is associated with high pain sensitivity. The extent to which cortisol concentrations and hemodynamics contribute to gender differences in pain sensitivity has not been investigated. Thirty-four women and 31 men performed the hand cold pressor test (CPT). Participants rated their pain every 15 s during a 90-s CPT and a 90-s post-CPT recovery period and reported pain using the McGill Pain Questionnaire (MPQ). Salivary cortisol samples and cardiovascular measures were collected prior to, during, and after the CPT. Women reported greater pain than men during and after the CPT and on the MPQ (Ps<0.01). CPT disrupted the expected diurnal decline in cortisol, as shown by a significant increase in cortisol concentration post-CPT (P<0.01) in men and women. Regression analyses revealed that pre-CPT cortisol concentrations predicted lower pain reports during and after CPT in men only (P<0.01). Systolic blood pressure (BP) and stroke volume correlated negatively with pain reports only in women (Ps<0.05). Controlling for potential confounding variables did not alter these relationships. The negative association between pre-CPT cortisol and pain perception in men and the association between BP and pain in women demonstrate different physiological predictors of pain perception in men and women.

Original languageEnglish (US)
Pages (from-to)197-204
Number of pages8
Issue number1-2
StatePublished - 2002

Bibliographical note

Funding Information:
We thank Clemens Kirschbaum of the University of Dusseldorf, Germany, for assistance with the salivary cortisol assay. We also thank Katie Bellmont and Josh Rosefelt for assistance with data collection and management. This research was supported in part by grants from the Minnesota Medical Foundation, the University of Minnesota Graduate School Grant-in-Aid program, and the Whiteside Clinical Research Institute. During this study the first author was also funded by National Institute of Health Grants CA 88272 and HL 64794.

Copyright 2008 Elsevier B.V., All rights reserved.


  • Cortisol
  • Gender differences
  • Hemodynamics
  • Pain


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