Pain in Women: Current Concepts in the Understanding and Management of Common Painful Conditions in Females.

Pain in Women: Current Concepts in the Understanding and Management of Common Painful Conditions in Females Eds. ML Chin, RB Fillingim, TJ Ness. New York: Oxford University Press; 2013; pp. 335. ISBN 978-0-19-979641-0 [Hardback]; ISBN 978-0-19-979653-3 [e-Book] Astounding! The first textbook I have ever reviewed where the majority of the authors are women! And about pain in women! There should be more texts this good! This volume is a landmark and a benchmark, perhaps the best ever on this subject. The editors intended to address sex differences in pain mechanisms, and management of acute and chronic pain conditions in women. They have achieved these goals in a most exemplary fashion. These differences include anatomically specific pain conditions, and pain conditions that have a higher female prevalence. The editors have recruited established clinicians and researchers, and other authors/clinicians on the cusps of their careers. This combination results in the immaculate editing outcome that we know and respect from the editors’ and authors’ extensive published research on pain in general, and pain in women in particular. There are 22 chapters in this volume, divided into three sections. The first four chapters [Section I] address epidemiology of pain conditions with higher prevalence in women, and sex differences in experimental pain responses, imaged cerebral responses, and analgesic responses. The epidemiologically significant pain conditions include fibromyalgia, complex regional pain syndrome, irritable bowel syndrome, interstitial cystitis, chronic pelvic pain, cardiac pain, migraine, and orofacial pain. Women may be more sensitive to experimental pain in the laboratory for complex reasons, including biopsychosocial variables. Brain imaging in pain states is in its infancy. Even though chronic pain conditions seem to have a female preponderance, central mechanisms are unclear. Future studies will need to carefully designed to evaluate, in particular, hormonal issues. Questions relating to responses to opioid and non-opioid analgesics have not been adequately addressed or answered yet. Chapter 4 shows trends for greater responses to opioids in women. However, it points out the paucity of the current literature regarding gender influences on … wilson.peter{at}mayo.edu