ArticlePain2021
Effects of sex on placebo effects in chronic pain participants: a cross-sectional study.
Article in Pain, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed.
- Trial
- Understanding Placebo and Nocebo Responses Based on a Randomized Sham-Controlled Study on Acupuncture in Integrative Cancer Care.Integrative cancer therapiesTrial
- Top-down control of the descending pain modulatory system drives multimodal placebo analgesia.Neuron · 2026Article
- Article
- The effects of socioeconomic position on endogenous pain modulation: A quasi-experimental approach.The journal of pain · 2025Article
- Orofacial pain/headache interlaced to insomnia, sleep apnea and periodic limb movement during sleep/restless leg syndrome: a critical and comprehensive review with insights into social determinants.Journal of oral & facial pain and headache · 2025Review
- Do patients with fibromyalgia syndrome and healthy people differ in their opinions on placebo effects in routine medical care?Pain practice : the official journal of World Institute of Pain · 2025Article
- Placebo and nocebo effect in pain.Handbook of clinical neurology · 2025Review
- Placebo treatment affects brain systems related to affective and cognitive processes, but not nociceptive pain.Nature communications · 2024Article
- Clinical Phenotypes Supporting the Relationship Between Sleep Disturbance and Impairment of Placebo Effects.The journal of pain · 2024Article
- Mapping expectancy-based appetitive placebo effects onto the brain in women.Nature communications · 2024Article
- Placebo effects in osteoarthritis: implications for treatment and drug development.Nature reviews. Rheumatology · 2023Review
- Individual Dimensions of Pain Catastrophizing Do Not Mediate the Effect of Sociodemographic and Psychological Factors on Chronic Orofacial Pain Severity, Interference, and Jaw Limitation: A Structural Equation Modeling Approach.The journal of pain · 2023Article
- Yoga and massage are associated with small experimental placebo effects in chronic orofacial pain.European journal of pain (London, England) · 2023Article
- The Biology of Placebo and Nocebo Effects on Experimental and Chronic Pain: State of the Art.Journal of clinical medicine · 2023Review
- Predicting Treatment Responses in Patients With Osteoarthritis: Results From Two Phase III Tanezumab Randomized Clinical Trials.Clinical pharmacology and therapeutics · 2023Article
- Placebo and nocebo effects: from observation to harnessing and clinical application.Translational psychiatry · 2022Review
- The neglect of sex: A call to action for including sex as a biological variable in placebo and nocebo research.Contemporary clinical trials · 2022Review
- Placebo Effects on Stress, but Not on Pain Reports. A Multi-Experiment Study.Frontiers in psychology · 2021Article
- Quantitative Sensory Testing Across Chronic Pain Conditions and Use in Special Populations.Frontiers in pain research (Lausanne, Switzerland) · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
abstractSex-related differences can influence outcomes of randomized clinical trials and may jeopardize the effectiveness of pain management and other therapeutics. Thus, it is essential to understand the mechanistic and translational aspects of sex differences in placebo outcomes. Recently, studies in healthy participants have shed light on how sex-related placebo effects might influence outcomes, yet no research has been conducted in a patient population. Herein, we used a tripartite approach to evaluate the interaction of prior therapeutic experience (eg, conditioning), expectations, and placebo effects in 280 chronic (orofacial) pain patients (215 women). In this cross-sectional study, we assessed sex differences in placebo effects, conditioning as a proxy of prior therapeutic effects, and expectations evaluated before and after the exposure to positive outcomes, taking into account participant-experimenter sex concordance and hormonal levels (estradiol and progesterone assessed in premenopausal women). We used mediation analysis to determine how conditioning strength and expectations impacted sex differences in placebo outcomes. Independent of gonadal hormone levels, women showed stronger placebo effects than men. We also found significant statistical sex differences in the conditioning strength and reinforced expectations whereby reinforced expectations mediated the sex-related placebo effects. In addition, the participant-experimenter sex concordance influenced conditioning strength, reinforced expectations, and placebo effects in women but not in men. Our findings suggest that women experience larger conditioning effects, expectations, and placebo effects emphasizing the need to consider sex as a biological variable when placebo components of any outcomes are part of drug development trials and in pain management.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.