Somatic symptom reporting in women and men

Women report more intense, more numerous, and more frequent bodily symptoms than men. This difference appears in samples of medical patients and in co mmunity samples, whether or not gynecologic and reproductive symptoms are e xcluded, and whether all bodily symptoms or only those which are medically unexplained are examined. More limited, but suggestive, literature on exper imental pain, symptom reporting in childhood, and pain thresholds in animal s are compatible with these findings in adults. A number of contributory fa ctors have been implicated, supported by varying degrees of evidence. These include innate differences in somatic and visceral perception; differences in symptom labeling, description, and reporting; the socialization process , which leads to differences in the readiness to acknowledge and disclose d iscomfort; a sex differential in the incidence of abuse and violence; sex d ifferences in the prevalence of anxiety and depressive disorders; and gende r bias in research and in clinical practice. General internists need to kee p these factors in mind in obtaining the clinical history, understanding th e meaning and significance that symptoms hold for each patient, and providi ng symptom relief.