A meta-analytic review of pain perception across the menstrual cycle (original) (raw)
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Indian journal of physiology and pharmacology
A b s t r a c t : G e n d e r d i f f e r e n c e s i n p a i n p e r c e p t i o n h a v e b e e n r e p o r t e d i n literature. However, most such studies have ignored the role of female sex hormones in influencing pain response across menstrual cycle (MC). In this study, we have investigated the variation in pain response on different days o f t h e m e n s t r u a l c y c l e . N i n e t y s u b j e c t s ( 6 0 f e m a l e s ) w e r e s u b j e c t e d t o experimental pain of cold pressor task, on days 1, 7, 14, and 21 of the MC (females), and on four consecutive Mondays of a month (males). Male subjects showed no variation in pain response. Females reported higher pain sensitivity on days 7 and 14 of MC. We suggest that experimental pain studies involving female menstruating subjects should be carried out only during a particular phase of the cycle, and this phase should be reported in literature to increase the reproducibility of the experiment.
Menstrual cycle phase does not influence gender differences in experimental pain sensitivity
European Journal of Pain, 2010
Influence of menstrual cycle phase on experimental pain sensitivity in women and on gender differences in pain sensitivity was examined in 48 men and 49 women in response to cold pressor, heat, and ischemic pain. Each woman was tested at three points in their menstrual cycle in randomized order, the early follicular, late follicular, and luteal phases, while men were also tested three times, controlling for number of days between test sessions. Cycle phase was confirmed via serum hormone levels. As expected, women were significantly more sensitive to cold pain (p < .01), to heat pain (p < .0001), and to ischemic pain (p < .01) than men. However, pain perception during each task was not influenced by the menstrual cycle in women, nor did the menstrual cycle influence the magnitude of the gender differences in pain sensitivity. These results indicate that although women are more sensitive to a variety of noxious stimuli than men, menstrual cycle phase does not appear to moderate those differences in healthy men and women.
Experimenter Effects on Pain Reporting in Women Vary across the Menstrual Cycle
International Journal of Endocrinology, 2015
Background. Separate lines of research have shown that menstrual cycling and contextual factors such as the gender of research personnel influence experimental pain reporting.Objectives. This study examines how brief, procedural interactions with female and male experimenters can affect experimentally reported pain (cold pressor task, CPT) across the menstrual cycle.Methods. Based on the menstrual calendars 94 naturally cycling women and 38 women using hormonal contraceptives (Mage=19.83, SD=3.09) were assigned to low and high fertility groups. This assignment was based on estimates of their probability of conception given their current cycle day. Experimenters (12 males, 7 females) engaged in minimal procedural interactions with participants before the CPT was performed in solitude.Results. Naturally cycling women in the high fertility group showed significantly higher pain tolerance (81 sec,d=.79) following interactions with a male but not a female experimenter. Differences were ...
Menstrual Variation in Experimental Pain: Correlation with Gonadal Hormones
Neuropsychobiology, 2010
menstrual cycle with the highest thresholds on day 22, except for the cold pain thresholds, which peaked on day 14. There were no such changes regarding heat pain and all the detection thresholds. The correlations separately computed for each of the 4 days between salivary estrogen as well as testosterone on the one hand and the detection or pain thresholds on the other hand failed to show significant levels, except for the coupling of testosterone and electrical pain thresholds on day 1. Conclusions: The pain thresholds for all the physical stressors increased after menstruation. The acrophases were located in the follicular (cold pain threshold) or in the luteal phase (pressure and electrical pain thresholds). The results of our correlation analyses indicate only minimal influences of the physiological levels of gonadal hormones on pain sensitivity in women.
Excitatory and inhibitory pain mechanisms during the menstrual cycle in healthy women
Pain, 2009
Sex differences in pain perception have been clearly documented in the literature during the last decades and it has been shown that women perceived more pain than men. Sex hormones (SHs) are thought to be one of the main mechanisms which explain sex differences in pain. Pain is a dynamic phenomenon involving both excitatory and inhibitory mechanisms. Previous studies have verified the effect of SH on excitatory mechanisms but not on endogenous pain inhibitory mechanisms. The main objective of this study was to establish if pain perception and diffuse noxious inhibitory control (DNIC) vary across the menstrual cycle (MC). Thirty-two healthy women with a regular MC were tested three times across their MC (days 1-3, days 12-14 and days 19-23). Experimental pain consisted of two tonic heat pain stimulations (thermode) separated by a 2-min cold pressor test (CPT) (conditioning stimulus activating DNIC). Pain ratings were measured with a visual analogue scale. Heat pain threshold, pain tolerance and mean pain intensity during both the 2-min thermode test and CPT did not vary throughout the MC. However, we found significantly more pain inhibition (DNIC effectiveness) during the ovulatory phase compared to the menstrual and luteal phases (p = 0.05). The main finding of this study is the observation that only inhibitory mechanisms (DNIC analgesia) and not excitatory pain mechanisms vary throughout the MC, where women have greater DNIC in the ovulatory phase. The higher occurrence of pain and lower pain threshold previously reported during the MC could be related to a reduction in endogenous pain control mechanisms.
Journal of Behavioral Medicine, 1989
It has been proposed that dysmenorrheic women have a heightened pain sensitivity compared to nondysmenorrheic women, although previous studies investigating this hypothesis have yielded conflicting results. This study investigated the pain sensitivity of nondysmenorrheic women and of women suffering from spasmodic, congestive, and combined dysmenorrhea, across three phases of the menstrual cycle." premenstrual, menstrual, and intermenstrual. No interaction between type of dysmenorrhea and menstrual phase was found for either pain threshold or pain tolerance, using three procedures of experimentally induced pain. On a self-report measure of pain, however, the congestive and combined dysmenorrheics reported the highest degree of pain and distress, especially during the premenstrual and menstrual phases; nonsufferers reported the lowest degree and were stable across phases.
Phase and Sex Effects in Pain Perception: A Critical Review
Psychology of Women Quarterly, 1985
The psychological literature in pain perception is reviewed to clarify the influence of sex and menstrual phase on the phenomenon of pain. An attempt is made to resolve some of the discrepancies in the reported findings by taking special note of the methodological differences in the pain studies. The appropriateness of the measures of pain threshold, pain tolerance, discrimination accuracy, and of response bias to the study of pain are discussed.
PLoS ONE, 2014
We explored the social-signaling hypothesis that variability in exogenous pain sensitivities across the menstrual cycle is moderated by women's current romantic relationship status and hence the availability of a solicitous social partner for expressing pain behaviors in regular, isochronal ways. In two studies, we used the menstrual calendars of healthy women to provide a detailed approximation of the women's probability of conception based on their current cycle-day, along with relationship status, and cold pressor pain and ischemic pain sensitivities, respectively. In the first study (n = 135; 18-46 yrs., M age = 23 yrs., 50% natural cycling), we found that naturally-cycling, pair-bonded women showed a positive correlation between the probability of conception and ischemic pain intensity (r = .45), associations not found for single women or hormonal contraceptive-users. A second study (n = 107; 19-29 yrs., M age = 20 yrs., 56% natural cycling) showed a similar association between greater conception risk and higher cold-pressor pain intensity in naturally-cycling, pair-bonded women only (r = .63). The findings show that variability in exogenous pain sensitivities across different fertility phases of the menstrual cycle is contingent on basic elements of women's social environment and inversely correspond to variability in naturally occurring, perimenstrual symptoms. These findings have wide-ranging implications for: a) standardizing pain measurement protocols; b) understanding basic biopsychosocial pain-related processes; c) addressing clinical pain experiences in women; and d) understanding how pain influences, and is influenced by, social relationships.
Effect of the menstrual cycle phase on post-operative pain perception and analgesic requirements
Acta Anaesthesiologica Scandinavica, 2012
Background: Research has shown that menstrual cycle phase may affect pain sensitivity. There is a lack of studies evaluating this effect on post-operative pain and analgesic needs. Methods: In this prospective cohort study, we determined the effect of menstrual cycle phase on pain perception and analgesic requirements following total abdominal hysterectomy. Sixty women with regular menstrual cycles undergoing elective surgery were recruited and divided into 'follicular' and 'luteal' groups according to their menstrual history. Post-operative pain was managed with intravenous patient-controlled analgesia using tramadol. Intravenous morphine was used for rescue analgesia, and pain was assessed for 24 h. Results: Pain scores in the recovery room and ward six and 24 h post-operatively were similar in the groups at rest and on coughing. Pain scores at rest 12 h post-operatively were significantly higher in the luteal group (P = 0.043), while they were similar on coughing. There was no significant difference in the total tramadol requirement. Number of patients requiring rescue analgesia and the amount of morphine used was also similar. Conclusion: There was no difference in pain scores or analgesic requirements between the two groups except for rest pain at 12 h, which was significantly higher in the luteal group. As pain was assessed at 13 different time points, a significant difference seen only at one point could be due to random chance. We suggest that future research should concentrate on studying this issue in patients of relatively younger age groups with more pronounced hormonal variations during the cycle.