Circulating sex steroids and bladder pain sensitivity in dysmenorrhea

Abstract

Although elevated estradiol levels facilitate chronic pelvic pain in animal models, it remains to be determined whether sex steroid levels are altered in a cross-section of women with chronic pelvic pain (CPP) and those at-risk for developing CPP. We sought to determine if sex steroid levels are increased in women with menstrual pain and whether those changes were more extreme in two groups of women with worsened pelvic pain profiles: a) dysmenorrhea plus evidence of bladder pain sensitivity and b) bladder pain syndrome. Serum samples were collected during the mid-luteal phase to measure estradiol, progesterone, testosterone, and sex hormone-binding globulin. We also compared quantitative sensory testing profiles to evaluate how sex steroid differences influence proposed pain sensitivity mechanisms. Women with combined dysmenorrhea and bladder sensitivity had higher estradiol concentrations than controls (487 [IQR 390 – 641] vs 404 [336 – 467] pmol/L, p = 0.042). Bladder pain syndrome participants had greater sex hormone-binding globulin than controls (83 [71 – 108] vs 55 [42 – 76 nmol/L; p = 0.027). Levels of pain sensitivity and mood were different across the groups, but the only significant relationship to sex steroids was that sex hormone-binding globulin was correlated to somatic symptoms ( r = 0.26, p = 0.03). These findings show women potentially at-risk for CPP and women with diagnosed CPP exhibit altered circulating levels of sex steroids. Because these hormonal differences appear to be independent of mood or pain sensitivity, the role of sex steroids in the emergence of CPP may be via sensitization of visceral afferents.

Interstitial cystitis—an imbalance of risk and protective factors?

“…Increased heart rate and changes in heart rate variability are also related to chronic primary pain conditions like IC (54). Dudarev et al (227), recently reported a positive predictive relationship between increased sleep heart rate and next-day pain intensity in patients with two chronic primary pain conditions, fibromyalgia (228) and primary back pain (229), with no interaction between the types of chronic pain.…”

Scientific Knowledge Graph of Dysmenorrhea: A Bibliometric Analysis from 2001 to 2021

“…The group of Hsieh JC mainly focused on the neuroimaging studies of dysmenorrhea, especially on structural alterations in the brain, BDNF Val66Met Polymorphism, and functional connectivity of pain modulatory systems; 1,[17][18][19][20][21][22][23][24][25][26][27][28][29] the group of Hellman KM mainly focused on the research of bladder pain sensitivity and spontaneous pain in dysmenorrhea women. [30][31][32][33][34][35][36][37][38][39][40][41][42][43] Dawood MY is the most dominant author and the most frequently cited author, which is a medical doctor of the Department of Obstetrics and Gynecology, West Virginia University School of Medicine, writing a great number of reviews on dysmenorrhea, mainly about the nonsteroidal anti-inflammatory drugs like Ibuprofen. 5,[44][45][46][47][48][49][50][51][52][53][54][55][56][57] The team notes that once primary dysmenorrhea is diagnosed, the most effective treatments are NSAID and oral contraceptives.…”