Menstrual Variation in Experimental Pain: Correlation with Gonadal Hormones

Abstract

Background: The results of studies examining the response to experimental pain during the menstrual cycle are conflicting because of differences in the definitions of the menstrual period, outcome measures and types of experimental pain stimulation. So far, there have been only a few studies correlating experimental pain with the levels of gonadal hormones over the menstrual cycle. Therefore, we assessed the responses to multiple experimental pain stimuli during the menstrual cycle and computed their correlations with the salivary concentrations of the gonadal hormones estrogen and testosterone. Methods: Twenty-four healthy and regularly menstruating women between 20 and 41 years old took part in the study. Detection thresholds (warmth, cold and electrical current) and pain thresholds (cold, heat, pressure and electrical current) were assessed on days 1, 4, 14 and 22 of the menstrual cycle. In each session, salivary samples were collected for the determination of the physiological estrogen 17β-estradiol, progesterone and testosterone. Progesterone was used exclusively to verify regular menstrual cycling. Results: Significant variations in pain thresholds for cold, pressure and electrical stimuli were observed over the 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.

Endogenous pain inhibition during menstrual cycle in migraine

“…We previously reported on the results of the QST (Teepker et al, 2010(Teepker et al, , 2011 and do not refer to these results anymore in the present report. In the second part, a well-established CPM paradigm was used to study CPM inhibition (Lautenbacher and Rollman, 1997;Pielsticker et al, 2005).…”

“…Furthermore, menstrual cycle phases were determined by use of diaries and questionnaires but not by hormonal assays. In our earlier study (Teepker et al, 2010), the relationship between the saliva concentrations of sexual hormones (oestrogen, testosterone) and psychophysical parameters was too weak to warrant a second try. Due to our interest in potential menstrual variations, we did not test men.…”

Evaluation of the neuromuscular compartments in the peroneus longus muscle through electrical stimulation and accelerometry

“…Future investigations should determine the effects of gender on these differences. Teepker et al 36 noted that menstruating women had a lower pain threshold for electrical stimuli. In the present study, we did not consider the presence of menstruation cycle of women who were evaluated, which could have influenced the results 36 .…”

Menstrual Cycle Effects on Perceived Exertion and Pain During Exercise Among Sedentary Women

“…Further, when pain is induced experimentally in healthy subjects, a lower pain threshold has been found in women during the early follicular phase compared to the luteal phase. 26,29,30 However, Choi et al 31 reported higher ratings of pain in the luteal compared to the follicular phase.…”